Pubdate: Fri, 25 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

LOCAL DOCTOR PREPARED TO DISTRIBUTE LIFE-SAVING DRUG TO ADDICTS

WATERLOO REGION -- People at risk of dying from an opioid overdose 
will soon have access to a life-saving drug in Waterloo Region.

A doctor who runs a Waterloo clinic for people with Hepatitis C and 
HIV is willing to begin distributing naloxone, a drug that reverses 
the effects of an opioid overdose.

"We're in the process of evaluating and putting together a program to 
distribute naloxone to at-risk individuals," Dr. Chris Steingart, 
director of the Sanguen Health Centre, said Wednesday.

Steingart said he will write a medical directive allowing staff at 
the clinic to hand out naloxone for free to addicts. Distribution 
won't likely start for several months because his staff must be 
trained and Steingart wants to consult with other community agencies 
about his plans.

His clinic is one of three organizations prepared to begin 
distributing naloxone in this area, said Michael Parkinson of the 
Crime Prevention Council of Waterloo Region, which recently 
established a drug strategy for the region.

"We're thrilled. It's an initiative that will save lives, reduce harm 
and connect marginalized people in our community with health and 
social services aE&" Parkinson said.

"It's going to reach hundreds of people. I would expect it's going to 
reach people who are most at risk of an accidental overdose in 
Waterloo Region."

He wasn't prepared to identify the other two organizations.

In Waterloo Region, there have been nine cases of suspected heroin 
overdoses, six of them fatal. Many OxyContin addicts switched to 
heroin and fentanyl after the Ontario government delisted the opiate 
OxyContin last spring over concerns the powerful painkiller was being abused.

Addicts weren't used to heroin and unsure of the strength of the 
drug, which can be cut with other ingredients. There have also been 
fatal overdoses of fentanyl, an opiate more powerful than morphine, 
in some Ontario cities.

Parkinson has been pushing to have naloxone made available to drug 
users so they can use it on a fellow addict who is overdosing.

There are two ways someone can get the drug: a doctor can write a 
prescription for a patient who would have to pay for the drug because 
it is not included in the provincial drug benefit plan; or a doctor 
could issue a medical directive allowing other trained people to 
dispense naloxone.

The drug is an antidote currently used by emergency doctors and 
paramedics to revive people from an opioid overdose.

Steingart may model his naloxone distribution program on one run by 
the Toronto public health unit called the Naloxone Point Program.

It trains current and past opioid users, their friends and families, 
to recognize signs of an overdose. They're also taught how to inject 
naloxone in case of an overdose. They're given take-home naloxone 
kits with instructions on how to use the drug.

Steingart, an infectious diseases specialist, already works with many 
opiate addicts at risk of accidentally overdosing.

The Sanguen Health Centre is also a satellite office of the 
Guelph-based Masai Centre, which cares for HIV patients. Steingart 
would offer naloxone in both cities.

Sanguen already provides free harm-reduction supplies for substance 
users at St. John's Kitchen in Kitchener.

Steingart isn't sure how many drug users know about naloxone.

"I think there's a bit of a growing awareness of it," he said.

He plans to start "relatively slowly and carefully," then possibly 
expand to other places where Sanguen does outreach work.

"The evidence seems to be there it can help save lives," Steingart 
said. "The time has come. We're moving towards it, for sure."

Naloxone kits are currently free through the Ontario Harm Reduction 
Distribution Program which got one-time funding from the Ministry of 
Health and Long-Term Care to buy 4,000 overdose prevention kits.

"I want to be sure of the sustainability of that supply," Steingart 
said. "Right now, it's available."

The three organizations willing to dispense naloxone in Waterloo 
Region came forward after a recent workshop was held on opioids and 
overdose prevention in Cambridge.

It was sponsored by the Waterloo Region Crime Prevention Council, the 
Langs community health centre in Cambridge, and Preventing Overdose 
Waterloo-Wellington, a grassroots community group led by Parkinson.

A Toronto doctor spoke out in support of making the drug easily 
accessible and said it has long been accepted in the United States 
and other countries.

It's similar to an EpiPen being used on someone having an allergic 
reaction. Naloxone works within several minutes of injection.

Naloxone distribution programs also exist in Ottawa, Edmonton and 
British Columbia.

A push is also underway in Ontario to get the province to include 
naloxone on its drug benefit plan.

Dr. Rosana Pellizzari, Medical Officer of Health in Peterborough, has 
asked all health care providers to sign a letter supporting the request.

Pellizzari said family physicians can help protect their patients 
from an unintentional overdose by ensuring that people using opioids 
for chronic pain have access to naloxone.
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MAP posted-by: Jay Bergstrom