The power of naloxone
For people who overdose on opioids, naloxone is a lifesaver.
“It can basically bring somebody from a coma back to being normal in about three minutes,” says Dr. Glen Bandiera, chief of emergency medicine at St. Michael’s Hospital.
Until recently, the kit consisted of two ampoules of naloxone sucked up with a syringe and injected. New kits are filled with easierto-use nasal spray.
For years, it was only available in Ontario by prescription or, in Toronto, through a Public Health branch called The Works, which distributed 4,000 kits since 2011.
Demand was far greater than the restricted supply so Raffi Balian, a well-known harm reduction worker who recently died of an overdose, helped set up a kind of underground railroad a decade ago that brought thousands of naloxone kits to Toronto from the United States, where the antidote was more widely available.
One Chicago supplier, who spoke on the condition he not be identified, estimates that he alone supplied Toronto with about 8,000 naloxone kits in a decade.
“We were getting booze from you guys during Prohibition, so it’s kind of funny that in this situation it’s the reverse,” the supplier says.
Harm reduction workers credit the underground supply of naloxone, and the outreach of peer workers, with keeping Toronto’s body count well below Vancouver’s, where 215 people were killed by illicit drug overdoses in 2016. In July 2016, Ontario’s ministry of health removed the need for a prescription to get naloxone and made it available free at pharmacies to opioid users, their family members and friends. Since then, 17,500 naloxone kits have been distributed this way in Ontario, including 3,000 in Toronto. Some pharmacies insist on registering OHIP cards before providing naloxone, a practice that users say keeps them away.
Toronto Public Health’s overdose plan calls on the provincial government to allow harm reduction programs and other community agencies to distribute naloxone kits to their clients. The ministry of health, which provides $8.5 million a year for harm reduction programs, has so far not responded to the recommendation.
Natalie Kallio, a Parkdale harm reduction worker, argues the reluctance is based on a twisted belief that more naloxone would encourage riskier drug behaviour. “It’s ludicrous,” she says. “No one wants to overdose. It’s like saying people who are allergic to peanuts will eat peanuts just because EpiPen exists.”