Pubdate: Tue, 30 Aug 2016
Source: Globe and Mail (Canada)
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Andrea Woo
Page: A6

THE OPIOID CRISIS

As thousands die of overdoses, police are becoming front-line medics and 
politicians are forced to respond

Police Chief Bill Collins says some days his officers in Marion, Ohio,
respond to several drug overdoses an hour, as the local opioid crisis
has become so severe his department is now unable to handle basic
tasks like routine patrols.

"It takes away from a lot of our pro-active policing; it takes away
from our response time. Maybe we couldn't get to a burglary [in time]
because we were on an overdose," Chief Collins says from Marion, a
county of about 66,000 people a 21⁄2-hour drive northeast of
Cincinnati.

"Sometimes, these come in two, three, four an hour and you're just
going from one to another to another."

Police officers in U.S. cities hit hardest by overdoses from fentanyl
and other opioids have essentially become front-line medics - the
first to arrive to overdoses and, armed with naloxone, the ones
best-positioned to reverse their effects. Police in Canada have also
begun carrying the drug as part of their response to the opioid
epidemic that is gripping B.C., Alberta and, increasingly, Ontario.

Cincinnati recorded 174 overdoses in six days last week - a figure
health officials called "unprecedented." Last year, accidental
overdoses killed 3,050 people in Ohio - an average of eight a day.
Communities in neighbouring Indiana, Kentucky and West Virginia have
also seen the number of overdoses rise in recent years, driven in
large part by the growing prevalence of illicit fentanyl.

Last week, the U.S. Surgeon-General took the unprecedented step of
contacting every physician in the country with a plea to help turn the
tide on the opioid crisis. More than 14,000 Americans died of
overdoses involving prescription opioids in 2014, according to the
U.S. Centers for Disease Control and Prevention. Canada has no
national-level data for prescription-opioid related deaths, but the
figure is estimated to be about 2,000.

People who abuse or are dependent on prescription opioids are much
more likely to transition to street drugs such as heroin, experts say.

In Hamilton County, which includes Cincinnati, a new initiative from
the county's anti-heroin task force has officers bringing willing drug
users to treatment facilities rather than jail, said Tom Synan,
Newtown police chief and head of the anti-heroin coalition.

"We've gone from traditional policing to everything from being
lifesavers by carrying [naloxone], to getting people prepared for
treatment and driving them to treatment, working with addictions
specialists to help them," Chief Synan said.

"It has forced us to really focus on the user just as much as we focus
on the dealer. Our traditional role has been reducing the supply; this
has really forced us to work on reducing the demand."

Chief Synan said the steep rise of overdose deaths had been
"overwhelming" for police and forced departments to re-evaluate what
their roles are when it comes to drugs.

"I don't think we're there yet. Right now, we're getting overwhelmed
and we're just starting to bring up these questions and say, 'This
isn't working. What can we do that would work better?' "

Police in Marion and Newtown are among a growing number of departments
in both the United States and Canada now carrying naloxone, a drug
that reverses the symptoms of an opioid overdose. Police in Vancouver
and Surrey also carry the drug.

On Monday, the Ontario Association of Chiefs of Police and the
Waterloo Region Crime Prevention Council were among four groups to
issue an advisory warning of an imminent public health crisis due to
illicit fentanyl, an opioid that can be 50 to 80 times more potent
than morphine.

B.C., which has seen illicit overdose deaths increase 74 per cent this
year over the same period last year, declared a public health
emergency in April.

In Vancouver, police have a policy of not responding to overdose
calls, leaving those to paramedics. Constable Brian Montague, a
spokesman for the city's police department, said while police have
been investigating a growing number of drug-related deaths, the policy
means resources have not had to be diverted as a result in the recent
surge.

Joe Couto of the Ontario Association of Chiefs of Police said
officials in that province are bracing for the crisis to move east.

"We have a growing concern that what's already happening in B.C.,
where they have a health emergency, will eventually wind up happening
here in Ontario," said Mr. Couto. "It's sort of inevitable."

The federal government, too, has been forced to respond. Canada is the
world's second-largest per-capita consumer of opioids, behind only the
United States.

Health Minister Jane Philpott has endorsed harm-reduction facilities
such as supervised injection sites, and Ottawa has made naloxone
available without a prescription.

Dr. Philpott's office has also released a five-point plan of action on
opioid misuse that includes a proposal to require a prescription for
low-dose codeine products, mandatory risk-management plans for certain
opioids and promotion of prescription-monitoring programs that would
track how many prescriptions are written and how many are filled.

An opioid summit is also planned for the fall, although a date has not
yet been set.
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MAP posted-by: Matt