Prompted by a continuing rise in opioid-related deaths, the government of Ontario, Canada has announced a unique program to combat the problem: making Narcan nasal spray available free of charge in pharmacies, by the end of March.
The provincial officials said there were 1,053 opioid-related deaths from January to October 2017, compared with 694 during the same time period in 2016. Also, the government data shows 7,658 emergency department visits related to opioid overdoses from January to October of last year, up from 4,453 during the same time period the previous year.
Naloxone nasal spray will be available in pharmacies by the end of the month at no charge, in addition to existing naloxone kits that include an injectable version of the drug meant as an emergency treatment for opioid overdoses.
“The nasal spray is a lot easier to use in the event of an overdose. It’s a bit stronger and lasts a little longer, which gives paramedics more time to attend to an overdose emergency,” Mark Barnes, a pharmacy owner in Ottawa, told the Canadian Broadcasting Corp.
Barnes has trained more than 5,000 people on using naloxone kits to treat overdose victims. He said nasal spray seems to be more effective than the injectable form. “It’s just that with the strength of the opioids we are seeing, especially in fentanyl and carfentanil in Ontario, we’re seeing that the nasal spray may work a little better to prevent the overdose.”
In Ontario, 56 per cent of people who died of opioid-related causes filed a prescription for the drug in the months before their death, Barnes said, which makes pharmacies a logical point for providing prevention information to customers, Barnes said. But, he said, pharmacists need to do more to educate their customers about how to use opiate painkillers without becoming addicted.
“There’s a public perception that these kits are only used for people addicted to heroin on the street,” he said. “Overdoses can happen in many situations — overdoses can happen with your own prescription that you use incorrectly.”
The provincial government also announced that more than 30 communities will see new or enhanced Rapid Access Addiction Medicine (RAAM) clinics. The clinics are designed to get willing addicts into treatment with little or not waiting period, starting with immediate, medication-assisted treatment. They were first tried as a pilot project in seven communities in Ontario,
Kate Hardy is the manager of a first-of-its-kind program, Mentoring, Education, and Clinical Tools for Addiction: Primary Care-Hospital Integration (META:PHI), designed to reduce emergency room visits for opioid and alcohol addictions and improve patient care. META:PHI ran the pilot programs in the province. In a statement emailed to CBC, Hardy said the clinics have been successful in their goal of reducing emergency room visits — which have also spiked in opioid-related visits.
“Unlike traditional treatment programs there are no wait times, scheduled appointments, or complicated intake assessments,” said Hardy, adding the clinics are made to be more accessible for people dealing with addictions.
“RAAM clinics are outpatient to allow patients to continue with their work and family responsibilities, and the service providers are non-judgmental,” she said.
The Ontario government has pledged to spend more than $222 million over three years to address the growing opioid crisis in the province, with the money targeted to expand harm reduction services and hire more patient care staff.
The Windsor-Essex Community Opioid Strategy, released in January, includes a long-term plan for the local Health Unit to investigate the feasibility of safe injection sites.
The Health Unit received $250,000 from the provincial government to complete the strategy which was first announced last August and sent out for public consultations in October.
“We’re at the stage where we already know we have a problem,” said Byron Klingbyle, a harm reduction coordinator with the AIDS Committee of Windsor. “Conversation is not taking any action — we need to take some action.”
Klingbyle said his organization wants to apply for an Overdose Prevention Site, which would be temporarily funded by the provincial government and aims to collect data on opioid use and overdoses at the site. He is seeking potential partners. “That would be fantastic, because it’s a community problem and not just one community can address this issue and the more people on board the more effective it will be.”