HEALTH Nasal option promoted to curb overdose deaths

TTravis Lupick

his week, David Renwick, general manager of Adapt Pharma Canada, was in Metro Vancouver talking with people about the country’s overdose epidemic. His company is the Canadian distributor of Narcan Nasal Spray (better known in Canada by its generic name, naloxone), the so-called overdose antidote that’s used to save lives by blocking the effects of opioids.

“We’re trying to create some noise at a grassroots level,” Renwick said in a telephone interview ahead of his trip to Vancouver. “It’s already available in Ontario without a prescription and completely free of charge to anyone. In Quebec, it’s also available to anyone over the age of 14, completely free.… But there is no political will right now in British Columbia.”

The primary difference between Adapt Pharma’s Narcan Nasal Spray and the generic naloxone that’s already widely available for free in B.C. is the two products’ delivery systems.

Generic naloxone is a liquid that comes in a vial. To use it, the individual responding to an overdose must snap off the top of a glass vial, load up an accompanying syringe, and then perform an intramuscular injection. As its name suggests, Nasal Narcan Spray comes ready to use and is administered via the nose. So it’s easier to use. Yet a number of Vancouver’s nonprofit-housing providers said they’re not especially eager to see their stocks of intramuscular naloxone replaced with nasal Narcan.

Raincity Housing, Lookout Housing and Health Society, PHS Community Services Society (the Portland Hotel Society), and Atira Women’s Resource Society felt that Narcan Nasal Spray is nice to have as an alternative option, and they’ve paid out of pocket to have limited supplies at certain locations. But, in general, nonprofit-housing staff are accustomed to intramuscular naloxone and find that it’s working well. Dr. Jane Buxton, the B.C. Centre for Disease Control’s medical lead for harm reduction, said there are cost considerations.

The BCCDC’S free naloxone kits cost the provincial government roughly $20 for an overdoseresponse package that contains three doses of 0.4 milligram of naloxone. Meanwhile, Adapt Pharma said it can supply its Narcan Nasal Spray devices for $46 for one dose of four milligrams of the drug.

Buxton said the difference is partly because the formulation of naloxone adopted by B.C. is generic, whereas Adapt Pharma’s remains proprietary.

Renwick noted B.C.’S fentanyl overdoses often require several 0.4-milligram doses of naloxone to block, whereas his company’s four-milligram doses usually work with just one administration. “You cannot equate one injectable vial to one nasal spray,” he emphasized. g