We need naloxone kits in more hands during this opioid crisis

Within the background of COVID-19, the opioid crisis has continued to progress insidiously. Data from Ontario Public Health show that emergency room visits, hospitalizations, and deaths from opioid overdose have risen dramatically since 2016. Since then, over 15,000 people in Canada have lost their lives to the opioid epidemic.

One contributing factor has been the increased prevalence of fentanyl in North America. Not only have supplies of fentanyl been made more available to users, but it has been found to contaminate other opioid substances such as morphine, heroin or cocaine. For this reason, opioid overdoses are often accidental tragedies.

But what is fentanyl? Fentanyl is a prescription medication approved in Canada for the treatment of pain. It is clinically indicated in a variety of settings, and like many drugs, it is often used appropriately under the supervision of health care professionals. However, fentanyl can also be produced illegally, and the misuse of fentanyl from any source can lead to overdose and death.

The reason opioids can be so dangerous is they suppress the activities of our nervous system, including the brain. For patients suffering from pain, this can be helpful as pain signals are dulled when our nervous system is suppressed.

Recognizing the dangers of opioid misuse, the province has made naloxone kits widely available at pharmacies free of charge. Pharmacists provide training for naloxone users to recognize an overdose and to become comfortable with the technical process of naloxone administration. Although naloxone was given in the past as an injection, its administration has been made easier as it is now available as a nasal spray.

Naloxone directly reverses the overdose by displacing opioids in the brain.

This temporarily stops opioid activities. Naloxone is very specific and carries little risk of side effects as it does very little else to the body. For these reasons, naloxone is safe and effective in providing temporary reversal of an opioid overdose. However, as in all cases of medical emergencies, the response does not stop here. Even with the timely administration of naloxone, it is necessary to dial for an ambulance to get the patient to an emergency room.

Being equipped with naloxone could make the difference between life and death. Importantly, for friends, family, or users of opioid medications, it should be a necessary household item — much like an Epi-pen for people at risk for anaphylaxis. Furthermore, pharmacists counselling new prescription opioid users should encourage naloxone as a precautionary safety measure for opioid therapy.

But there are also those who perhaps do not consider themselves closely acquainted with opioid usage who may be well-situated to become trained and naloxone-equipped. This could include cab drivers, transit operators, waste collectors, park rangers and many more. Outdoor workers, commuters or bystanders who find themselves routinely venturing through different parts of the city can become unexpected heroes in cases of opioid overdose.

Although tackling the opioid epidemic with a responsive strategy may not be the most efficient tactic, the serious nature of its consequences may deem it to be necessary. Until the underlying contributing factors are resolved, each naloxone kit dispensed could mean another life saved. While the opioid crisis is becoming more and more deadly, the antidote is already here, and we need to get it into the hands of more people.