Some of our readers who access the ANKORS Needle Exchange may have been aware of or taken part in a recent survey. The survey was administered on behalf of the BC Center for Disease Control (BCCDC). It was meant to discover baselines around drug use, by region. The regions involved were: Prince George, Vancouver’s Downtown East Side, and the East and West Kootenay and Boundary areas. Our region was included as a rural example.

The reason this baseline information was being collected was to show a need for overdose first aid programs, including the use of take-home Naloxone kits. Naloxone (also known as Narcan) is a pharmaceutical drug, developed in the 1960′s which is an antidote for opioid overdose. In essence, it removes the opioid from the brain of the user, putting them in immediate withdrawal, and restoring depressed body functions such as breathing and heart rate.

Naloxone has been used for decades in hospitals when prescribed opioids caused overdose in emergency and operating rooms. It is extremely effective and is a life saving intervention for individuals who experience opioid overdose.

ANKORS and the BCCDC are working toward being able to provide first aid training for opioid overdose. Work is being done to increase the availability of Naloxone, since currently it is a prescription medication. Many people who use opioids, other than as prescribed by their doctor, have difficulty accessing a physician. Furthermore, physician perspectives on prescribing Naloxone for opioid users impact how the medication is prescribed. Some healthcare and harm reduction activists feel that prescriptions of Naloxone (and training on how to use it) should accompany every single opioid prescription. As well, any individuals who identify as opioid users (for whatever reason) should be referred for Naloxone training and a take-home opioid first aid kit.

There are take-home Naloxone programs running in cities around the world. In Canada, Toronto and Edmonton are running such programs. In Edmonton, the training takes place on a drop in basis. As individuals access needle exchange services, they are encouraged to take the 20 minute opioid overdose first aid training and to take a Naloxone kit home with them to have on hand in case a fellow user overdoses in their presence. Also, they can show others how to use it, in case they overdose themselves.

For those concerned about the possibility that this training and access to Naloxone has the potential to enable opioid use, there are a few things to consider:

1. The sudden withdrawal caused by treatment with Naloxone is highly uncomfortable. Anecdotal evidence shows that users are often sick, in pain, and very upset that their dose has been wasted- especially since financial barriers may mean that they can’t easily get more. Evidence also shows that education among users about OD and Naloxone means safer use practices meant to avoid having to go though this OD-Death or Naloxone cycle.
2. Overdose and the administration of Naloxone is very stressful and can be traumatic for those who are around and actually do the Naloxone administration. There is very little time between the beginning of the OD and the start of brain damage due to depressed respiration. Those in the helping position have to be fast and efficient, willing to inject another person, call 911, and stick around with the person who overdosed, to wait for help to arrive. It isn’t easy and it isn’t fun, especially when the user is sick, in pain, and desperate to feel better-despite the fact that they almost just died.
3. Naloxone truly is a life saving intervention. To limit the availability of this training along with access to take home Naloxone kits means that society values the lives of users less than they value people in hospitals who are given opioids for medical reasons. Opioid first aid training and access to Naloxone kits means that we value the lives of users and that we don’t expect them and their loved ones to accept death as the inevitable outcome of the illness of addiction.