A smart way to cut overdose deaths

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.