AHS forms emergency command centre to target fentanyl, expand access to life-saving antidote

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Health officials charged with countering Alberta’s fentanyl crisis are attempting to more widely dispense a life-saving antidote to drug users in the hopes of reaching suburban teenagers and others who are dying from overdoses before they can reach emergency rooms.

The province’s health authority has formed an emergency command centre — previously used to monitor measles and H1N1 outbreaks — to co-ordinate a response to fentanyl’s meteoric rise in Alberta, with 300 deaths forecast by the end of the year. The team’s first target is to expand the distribution of naloxone, a prescribed medicine that reverses the effects of fentanyl overdoses.

Six social agencies across the province dispense naloxone, but there are concerns that many drug users — including those who hail from suburbia where a big share of overdoses occur — are unlikely to line up at needle exchanges to get the medicine.

Officials are now considering proposals that would allow users to access naloxone through universities, family doctors, opioid addiction clinics in Calgary and Edmonton, rural agencies and First Nations reserves, among other sources.

“Reaching recreational users is a challenge,” said Dr. Nicholas Etches, the medical officer of health for the Calgary area. “Many of them may not realize that if they’re popping a pill at a party, that they’re at risk.”

Fentanyl, a highly potent opioid that has exploded in Alberta’s illicit drug trade, is sold on the street with no controls over dosage, increasing the risks of overdose and death. A high dose of the drug can cut oxygen to the brain and heart until the victim stops breathing. Naloxone, an injection that users carry with them, temporarily removes opioids from brain receptors, allowing the victim to breathe again, until more help arrives.

Sparla McCann, a Calgary mom whose 19-year-old son died from a fentanyl overdose in January, believes Rory would still be alive if her family had access to naloxone the day they discovered him overdosing. After first learning about the medicine, she believed it would “promote more drug use,” given fears that users would feel safe using a potentially deadly drug knowing they could be revived if they took too much.

“But if you can save a life, in that immediate instance, it doesn’t matter how,” McCann said. “You still have the hope of treating the addiction. I have no hope left. I don’t have my son. I would have liked to have that chance.”

Alberta officials are working with Health Canada and other provinces to reclassify naloxone as an over-the-counter drug, which means users would not need a prescription to obtain the life-saving antidote. Dr. Ada Bennett, Alberta’s acting chief medical officer of health, said she is “quietly confident” the change would get the green light, though she said it would take a few months.

Etches said he has been in talks with officials at the University of Calgary and Mount Royal University to find out how they could help deliver naloxone to a wider population. His team is also looking at getting naloxone into the hands of released criminal offenders who are at high risk of overdosing because they lose their tolerance to the drug while behind bars.

Dr. Mark Yarema, medical director of the province’s Poison and Drug Information Service, said another method under consideration is to dispense naloxone to patients who show up at emergency rooms for treatment of overdoses.

After being treated, fentanyl users would receive in-depth addictions counselling, perhaps more extensive than what’s currently offered, and they would leave with a dose of naloxone, said Yarema, also an emergency room doctor.

Naloxone is designed to reduce the harm of fentanyl use, but it does nothing to address root causes behind addictions, with physicians reporting long waits for treatment. Alberta Health Services reported earlier this month it has a draft plan to add new addiction treatment spaces, though it may take months to roll out.

Yarema said anyone who receives naloxone must also be made aware of the dangers of fentanyl and what treatments are available if they want to quit using drugs.

“If you’re simply giving them naloxone without the other instructions, then it’s just a band-aid solution. and we wouldn’t be doing anything to fix the other communicable disease components with this as well, whether it’s HIV or hepatitis C, if they’re injecting.”

rsouthwick@calgaryherald.com