Easier to use Naloxone kits will soon be available free of charge to anyone in Oxford County to help prevent opioid overdose deaths.
“We're just finishing up our policies to be able to dispense it, so we're really close,” said Lisa Gillespie, a nurse with Oxford County Public Health. “We should be able to dispense it within the next few weeks.”
Oxford County Public Health has been dispensing Naloxone – a drug that counteracts the effects of opioids by blocking receptors in the brain – since 2014.
The original kits included two 0.4 milligram doses of Naloxone in glass ampules that were administered through intramuscular injection using a one inch needle.
The new kits contain two, four milligram doses that are delivered with prepared intra-nasal devices.
Gillespie said opioids are the number one “drug of choice” in Oxford and that overdose is among the risks of opioid use.
“We are in a crisis situation with opioid addiction and we need a comprehensive strategy to deal with it,” she said. “Naloxone is just one example of a harm reduction approach, it's not the only answer.”
With that in mind, Oxford was the fifth public health unit in the province to implement a Naloxone program.
“We were very proactive in Oxford because we knew we had an opioid issue,” Gillespie said.
Oxford County Public Health has dispensed 62 kits so far and refilled some of them.
Gillespie said seven people have used kits to reverse an overdose and save lives.
“There's likely (been) more than that, but we don't always hear back.”
Oxycontin was previously the most popular opioid used in Oxford, but hydromorphone is now number one, she said.
While the local health unit hasn't encountered a lot of Fentanyl opioid use so far, Gillespie said it is receiving anecdotal reports that “it's here.”
Of particular concern is so-called “bootleg Fentanyl” that is not pharma produced and is 100 times more potent than the prescription variety.
“One little (piece the size of a) grain of salt can be too much and cause an overdose,” said Gillespie. “(Oxford County Public Health) and the Ministry of Health are taking this very seriously.”
While they don't yet have access to the new kits, pharmacies have been able to dispense intramuscular Naloxone kits since July 2016 along with methadone and suboxone, substances used to treat opioid addiction.
Gillespie said there are four pharmacies in Woodstock, two in Ingersoll and one in Tillsonburg involved so far and the health unit is continuing to reach out to others.
“All pharmacies in Ontario, people all over Ontario, have access to Naloxone free of charge over the counter without a prescription,” said Gillespie explaining that includes family members and friends of opioid users. “We want Naloxone in the hands of as many people as possible to reduce the chances of an overdose death.”
Nancy Kyrolls, pharmacist at Ingersoll Medical Pharmacy, said she has distributed 19 of the 20 Naloxone kits she received from the Ministry of Health in the past three months and is looking into acquiring more.
An opioid overdose can cause depression of the central nervous system and respiratory arrest leading to death. By blocking opioids from getting to the receptors in the brain, Naloxone can reverse those effects.
Naloxone only works if there are opioids present in the body, otherwise it has no effect.
It isn't a silver bullet when someone overdoses, because the effect of the Naloxone only lasts for 30 to 90 minutes, so the person still needs to get to a hospital for further treatment.
“We always stress the importance of calling 9-1-1 (when someone overdoses),” Gillespie said. “(Naloxone) basically buys them time to get them to the hospital.”
Because Naloxone causes immediate withdrawal, there is a risk that someone who overdoses and doesn't go to hospital for treatment could end up using more opioids and go right back to overdosing, Gillespie said.
“Withdrawal) is the last thing a person with an opioid addiction wants because it makes them very sick.”
All Oxford paramedics are trained to administer Naloxone, Gillespie said, and police and fire services may not be far behind.
Learning to use a Naloxone kit takes less than an hour.
Gillespie said when someone comes in for training they are taught some basics, including how to prevent an overdose from happening in the first place and what an overdose looks like.
People are also provided with information about addiction services and the Woodstock and Area Community Health Centre.
Then there is some hands on training including tips on how to perform CPR and rescue breathing leading up to how to administer the Naloxone.
When it comes to legal implications of Naloxone use, Gillespie said the Good Samaritan Law should apply. She said health officials are looking for some changes to protect people who administer Naloxone to someone else when they may be using or in possession of opioids themselves.
“It's a life and death situation, so if you have the training you're probably going to use the kit if you know the person has an opiod on board. We're hoping to see changes to the Good Samaritan Law that if someone is acting in the best interest of a person and calls 9-1-1 they won't be charged with simple possession.”
Besides dispensing Naloxone, the public health unit operates a needle exchange for drug users and Gillespie said that is accessed about 2,200 times each year.
She said it's part of the strategy to address opioid use in the county along with talking about it and getting people to “realize it's a medical concern, not a moral one.”
“I think it's great this issue is finally getting the attention it deserves because I think we've known for quite a while that we have an opioid addiction problem.”
Anyone interested in getting a Naloxone kit can call Oxford County Public Health at 1-800-755-0394 ext. 3490.
Besides the Oxford County Board of Health, Naloxone kits are available at the following locations:
Access Care Pharmacy – 35 Metcalfe St., Woodstock
All About Health Remedy's RX – 360 Norwich Ave., Woodstock
Clinic 461 – 461 Dundas St., Woodstock
Shoppers Drug Mart – 959 Dundas St. E., Woodstock
Ingersoll Pharmasave – 19 King St. E., Ingersoll
Ingersoll Medical Pharmacy – 17 Thames St. S. Ingersoll
Shoppers Drug Mart – 200 Broadway St. Unit A1, Tillsonburg