Pubdate: Tue, 15 Jan 2013
Source: Record, The (Kitchener, CN ON)
Copyright: 2013 Metroland Media Group Ltd.
Contact:   http://news.therecord.com/
Details: http://www.mapinc.org/media/225
Author: Dianne Wood

CANADA NEEDS STRATEGY TO DEAL WITH OPIOID OVERDOSES, WORKSHOP HEARS

CAMBRIDGE - It takes one to three hours for someone to die from an
overdose of an opioid, such as OxyContin or heroin.

And in many cases, there's someone else around to witness the
overdose, a Toronto addiction medicine doctor toldpeople attending a
workshop on opioid overdose prevention in Cambridge on Monday.

"There's time to intervene," Dr. Ashok Krishnamurthy told a crowd of
close to 100 people. Nurses, police officers, public health officials
and social service workers from 61 Ontario communities took part in
the event in person and by webinar.

Accidental overdose deaths are preventable, said Krishnamurthy who
once worked in a community health centre in Vancouver's notorious
Downtown Eastside, a neighborhood populated by drug users and homeless
people.

Krishnamurthy now runs an inner-city addictions consulting service in
Toronto and is on staff as a consulting physician at several Toronto
health centres.

Opioids are prescribed for pain, but can become addictive, he said.
Almost 35 per cent of people prescribed narcotics for pain meet the
criteria for addiction, he said.

The Ontario government removed the prescription painkiller OxyContin
from its drug plan last year, saying increased rates of opioid
prescribing had contributed to widespread addiction and opioid-related
deaths. The province estimated 50,000 people were addicted to
OxyContin and other opiate drugs.

Krishnamurthy called OxyContin "the most abused prescription
medication known to man."

Between 2002 and 2009, there were 229 deaths in Toronto due to toxic
amounts of oxycodone and related products, he said. In 2002, there
were 958 opioid-related deaths in Canada.

But the delisting of OxyContin caused other problems when addicts
switched to heroin and the prescription painkiller fentanyl. Anecdotal
reports began circulating about deaths from accidental overdoses,
which are now the third leading cause of death in Ontario.

Waterloo Regional Police recently reported there were nine cases of
suspected heroin overdoses, six of them fatal.

Krishnamurthy said statistics aren't being collected in a centralized
way in Ontario, so the true number of accidental overdose deaths isn't
known. And statistics on people who almost died, but were rescued,
aren't collected at all, he said.

Krishnamurthy said the United States is ahead of Canada in developing
strategies to tackle opioid abuse and prevent overdose deaths.

There are several harm-reduction programs in Canada aimed at
preventing overdose deaths.

Alberta, Toronto and British Columbia run Take-Home Naloxone programs.
Naloxone is the drug that reverses an overdose and can prevent fatalities.

Krishnamurthy called it a "life-saving medicine."

In Toronto, it's given out by staff at the public health unit to
addicts who must take training on how to use it. The Medical Officer
of Health issued a directive which allows non-medical staff to hand
out naloxone kits.

Naloxone acts within two to four minutes and its effects continue for
45 minutes when given by injection.

In Waterloo Region, Michael Parkinson of the Crime Prevention Council
of Waterloo Region, which co-hosted the workshop, is advocating for
the distribution of naloxone locally.

Only Ottawa and Toronto have programs where a medical directive is
issued allowing trained people - other than doctors and paramedics -
to dispense naloxone. It can be prescribed by a doctor.

Krishnamurthy said take-home programs don't replace treatment for drug
addicts. They just "help people stay alive," he said.

Addicts could be trained as "naloxone responders," he said. Surveys
show 70 per cent of intravenous drug users witnessed an overdose. They
find it empowering to save other peoples' lives, he said.

People aren't demanding naloxone because they don't know what the
solution is for overdose fatalities, he said.

In the U.S., there are 200 programs leading to 10,000 overdose
reversals. They fall within the scope of normal medical practice,
Krishnamurthy said

Dr. Liana Nolan, Waterloo Region's medical officer of health, has said
she is open to exploring the idea of using naloxone. She started a
committee to address that issue and others related to harm-reduction
programs.

The Crime Prevention Council has established a drug strategy for
Waterloo Region and hosted a drug forum in response to the reported
overdose deaths locally.

Parkinson said the workshop was one of the largest of its kind he has
ever seen in Ontario.

It attracted people from as far as Sioux Lookout, Kingston,Windsor and
Chatham, he said.

This is a corrected version of the original online story which stated:
Naloxone acts in 45 minutes when given by injection. The passage now
reads as follows: Naloxone acts within two to four minutes and its
effects continue for 45 minutes when given by injection.
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MAP posted-by: Jo-D