A smart way to cut over­dose deaths

The Hamilton Spectator - - OPINION -

Viewpoint: Toronto Star Med­i­cal ex­perts across Canada and the United States have been sound­ing loud warn­ings for the past few years about the ex­plo­sion of deaths re­lated to over­dos­ing on opi­oid-re­lated drugs. One U.S. au­thor­ity com­pares the epi­demic to the rapid spread of AIDS in the late 1980s and early 1990s.

Now there’s new ev­i­dence about the dis­pro­por­tion­ate im­pact on one spe­cific group — re­cently re­leased pris­on­ers. And it un­der­lines the need for more ro­bust ser­vices to treat them in the cru­cial first days when they are re­turn­ing to the community.

The ev­i­dence comes from a study car­ried out by re­searchers at St. Michael’s Hos­pi­tal and the Uni­ver­sity of Toronto. They found that a tenth of adults in On­tario who died of a drug over­dose be­tween 2006 and 2013 had been in­mates in a pro­vin­cial jail within one year of their death.

Also strik­ing is the fact that many of the deaths came al­most im­me­di­ately af­ter in­mates were re­leased. Twenty per cent of deaths oc­curred within a week af­ter a pris­oner was set free, and 9 per cent came in the first two days.

Re­searchers say that sug­gests there is a “crit­i­cal time pe­riod” right af­ter re­lease when in­ter­ven­tion might make a dif­fer­ence, and cut the ris­ing death toll from drug over­doses. That might in­clude bet­ter ed­u­ca­tion on drugs, sub­sti­tut­ing other drugs for opi­oids such as the painkillers oxy­codone and fen­tanyl, and chang­ing the way doc­tors pre­scribe drugs.

It also in­volves read­ier ac­cess to nalox­one, an an­ti­dote to opi­oid over­doses. On­tario took an im­por­tant step to­ward that in the past week when Health Min­is­ter Eric Hoskins di­rected his min­istry to ex­pand the prov­ince’s nalox­one pro­gram to in­clude newly re­leased in­mates.

On­tario has joined Bri­tish Columbia, Al­berta and the fed­eral gov­ern­ment in mak­ing nalox­one more eas­ily ac­ces­si­ble. The prov­inces are mak­ing nalox­one kits avail­able in phar­ma­cies with­out the need for a pre­scrip­tion. And Ottawa has added the an­ti­dote to its list of drugs cov­ered by the na­tional phar­ma­ceu­ti­cal pro­gram for abo­rig­i­nal peo­ple, who suffer dis­pro­por­tion­ately from opi­oid ad­dic­tion and over­dose deaths.

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