Today's editorial in the Toronto Star, highlights what is known to most front-line workers, health care practitioners, public health officials and healthcare advocates regarding the current opioid crisis. This crisis, could have been largely prevented if policy makers had reacted swiftly much earlier to the crisis.
Naloxone, the overdose antidote used to treat opioid overdose, has been available for decades and it has been used in many countries both in acute care settings and in the communities to help save lives. In Canada, it has only been relatively recently available to the public with ease, and front line workers such as firefighters and police do not have access to naloxone (firefighters will, reportedly in the fall), and the police still will apparently not. They will defer to paramedics to treat overdoses.
Unfortunately, what the police do not realize is that time is of critical essence in preventing an overdose death. Naloxone must be administered as soon as possible after the brain's opiate receptors become saturated with very potent opioids. If police officers on patrol are the first responders to the scene, and "do not carry naloxone", calling for firefighters or paramedics to arrive increases the delay of oxygen getting to the victim's brain- and and make no mistake will cost lives.
The editorial also points out that though supervised injection centers are being planned at various sites in the city, temporary sites could be set up in the interim to provide the necessary assistance until the future injection sites are completed.
Sadly, the problem does not only occur at the municipal level, but also occurs with certain agencies in the city that work with or house clients at risk for opioid overdose. While some agencies take extra effort to train their staff and clients on the use of naloxone and proper safety measures in overdose, others once again defer to the paramedics or to the acute care system, which just like the police policy, increases the delay to treatment and increasing the risk of overdose death.
Were it instead a respiratory epidemic, like influenza, or SARS, do you believe the sluggish actions of our officials would be the same? Is a human life not important no matter who we are talking about? I am appalled that the response to the opioid crisis in Toronto has been so sluggish- we had a massive head start as our friends in Vancouver have been dealing with this for longer than us and this epidemic has been quickly moving east.
And lastly, I've heard time and time again that people are afraid of administering naloxone- it is something that doctors and nurses do, its "medical", etc etc. Get this straight: AED, life saving cardiac defibrillators, are also medical! Nurses and doctors use these all the time in the hospital, but yet, they are found everywhere in airports, stadiums, theatres, etc. How come? The Epi-pen, used to treat life threatening allergies- also as ubiquitous.
Naloxone is no different. Naloxone IS the Epi-pen, the AED of opioid overdoses. In all cases, delivery of medicine via Epi-pen and AED are time sensitive, as it is with naloxone. And giving naloxone to someone who is not in opioid overdose will not cause them harm.
Give the front-line providers the chance to save lives, I say to our policy makers and to anyone, with any power to make policy decisions- "fear not doing the wrong thing"- or the consequences of not doing so are irreversible.
Reference:
https://www.thestar.com/opinion/editorials/2017/08/03/torontos-plan-for-tackling-opioid-crisis-falls-short-editorial.html