Pubdate: Thu, 07 Apr 2016
Source: Now, The (Surrey, CN BC)
Copyright: 2016 Canwest Publishing Inc.
Contact:  http://www.thenownewspaper.com/
Details: http://www.mapinc.org/media/1462
Author:  Amy Reid

Part Three

NARCAN ON HEAVEN'S DOOR: HOW TO SAVE A LIFE

Holding the addict's hand as he overdosed isn't what hit Erin Schulte 
the hardest.

It was the way he smelled.

"I remember looking at him and thinking he was so 'normal.' Clean 
cut. I smelled his cologne. No scabs or wounds. Nice clothing. I just 
remember how he smelled and remember thinking, 'Why does this guy 
feel the need to get so high he leaves this planet?'"

She sat on the ground with him, rubbing his hand. She told him to 
come back and not to stop breathing.

"I didn't want him to be alone and if it was my child I would want 
someone to be with them in the end," said Schulte.

Two women ran over and hit him with a syringe of Narcan, she recalled.

It did nothing.

Staff from the nearby shelter flew over and hit him with the opioid 
overdose-reversing drug a second time.

"The second dose brought back a light breath. Still holding that same 
hand, he held mine back."

His first words?

"Thank you."

He said it four or five times.

In that moment, Schulte promised herself she'd be trained to use 
naloxone. Next time, she could be the one to save a life.

"The fact that a shot in the leg could save a family and friends such 
heartache... A simple needle. That could mean the difference between 
life and death."

- -------

Schulte said she has witnessed countless overdoses during the two 
year's she's run the Pop-Up Soup Kitchen that feeds street people 
along 135A Street. But in recent months, overdoses have increased immensely.

"The bad drugs are here," Schulte remarked. Street drugs are being 
laced with fentanyl and possibly the powerful painkiller W-18, which 
has been killing people in Alberta.

"When someone goes down, you hear ('Narcan!') ripple through the 
street. One yells and as people hear, they yell as well. They circle 
around the person who is down. They call out their name over and 
over, offer blankets or their own clothing to put under their heads.

"And then you hear the faint sound of an ambulance or fire truck from 
far away... And as quickly as it happens, the ambulance leaves and 
life goes on."

She can now answer that call when it rings out on 135A Street. And 
training took just 30 minutes.

"It's a half hour out of your day that has the ability to change a 
person's life and the lives of the people who love them. We have to 
choose to be a part of the solution. There will always be drugs out 
there but there will be more people saved the more educated we all get."

Soon, anyone will be able to walk into a pharmacy and buy a naloxone 
kit and be trained to use it after Health Canada made the drug 
available without a prescription on March 22.

While anyone could previously be trained to use it, only drug users 
were able to get a kit.

Leslie McBain, a member of mumsDU (Moms United and Mandated to Saving 
the Lives of Drug Users), is thrilled.

She lost her son, Jordan Miller, two years ago.

"We, people who are fighting for drug policy reform, have been 
working on this particular issue for a long time," said McBain.

"It will save lives, there's no question. Having it been given the 
blessing by the government basically, is a huge step for people 
paying attention to this drug and being able to access it."

McBain spoke in Surrey on April 5 at a training event for local pharmacists.

"They wanted a mom's voice, somebody who's close to the drug 
addiction scene," she said. "After my son died, all I wanted was for 
no one else to go through this."

Jordan wasn't your stereotypical addict. He had a normal upbringing, 
McBain said.

"He was very energetic, hard-working, a very, very funny person who 
was beloved by many. He had a huge circle of friends and he had a 
great upbringing. The three of us were very close.

"But he had an addictive personality. You could see that."

In his teen years, McBain said Jordan experimented with pot and alcohol.

But the trouble didn't truly begin until he was prescribed oxycontin 
after he hurt his back at work when he was 23.

"He became addicted quickly," McBain said. Jordan went to treatment 
but relapsed a few months later.

At the age of 25, a combination of oxy, hydromorphine, opioids and 
xanax stopped his heart.

McBain said that day, he broke the first rule of using drugs - he used alone.

"If his girlfriend had been there and had naloxone, she could have 
saved him... That's the biggest thing. You can't use naloxone when 
you're overdosing yourself."

It's not yet known what a naloxone kit will cost at a pharmacy but 
McBain guessed between $30 and $60.

"I think the pharmacies will be good for people who are in the 
position of caring for someone who is taking opioids as a 
prescription as well," she said. "There's a full spectrum of our 
culture who are addicted or taking recreationally."

Dr. Marcus Lem is a Medical Health Officer for Fraser Health who 
heads up harm reduction. He said the number of people overdosing is 
concerning and accounts for a high number of emergency room visits.

While Lem didn't have exact numbers, Surrey's fire department said it 
responds to 1,200 incidents a year.

Illicit drug overdose deaths have doubled in B.C. - and in Surrey - 
over the last decade. From 2006 to 2015, the death toll in Surrey 
rose from 34 to 67 and from 229 to 465 provincially.

Last year, a third of the deaths involved fentanyl, up from 25 per 
cent in 2014, 15 per cent in 2013 and just five per cent in 2012. The 
synthetic opioid - said to be 40 to 50 times more potent than pure 
heroin - killed 471 people in Canada in 2015 and 132 in the first two 
months of 2016.

"We need to get more people off illicit drugs.... There's no way to 
make it safe," said Lem.

"Before fentanyl there was other things, after there will be 
something else. We need to address the addictions issue."

Lem said the health authority is trying to get better data on 
overdoses - who they're happening to, where they're happening and the 
best way to design intervention.

Success will come from dealing with the root causes of addiction, 
according to Lem.

"I think we need to go further upstream. We know that addictions have 
a whole bunch of determinants - some social, some biological," he said.

"We need to both talk about various programs - counselling programs, 
early intervention programs - to try to affect and get at the 
modifiable risk factors for addiction."

Lem noted there's a strong relationship between addiction and 
physical and emotional trauma.

"A lot of folks who are using drugs are doing so because they're 
trying to block out all the crummy things that happen in their lives.

"We need to try and help people deal with those things in a way 
that's more productive and more acceptable."

Lem said it's important to remember that addiction is a disease.

"Unfortunately in society we have a tendency to dehumanize people 
with addictions and to think that people are using drugs by choice," he said.

"And within medicine and within social science, we know that 
addictions are both a disease and a reaction to a bunch of social 
issues as well. So everybody who's a drug user is somebody's child. 
In some cases, they're someone's parents. A brother, a sister, a 
mother, a father."

Lem added, "Nobody wakes up in the morning or is asked as a child 
what they want to be, and says, 'I want to be a drug addict.'"

For more information on naloxone and to find a training location near 
you - if it's not yet available at your local pharmacy - visit 
www.towardtheheart.com/naloxone

- ----------------------------------------------

[sidebar]

Naloxone 411

Naloxone, also known as Narcan, is an antidote to an opioid overdose. 
Taking too many opioid drugs - such as morphine, heroin, oxycodone 
and fentanyl - can make breathing slow down or stop. Naloxone 
reverses this. It does not work for non-opioid overdoses such as 
cocaine, ecstasy, GHB or alcohol.

Naloxone and opioids bind to the same sites in the brain which affect 
breathing. However, naloxone binds more tightly and knocks the 
opioids off the receptors to restore breathing. It usually acts 
within five minutes. If large doses, strong opioids (like fentanyl) 
or long-lasting opioids (like methadone) are involved, or if there is 
liver damage, another dose may be required. Naloxone can be injected 
into a muscle, vein or under the skin, and it can be sprayed through 
the nose, but intranasal naloxone isn't approved in Canada.

Naloxone - on the World Health Organizations List of Essential 
Medicines - does nothing to someone who has not taken opioids. In 
drug users, it can cause withdrawal symptoms.

Source: Toward the Heart
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MAP posted-by: Jay Bergstrom