Naloxone use in Thunder Bay rising due to toxic drug supply: EMS

The number of doses of naloxone that have been administered in Thunder Bay this month is much higher than normal due to a toxic drug supply in the northwestern Ontario city, the chief of Superior North EMS said.

Wayne Gates said Thursday that 83 doses of naloxone — a medication that reverses the effects of opioid overdoses — had been administered to that point in July. Twenty-three of those doses were given by paramedics and the remainder by bystanders.

The number marks a jump over June, when 45 naloxone doses were administered in the northwestern Ontario city. Gates said that generally, 40 to 50 doses are administered over a month.

He said drug overdoses have been rising in the city for the last year.

"Now, in Thunder Bay and district, we're probably averaging about two overdose calls a day, which is substantial," he said, adding more overdoses are likely occurring. "I know often there are cases out there where people don't call 911 because they've been given naloxone, and they haven't called us."

Complicating things is a toxic drug supply. The city's drug strategy and Thunder Bay District Health Unit (TBDHU) issued a warning last week after a rise in overdoses.

More rescue drug needed

Recently, more naloxone than normal is required to reverse an overdose, due to the potency of the drugs, said Gates.

"We've had a few cases where we've had naloxone given to some individuals and then they seem to be OK. But then within 10 to 15 minutes, they have a bit of a relapse and we have to give them another dose.

"It definitely indicates a much more powerful substance is out there on the street," he said. "And we always encourage people for any overdoses that you really should go to the hospital, even if you've been given the naloxone as a followup, because there can be a relapse."

Gates said paramedics give naloxone doses via direct injection, which is faster acting than the nasal sprays available in naloxone kits provided to the public.

Carrying more than 1 naxolone kit urged

Kandace Belanger, manager of the TBDHU's street outreach and harm reduction programs, said that ideally, one or two doses of naloxone nasal spray would reverse an overdose, depending on the amount of drug ingested.

Recently, she's heard of instances where up to six doses are required.

"Naloxone can kind of temporarily reverse the effects of an overdose," she said. "But if there's still a lot of opiate onboard in the individual — they can go back into an overdose.

"So it does require followup, which is why we always recommend calling 911, and followup at the hospital in terms of overdoses, because that can happen."

Belanger also suggested people who carry naloxone kits have more than one, as each kit contains two doses of naloxone nasal spray.