That’s what the Canadian government calls it, yet they have known about it for years. Since October 2013 the Ministry of Health and Long Term Care (MOHLTC) has offered free training and kit supplies to many agencies including Public Health Units throughout the province.
The Ontario Harm Reduction Program, established in 2006, started needle exchange programs but knew more had to be done. As early as 2011 Toronto Public Health started to educate and put forth an application to the Ontario government to make Naloxone an “Over The Counter” drug (OTC).
At the time these programs were started it was believed there were approximately 300 – 400 accidental overdoses in Ontario a year due to opioids such as fentanyl, morphine, heroin, methadone or oxycodone.
Prescriptions for oxycodone alone rose 850% through the 1990’s into the 2000’s. This increased availability has a direct relationship to the doubling of overdose deaths during this same time. The study shows that there were 340 opioid related deaths reported in Ontario from 1991-2004. (OHPE, 2013)
Overdoses are usually always considered accidental for many reasons. Sometimes the dealer and what is in the drug is unknown. The type of drug could be different and the amount needed could have changed. Users could have also mixed the drug with alcohol. The real tragedy is when the user is alone. Opioids when in a powder or liquid form are fast acting. When opioids are introduced to a person’s body the drug attaches to the brain causing drowsiness and users are usually unresponsive. It also depresses the respiratory centre of the brain causing the user’s breathing to significantly slow down and often stop. Opioids also attaches to a person’s spinal column causing numbness and paralysis. The bottom line is the opioid user cannot move, becomes unresponsive and stops breathing. There is some good news from all this. Studies have shown that most users inject with people or are injected by other people.
“Naloxone (noun, nal·ox·one, na-ˈläk-ˌsōn) is a synthetic potent antagonist C19H21NO4 of narcotic drugs and especially morphine that is administered especially in the form of its hydrochloride”. (Naloxone, 2016) To further explain naloxone is a man-made drug that attaches to the same area of the brain as opioids. Naloxone displaces the opioid within three to five minutes and lasts for 60 to 90 minutes allowing the user’s breathing to return or increase to more normal levels.
This antidote is considered “an effective rescue medication for opioid overdoses” that has been around since 1964. It is effective because users typically cannot build up a tolerance to this antidote, it is not addictive, you cannot overdose on it, and costs one to two dollars a dose. With all this said you now see how the drug can be sold OTC and not only administered by doctor’s, nurse and medics but by anyone with as little as 20 minutes of training.
To be continued…
Would you be surprised to know that naloxone education is coming to first aid training?
Next week we’ll look into other ways the government and a couple of the larger Ontario Public Health Units efforts to stop these preventable deaths in our communities.