Free naloxone nasal spray needed to deal with Sask. overdose spike, say front-line groups

An alarming spike in overdoses in Saskatoon has some front-line workers calling on the Saskatchewan government to expand its Take Home Naloxone program to include the more user-friendly nasal spray, not just injection kits.

Free naloxone nasal spray is offered in Ontario, Quebec, the Yukon and Northwest Territories. Unlike the more invasive injectable version, the overdose-reversing medication is sprayed directly into the nose.

"Some people just are not going to feel comfortable using the needles and if that is something that stops somebody from using naloxone, or carrying naloxone, then that's a barrier that we should get rid of," Sarah Kozusko, pharmacy manager at Queen City Wellness in Regina, said.

Her pharmacy is one of more than 480 locations in the province — including health clinics, certain pharmacies and community based organizations — where people can pick up free injectable naloxone. About 80,000 naloxone injection kits have been distributed since the program launched in November, 2015, according to the Ministry of Health.

Kozusko said she believes the lack of publicly-funded nasal spray is preventing more people from carrying the life-saving medication.

A take-home nasal kit with two nasal sprays costs around $72, whereas the injection kit with two needles that's covered by the province retails around $50.

'We haven't made a decision'

On Wednesday afternoon, the province's minister of mental health and addictions said the province is considering the request.

"We're looking at the nasal naloxone. We haven't made a decision as to whether that's something we're going to distribute, but it is something we're looking at," Lori Carr told reporters at the legislature.

"It should be everywhere," Kozusko said.

The pharmacist is often called upon to administer multiple doses of naloxone to people experiencing drug poisoning in the vicinity of her store. She usually starts with a quick shot of nasal spray, calls 911, then moves on to injections. In her personal time, she prefers to carry the smaller, more convenient nasal spray.

"It's like these little tiny things that I can just so easily throw into like a purse or fanny pack," she said. "It is not stronger, but it is easier to use."

She also appreciates that she doesn't have to worry about disposing of a needle.

Calls for nasal spray in Saskatoon

The Saskatoon Fire Department has responded to more than 700 overdoses this year, with an average of 24 a day for most of March. The Saskatchewan Public Safety Agency said it's providing more supplies of naloxone in Saskatoon, and on Tuesday health officials indicated that would include a shipment of nasal naloxone spray.

Kayla DeMong from Prairie Harm Reduction (PHR) in Saskatoon has made a public plea for donations to buy nasal spray.

"Just make it available. Make sure it is distributed, because it is the easiest way to teach people how to respond and to have that confidence to respond," DeMong said.

'It can be scary'

PHR has sought donations from the Federation of Sovereign Indigenous Nations and Saskatoon Tribal Council to raise thousands of dollars to buy the kits.

Rob Kraushaar is the clinical program director of the Regina Street Team, a group that offers services to vulnerable people.

He has no complaints about the supply chain for free injection kits. He said he fills out an order form, then picks up cases of take-home kits from the Ministry of Mental Health and Addictions. But his team is always searching for nasal spray. He said they rely on gifts from Indigenous supporters who receive the spray for free under federal health benefits.

People on the front lines say most overdoses require multiple doses of naloxone to revive the person, regardless of whether it's injectable or nasal spray.

"If people are reporting that four or five doses of the stuff is not bringing somebody back in Saskatoon, if you're looking at you have to pay for that as an organization, like, that's crazy," Kraushaar said.

He's convinced that more people would be willing to carry naloxone as a nasal spray than needles.

"It can be scary. Like, the first 30, 40, 50 overdoses that I responded to on the street and had to use the injectables, your hands are shaking, you're trying to fit [the syringe] into this little vial… all while, in your head, you're thinking every second is life or death for this person," Kraushaar said.