Health Canada has called the opioid crisis one of the most serious public health threats in recent history, and an addictions specialist says everyone can play a part in helping reduce the death toll. All it takes is access to naloxone, a life-saving medication that temporarily reverses an opioid overdose.
“It’s something that all adult Canadians, and I would hazard to guess teenagers as well, should have access to and be aware of,” said Dr. Sam Hickcox, chief officer of the Nova Scotia government’s Office of Mental Health and Addictions. “If there’s something we could do to save a life, why wouldn’t we?”
He compared administering naloxone to using an EpiPen to treat someone having an anaphylactic allergic reaction.
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Hickcox said the country’s ongoing opioid epidemic has been made worse as Canada’s illicit drug supply became “poisoned” in recent years with toxic, highly potent opioid additives like fentanyl and carfentanil. Some users report not knowing what’s in the drugs they’re using.
“It’s been wreaking havoc across the country … starting in the West Coast and heading eastward,” he said in a recent interview.
Since 2016, Health Canada has recorded 38,514 opioid-related overdose deaths. Between January and March this year, there were more than 1,900 apparent opioid overdose deaths in the country, an average of 21 a day.
Widespread access to naloxone is “not just about potentially saving someone’s life — it’s also about all of us playing some part in this and understanding this problem more,” Hickcox said.
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Here’s what you should know about naloxone, a life-saving treatment that can be administered by the average Canadian and is free to obtain.
What is naloxone and when is it used?
Naloxone: What to know about the opioid overdose-reversing drug, free across Canada. #Naloxone #OpioidCrisis #OpioidOverdose #OverdoseCrisis
Naloxone is a medication that blocks receptors in the body that take in opioids such as fentanyl, heroin, morphine and oxycodone. The medication does not reverse an overdose caused by stimulants like cocaine, ecstasy or Ritalin.
“Even if you’re not absolutely, 100 per cent sure that someone is having an opioid overdose, it makes sense to administer naloxone,” Hickcox said, because the drug is harmless and won’t interfere with other medications.
“And you might save a life.”
Someone who is experiencing an opioid overdose will likely have trouble walking, talking and staying awake. They will have very small pupils, weak breathing and they may make gurgling or snoring sounds.
Another sign of opioid overdose is someone’s skin turning blue or purple if they have a light complexion, or grey or ashen if their complexion is darker.
If you see someone exhibiting these symptoms, it’s recommended to call 911, administer naloxone, then follow the kit’s guide for chest compressions and CPR.
The vast majority of kits that are distributed for free across the country are injectable naloxone in ampoules that come with syringes, gloves, an alcohol swab and a “barrier shield” to place on someone’s face before mouth-to-mouth resuscitation. The medication is injected into the upper arm or upper leg, and it can be injected through clothing.
Kits typically come with two doses of the drug, allowing for a second dose if the person does not respond after the first.
Some provinces also make a nasal spray naloxone kit available.
How difficult is it to use?
Megan Horochuk, a naloxone take-home kit co-ordinator in Nova Scotia, said it’s “nerve-racking” to administer naloxone to someone experiencing an opioid poisoning, but it’s simple and effective.
“I felt comfortable doing it, though I was nervous. But as long as you’ve had the training, be it official training or not, it’s something most people can do,” she said in a recent interview.
“You just take your time …. 911 was great on the phone, which was reassuring. And the person (suffering a presumed overdose) came to before I even had to do CPR or rescue breathing.”
Across Canada, medical centres, pharmacies and community-based organizations that offer free naloxone kits also provide training, which typically takes 20 minutes. Horochuk said there are also reputable training videos online.
Horochuk speaks regularly with members of the public who have administered the drug.
“Most people I’ve talked to felt quite comfortable. I mean, no one wants to do it, but anyone that I know that has administered it said they felt good and comfortable doing it,” she said.
In British Columbia, a panel of opioid experts that includes people who use drugs has called for take-home naloxone kits across Canada to contain both a nasal spray and an injectable. Those who have used naloxone to save lives have said having nasal spray at hand could ensure a faster response because some people may be uncomfortable with needles.
Naloxone nasal spray comes in a device with two prongs that fit into each nostril to administer the medication. Ontario and Quebec offer free nasal spray naloxone at pharmacies that carry it, or through locations like needle exchange programs, shelters and public health units.
Where can I get one?
Depending on the region, naloxone can be obtained through community organizations, health centres or pharmacies.
In Alberta, British Columbia, Manitoba, Saskatchewan, Prince Edward Island, New Brunswick, Newfoundland and Labrador and Nunavut, kits are available for free to drug users and family and friends of anyone at risk of an overdose.
In Nova Scotia, anyone can obtain a free naloxone kit at more than 400 locations across the province.
Ontario makes both injectable and nasal spray naloxone available to anyone for free at most pharmacies and many community organizations.
Quebec makes both types of kits available for free at pharmacies for health card holders. People who use drugs can obtain free naloxone at many community group sites.
In the Northwest Territories and Yukon, access to naloxone is unrestricted and kits are available at pharmacies and health centres across the regions.
This report by The Canadian Press was first published Dec. 3, 2023.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
