Addiction Experts Are Concerned New Rules For Overdose Antidote Don’t Go Far Enough Amid Crisis

Naloxone has long been a tightly controlled yet life-saving substance. With Health Canada's announcement, things are about to change.

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Jan 15 2016, 6:11pm


A harm reduction worker in Hamilton, Ontario opens a naloxone kit. Photo by Allison Elkin

With the introduction of bootleg fentanyl and an increase in the number of opioids being prescribed, the rate at which overdose deaths in Canada have multiplied, leaving many advocates dumbfoundead. Now, Health Canada is proposing to change the restriction around an overdose antidote that has the ability to save thousands of lives.

In Ontario alone, nearly 5,000 people died from opioid-related overdose between 2000 and 2013—with a 464 percent increase since 2000—and it's estimated that hundreds more have died between then and 2015. Across the country, there have been similar epidemics, such as the fentanyl crisis in Alberta—an ordeal that left 213 people dead from overdose in the province between January and September last year.

According to a press release put out by the Government of Canada yesterday, Health Canada is aware of the growing number of opioid deaths across the country and is now opening a consultation program to reassess the possibility of naloxone—a lifesaving drug that has been used widely by doctors to reverse opiate overdose—being available as an over-the-counter (OTC) medication.

The consultation invites Canadians—both civilians and medical professionals—to input comments and ideas before the close date of March 19, after which the drug will either be allowed for non-prescription use or will remain restricted. The release notes that the current proposal is to proceed with derestriction of the drug.

Currently, access to naloxone is on a prescription-only basis, and many programs that offer it via "take-home" initiatives dispense it in controlled quantities. Most hospitals, while being readily equipped the drug, don't send patients home with it after experiencing an overdose.

Naloxone, an opioid antagonist, essentially works by binding to opioid receptors to reverse and stop an overdose from being fatal. Last month, the Municipal Drug Strategy Coordinators Network of Ontario (MDSCNO) put out a press release calling on the government to take the opiate epidemic more seriously by introducing new harm reduction initiatives and expanding upon existing programs such as naloxone programs.

Michael Parkinson, a spokesperson for MDSCNO, compared the lack of access to naloxone for some going into overdose to not having access to an EpiPen when going into anaphylactic shock, and advocacy groups have widely cited it as one of the critical flaws in addressing the growing number of overdose deaths.

"This is a simple solution that can be implemented easily. There is really no good explanation for not allowing this [medication] to be more widespread," Parkinson told VICE in December.

Parkinson told VICE today that, while he and other advocates are happy about the new perspective on the antidote, he worries that the lack of mention of it being included in a provincial or federal drug plan overlooks the fact that opiates will still be much cheaper for drug users to obtain than the naloxone itself.

"Re-scheduling naloxone is but one step in expanding access. Unlike our American neighbours, no provincial, federal, or veteran's drug benefit plan in Canada covers the cost—approximately $50 retail currently—of naloxone. By comparison, more than 150 opioids are on the Ontario Drug Benefit plan. Until naloxone is supported on drug benefit plans, opioids will continue to be cheaper and easier to obtain," he said.

Wiplove Alexander, an addiction physician at St. Michael's Hospital in Toronto, told VICE that the cost for the drugs are largely an issue due to fact that the formulas created by pharmaceutical companies tend to be extremely pricey. He also adds that the consultation process, which could change Health Canada's decision on derestriction of the medication, should rely largely on existing evidence, rather than on the personal opinions of people.

"I think you have to listen to what everybody says, and even in the long run, in addiction treatment, some of the people who work in the field are pro medication or anti-medication, pro-harm reduction or anti-harm reduction. But I hope there's somebody who is critically appraising the evidence and it's not just based upon personal input of people."

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