With the closure of more than half of the supervised consumption sites across the province, Réseau ACCESS Network spent Oct, 2 offering training to reverse opioid poisonings and overdoses.
Sudbury was one of a number of communities across the province that spent the day offering community Naloxone training, said Amber Fritz, former manager of harm reduction at Sudbury’s now-closed site.
She told Sudbury.com that without supervised consumption sites, there will be more drug use in public and more drug poisonings happening in public.
“We want folks to be aware that they may become bystanders and we want people to know how to use Naloxone should they come across someone who's in distress,” said Fritz, now manager of outreach and education for Réseau. She told Sudbury.com “we hope people never have to be in that situation, but without a safe place for people to use and trained staff to respond on site, bystanders may become first responders.”
On Aug. 20, Health Minister Sylvia Jones announced the official end of all but nine supervised consumption sites in Ontario, saying the province is shifting to a treatment-focused model.
Not only did some call it a “death sentence” for people who use drugs, but locally, harm reduction advocates spoke of the exponential increase in people needing ambulance or emergency services to treat an overdose.
To stem that tide, and not only save lives but prevent injuries such as traumatic brain injury (from lack of oxygen during overdose), knowing how to use Naloxone is the first step, said Fritz.
You can obtain Naloxone (also known as Narcan) free from your local pharmacy, the Réseau ACCESS Network or Public Health Sudbury and District’s The Point, a free and confidential program that provides harm reduction supplies. For a map of places you can find a Naloxone kit, click here.
First indicators, beyond someone who is not breathing or unresponsive, is colour changes to their skin and lips. For those with a light complexion, blue lips and blue fingertips are signs to look for; for darker complexions, the skin will appear quite pale and the lips will lose colour.
Fritz said “If you try to rouse the person, either with verbal stimuli or physical stimuli, they're not going to respond” and she noted “the main thing you want to look for is the barely breathing, not breathing at all, unconscious, unresponsive, and then, of course, the signs of a lack of oxygen, which is why lips go pale or blue.”
If you have identified a possible overdose, call 911 first, especially if you are by yourself.
“If you're with multiple people, you can delegate responsibilities; but if you're alone, call 911 right away,” she said. “And hopefully you have a Naloxone kit and you know how to use it.”
Naloxone is offered both as an injection and nasal spray. The nasal spray is easier to administer and recommended in these cases.
“You put the plunger all the way into the person's nostril, so the tops of your fingers are touching the base of the nostril, and then you push the plunger,” said Fritz. “Sometimes you get real lucky, and the person snaps out of it almost right away. But with the current toxicity of the supply, that doesn't happen as often as we would like.”
Fritz said rather than administer another dose immediately, you should wait at least two to three minutes for the medication to take effect.
While you wait, begin treating, as best you can, the respiratory distress: their breathing.
Fritz said rescue breathing, without chest compressions, will help while you wait for the ambulance. Often, 911 operators can talk you through, but you can also take a CPR course, or watch a YouTube video, she said. “You could also come to Réseau ACCESS Network for our in-person training.”
For your safety, there is a plastic RESQ-AID mouth protector and nitrile gloves in the Naloxone kit.
Fritz said she is grateful that Naloxone is so available now. “We're just trying to support people to respond to save a life, because naloxone is an incredibly safe, incredibly effective medication,” she said. “And if we didn't have Naloxone, we'd be in a far, far, far worse situation than we're in now.”
Naloxone is also known to be safe in situations where the person is not having an overdose. However, for those who are opioid dependent, meaning that they take one form of an opioid or another every single day to keep them going to withdrawal, the Naloxone will cause them to go into what’s known as precipitated withdrawal, said Fritz.
“When naloxone is administered to an opioid-dependent person, it removes all the opioids off the opioid receptors that we all have in our brain, and it sits in the receptors in its place,” she said. “Once opioids are removed in one fell swoop from all the receptors, opioid dependent people are put into precipitated withdrawal, which is a very, very uncomfortable and painful thing to experience.”
However, it is still in the person’s best interest to receive the Naloxone.
“If someone does end up in precipitated withdrawal, that's horrible, of course, but it's better than them no longer being with us, right?”
For more information about where to find Naloxone kits, click here.
Jenny Lamothe covers vulnerable and marginalized populations for Sudbury.com.