Naloxone distribution raises questions
CAMBRIDGE — Questions are being raised after an out-of-town pharmacist went door-to-door in a Cambridge neighbourhood offering naloxone kits free of charge to residents.
Michael Wade was watching a Stanley Cup final hockey game at home on Monday evening when two people from Delaware Pharmacy, located outside London, knocked on the door.
“I thought it was weird,” said Wade. “She was telling me about the product and she said, like, it’s no cost. She said all you need to do is just show you’ve got a health card that’s all.”
“I’ve never encountered nobody in my life who overdosed or anything,” he added. However, he said he has seen discarded needles in the community.
After the two trained Wade, he was given both a needle and nasal spray kit of the drug naloxone, which can temporarily reverse an opioid overdose. “The fact that we have the kit is just weird,” said Michael’s wife, Amanda Wade. “We’re clean people. We don’t do anything.”
Jason Newman, the pharmacist who was giving out the kits, said he targets areas where the risk for opioid use is higher. He said he has distributed kits in other cities, including London, Hamilton, Toronto and Windsor. “I have a strong interest in social issues,” said Newman.
News of the pharmacist going door to door quickly reached Helen Jowett, the regional councillor for Cambridge, who had some concerns. “I know the kits are important, but let’s not forget they are costing the taxpayer money,” she said. “We need to be putting them where they need to be used, not just in everybody’s hands.”
Jowett passed the information on to Waterloo Region’s public health department.
“This is not a usual form of naloxone distribution,” said Julie Kalbfleisch, spokesperson with public health. The information was passed on to the Ontario College of Pharmacists and the Ministry of Health and LongTerm Care.
Asked if door-to-door distribution of kits is allowed, ministry spokesperson Kent Anjo said pharmacists and pharmacy technicians are not to solicit an individual, except under limited
circumstances, such as when providing information about the availability of professional services. “If any member of the public has concerns or suspects a pharmacist, or pharmacy technician ... of soliciting a product via door to door sales, they should note the name of the suspected pharmacist/pharmacy technician and contact the Ontario College of Pharmacists (OCP) to verify the salesperson’s credentials and to file a complaint with the college,” he said in an email.
Newman said he is following the Drug and Pharmacies Regulation Act. “In my case, I inform any person that I meet that I am with a pharmacy and what service I am providing,” he said. “If the person does not want the service, I move on to someone else.”
On Feb. 21, the Ontario College of Pharmacists put a condition on Newman’s professional right to practise. The college said he “agreed to immediately cease the dispensing and/or sale of naloxone or facilitating the dispensing and/or sale of naloxone to persons except in accordance with the College’s guidance document, Dispensing or Selling Naloxone. In particular, Mr. Newman and the Pharmacy shall ensure that appropriate assessment and training are provided by a pharmacist to persons dispensed and/or sold naloxone.” The college would not elaborate but Newman said the conditions placed on him had to do with distributing the kits door to door.
“There is no charge, there’s nothing going on with what I’m doing. They’re just concerned with what I’m doing because it’s different,” said Newman.
He said the service he provides is a public good that not only helps communities at risk but also allows people to avoid the stigma associated with asking for a kit in a pharmacy.
“We know that there’s a problem in Preston and we know that there’s a problem in Galt,” he said. “The place we went to (Monday), from one of the residents we’ve been told there’s at least 10 units (in the complex) where people are either using or selling drugs”
Under the province’s Ontario Naloxone Program, started in September 2017, pharmacists are reimbursed by the province for kits they give to people who have a history with substance abuse, or who have a friend or family member who use. The ministry said a pharmacist gets $110 for an nasal spray kit, plus a $10 professional fee. For a first time recipient of an injectable kit, a pharmacist receives $35 for the kit, a $10 professional fee and a $25 training fee. Newman said he doesn’t make much money going door to door as he has to pay to put the kits together and bring assistants with him.
Cambridge resident Shannon Lowry is happy she received a kit earlier this week from a representative of Delaware Pharmacy.
“I really think it’s a gift,” said Lowry.