The risk posed by fentanyl and other opioids is low for those who don’t use illicit drugs, but take-home anti-overdose kits available in four Northern Manitoba communities this week can be a lifesaver for those who do.
Sixty take-home naloxone kits will be available for people in the Northern Regional Health Authority (NRHA) by the end of this week, says NRHA chief medical officer of health Dr. Michael Isaac - 15 each in Thompson, Flin Flon, Gillam and The Pas.
Naloxone is a drug that blocks the effects of opioids and can be administered intravenously, intramuscularly or via a nasal spray. Administering it to someone suffering from an opioid overdose can keep them alive and breathing so first responders have time to transport them to a hospital or other medical facility for treatment. Opioids include drugs derived from opium poppies like morphine and heroin as well as synthetic and semi-synthetic drugs like hydrocodone, oxycodone, fentanyl and carfentanil.
The kits will be available at the Thompson Public Health office at the NRHA administration building next to the Thompson General Hospital, at the Gillam Hospital public health office and at the primary health care centres in Flin Flon and The Pas.
“I think there’s community concern around fentanyl and carfentanil and I understand that but I think it’s important to get the message out to the public that for those who are not using illicit opioids the risk is very low to them,” Isaac said Jan. 4. “You hear a lot in the media about how it only takes a couple very small grains of fentanyl or carfentanil to kill someone and indeed that’s true but the average individual who’s not using illicit opioids in the Northern Health Region is unlikely to be exposed to those formulations. I think the risk to the general public here is quite low.”
The kits being distributed to drug users look like a pencil case and contain two vials of naloxone, two syringes, an alcohol wipe, a mask to help with rescue breathing and an instruction card. The drug can be injected intramuscularly - into either the deltoid muscle of the shoulder and upper arm area or the thigh and buttocks area - and is designed to reverse the effects of an opioid overdose for a period of time up to about 20 minutes, depending upon the strength of the drug that caused the overdose. As long as someone isn’t allergic to it, there is no health danger posed by naloxone, which is used by paramedics and in hospitals to treat suspected or potential opioid overdoses.
“People who are using opiates of course can be susceptible to having an overdose because of the actions of the drug on their brain stem but we’re also finding that those who are using other drugs are also potentially overdosing from opiates because those drugs are being added to non-opioid drugs and they don’t really know what they’re taking essentially,” says Isaac, listing some of the symptoms of a potential opioid overdose. “After someone becomes either unconscious or really looks like they’ve got severe sleepiness, they may have some slow, shallow breathing, snoring or gurgling noises, trouble breathing, slow heartbeat, they might have cold clammy skin or trouble walking and talking. If someone were to come up to them and try and rouse them they would be unresponsive.”
If you encounter someone you suspect has suffered from an opioid overdose, the first course of action would be to call emergency medical personnel, Isaac says. After that, go through a series of steps as outlined by the mnemonic device SAVE ME - stimulate the person, check their airway for obstructions, start ventilating or giving rescue breaths to that person, do an evaluation to see if they wake up or they’re improving, and if not to administer the naloxone injection. The kits have two vials so of naloxone so that a second injection can be given if the first doesn’t cause them to wake up with a couple of minutes.
Isaac says giving kits directly to drug users has shown to be effective in preventing opiod overdose deaths.
“If you go into the literature and look at who’s around when someone overdoses it’s usually someone that is also using illicit drugs,” Issac said. “We’re very much focusing on giving the kits to those who use illicit drugs. They are at the highest risk of overdosing or being present when someone else overdoses.”
Studies have also shown that fears that providing naloxone to drug users would encourage them to engage in riskier behaviour on account of feeling safer aren’t supported by evidence, Isaac says.
The Addictions Foundation of Manitoba (AFM) is also taking steps to address people’s concerns about fentanyl by hosting community forums around the province, including one in Thompson on Jan. 19 at the Letkemann Theatre from 7 p.m. to 9 p.m.
“We know that parents and young people are looking for more information about the facts and dangers of fentanyl and other drugs,” said AFM CEO Ben Fry. “That is why we have organized these community forums to give Manitobans more opportunities to get the information they need to know from the experts. Talking about drugs like fentanyl is the best way to keep kids safe.”
AFM experts as well as representatives of law enforcement, health care and other organizations will speak at the forums, which are free and open to the public.
“ “We know that one of the best ways to combat the rise of fentanyl is to provide greater public awareness and education,” said Dr. Ginette Poulin, AFM’s medical director. “These forums are a great way to bring together experts who deal with the realities of fentanyl and other drugs on a daily basis, and answer questions that youth and families have about drugs and the supports that are available. I encourage everyone along with their families and friends to come out and join us as we gather in your communities to discuss and share in this opportunity.”
“The RCMP is pleased that the Addictions Foundation of Manitoba is teaming with our local detachments to educate the public on the dangers of drugs such as fentanyl,” said Cpl. Scott Hanson, head of RCMP “D” Division’s synthetic drug operations. “Prevention and education play key roles in reducing the risk.”
