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Tackling fentanyl issue to halt more overdoses

The advertisements running on billboards across the province are one of several steps health professionals are taking to draw attention to and try to halt the upswing in Fentanyl and other opioid overdoses that became epidemic in Western Canada. (Daniel J. Rowe, The Eastern Door)

Taking a glance at the digital billboards along the highways in Kahnawake, it’s hard to miss the advertisement.

“Naloxone? See your pharmacist for a free kit.”

Pharmacists across the province can now give out the kit that includes two needles with the drug that prevents an opioid overdose from drugs such as fentanyl.

The reason for the program is simple, as pharmacist Kris Manoukian told The Eastern Door from the Proximed Old Malone Pharmacy.

“The number one aspect of medicine is to prevent harm or death,” said Manoukian. “So your goal isn’t to enable anybody else from having an antidote with them while they’re using, but to prevent them from dying.”

Quebec is advertising the antidote to attempt to prevent the massive epidemic of fentanyl, carfentanil (a synthetic drug 100 times more powerful) and other opioid overdose deaths seen in BC and Alberta in recent years.

“It’s coming this way, so the first step is to prevent deaths, so you give out the Naloxone kits,” said Manoukian.

The issue in BC was so drastic that the provincial health officer in the province declared a public health emergency in April 2016.

The kit comes with instructions to follow to respond to an overdose. The acronym SAVE ME (Stimulate, airway, ventilation, evaluate, muscular injection, evaluate again) provides a step-by-step guide to prevent an overdosing user from dying.

The take home Naloxone kit is meant to get ahead of the game and avoid the catastrophic overdose epidemic in western Canada by making an antidote available for fentanyl and other opioid addicts. (Daniel J. Rowe, The Eastern Door)

Manoukian explained how the antidote works.

“What it does is it will prevent any narcotic from binding to the narcotic receptors in our body, which causes respiratory distress and a cardiac distress where it slows down our cardiac rhythm and our breathing rhythm,” he explained. “So when we’re ODing, we can stop breathing or our heart will stop.”

A shot will pull the narcotic away from the receptors and wake the patient up, but further medical treatment is still necessary. The first step outlined in the instructions, stimulate, is to call 911 if a patient is unresponsive from a sternum rub.
“You have to be rushed to the hospital,” said Manoukian. “It saves your life, but you’re going to the hospital.”

The Eastern Door brought up the cynical suggestion that the antidote kit may increase fentanyl drug use, as some suggest having an antidote provides a safeguard for those wanting to try fentanyl and other powerful opioids.

Manoukian did not comment on the suggestion, but he did reiterate that the point of the program is to prevent deaths like those in western Canada.

“The province (who’s paying for the program) is saying, we don’t want these deaths on our turf. We want to be sure that they’re at least safe if they OD, and then we’re going to give them the resources to get them off the narcotics,” said Manoukian.

As reported in The Eastern Door last fall, Kahnawake Fire Brigade paramedics are trained to dispense Naloxone, and Kahnawake Peacekeepers will receive training this month on the nasal spray treatment Narcan, which is not available at a pharmacy in Quebec.

Education and prevention remain at the heart of the issue, as Manoukian said.

When prescribing an opioid painkiller, a doctor is responsible for telling a patient to only use the drug in cases of extreme pain.

When a pharmacist delivers the drugs to the patient, he or she will repeat this message.

“Our first rule of thumb here is as soon as we’re handing out a morphine or narcotic for any patient, we tell them off the bat, ‘be very careful. They’re not Tic Tacs. It’s highly addictive. Use it only if you absolutely need it,’” said Manoukian.

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