Drug users, families advised to keep naloxone kit handy

Island Health is advising illicit drug users and their family and friends to keep life-saving naloxone kits close at hand.

“Don’t keep the naloxone kit in your car,” said Tracey Thompson, Island Health’s regional harm reduction co-ordinator. “It’s not helpful. It’s also not accessible.”

Instead, she said, “put it in your backpack, purse or briefcase.”

Naloxone, medication that quickly reverses the effects of an overdose from opioids such as heroin, methadone, fentanyl and morphine, is available in B.C. at no cost to people who are at risk of an opioid overdose or those likely to witness and respond to an overdose, such as a family member or friend of someone at risk.

“People are dying, using alone at home,” Thompson said. “But that doesn’t mean they are home alone. They might be in a bathroom or bedroom. It’s important that people know where the kit is and how to use it. A hidden kit is not going to be a helpful kit,.”

The B.C. Coroners Service reported 1,143 illicit drug overdose deaths from Jan. 1, 2018, to Sept. 30, 2018. Eighty-six per cent occurred inside homes and other inside locations.

Vancouver, Surrey and Victoria had the most deaths.

More fatal overdoses occurred the days following income assistance payment than all other days in 2017- 18.

The next income assistance payment is on Wednesday.

Naloxone is temperature sensitive and can be less effective if exposed to hot or cold temperatures.

“We worry about the temperatures [inside cars], just like we worry about kids and dogs,” Thompson said.

“Temporary spikes of up to 40 C are permitted as long as they don’t exceed 24 hours.”

Naloxone remains stable after being exposed to temperatures as low as -20 C for up to two weeks, but that’s unlikely in Victoria, she said.

“It’s best kept between 15 C and 30 C. And it doesn’t like light, that’s why it’s in amber ampoules.”

If a naloxone kit is expired or if it has been left in an overheated car, it should be replaced.

“You can go to any place that provides the provincial take-home naloxone kit and get a replacement of just the ampoules themselves if they have them or completely swap out the kit,” Thompson said.

But if someone is overdosing and only expired naloxone is available, use what you have, she said.

Information on where to pick up a kit can be found at the B.C. Centre for Disease Control website at towardtheheart.com.

People in remote or rural areas where it might take longer than eight to 12 minutes for an ambulance to arrive might consider having more than one naloxone kit. If you’re in Victoria, one should be enough. There are three doses in each kit, and they can be administered every three to five minutes.

“When I’m doing naloxone training, I always tell people: ‘Don’t fall into the trap of I can only respond if I have a kit,’ ” Thompson said.

“It’s good to have a kit. But if you don’t, you can still respond by calling 911 and giving rescue breaths. We’re talking about a basic first-aid response.”

In an overdose, the heart continues to beat but sends out unoxygenated blood, Thompson said. Rescue breaths can introduce oxygen.

It’s possible to revive someone with just oxygen and no naloxone, she said. “That’s why we haven’t seen one death at an overdose prevention site or supervised consumption site. They support and monitor people and they have oxygen on site.”