Fentanyl overdose injection kits being made available to drug users

An antidote to accidental overdoses of fentanyl, morphine and other opiates will soon be available on the streets of Nova Scotia on a trial basis.

An injection of naloxone can save people from dying if administered within minutes of an opioid overdose. Provinces in central and western Canada have been increasing community access to the drug.

Nova Scotia is the first Atlantic Canadian province to roll out naxoline take-home kits, part of a one-year pilot project in Halifax.

It's long overdue, says Rick Marshall, who's struggling to beat his long-time addiction to opiates, including morphine.

'I don't know how many people we lost'

"I've been knocking these streets now for about 12 years, and wow, I don't know how many people we lost. OD. It's a shame. Hopefully this new project will help that," said Marshall.

Marshall, 60, says naloxone addresses the dilemma drug users face when someone overdoses: they fear calling 911 will result in an arrest, and so do nothing to help the person in distress.

"They don't want to call police because there's too many questions asked: 'Where did he get the drugs? Who shot him up?' Things like that. And [they] avoid the hassle, they just leave them, they die," said Marshall.

Marshall says he would not hesitate to administer the naxolone needle. 

Direction 180, a methadone clinic in Halifax, lobbied the Nova Scotia Health Department for the $68,400 to run the pilot project. 

The funding will pay for 200 kits, which will include two dosages of naloxone, along with a syringe and alcohol swabs. Latex gloves may also be included.

The money will also cover the cost of training people who will be prescribed the kits: people who use drugs, or are at risk of an accidental overdose.

"Literally, an individual who is in the process of dying from an overdose, when you inject that stuff, within seconds, they'll wake up and get very angry — 'what have you done to me?,'" said Dr. David Saunders, a team member at Direction 180.

"What's happened is their life has been saved, but the side effect of that is they go into immediate withdrawal."

How it works

During an overdose, opioids attach to opioid receptors in the body, causing the person to stop breathing, lose consciousness and die. 

Naloxone works by scooting in, binding to the opioid receptors, and "kicks out" the opioids, says Saunders. It must be injected into a muscle immediately after an overdose.

He says he isn't aware if the drug, which has been used in hospitals for decades, has any side effects.

Having drug users inject someone with naloxone shouldn't be an issue, he says, because for the most part they're comfortable using needles safely.

 
"It has a profound effect, a life-saving effect. So, I think that any risk is very small compared to the potential benefit," said Saunders.

About 120 Nova Scotians die every year from accidental overdoses, according to Cindy MacIsaac, the executive director of Direction 180.

So far this year, 83 people have died of overdoses in Nova Scotia, according to the Medical Examiners Office. Opiates were a factor in 59 of those deaths. 

She says a former client, who lived in an apartment building well-known for drug abuse, died last weekend. MacIsaac wonders if the young woman would be alive today if friends or neighbours had access to naloxone.

"Some people think that giving somebody naloxone is a ticket to use more, which isn't the case. It's a chance at life," she said.

It's expected naxolone will be available for use in Halifax by January.