How an over-the-counter drug can save lives

By Arianna Danganan and Natasha Grodzinski 

The first time Sean LeBlanc used a naloxone kit, he was at home in his apartment when someone crashed into his door. When LeBlanc opened the door, he was met by his friend, who collapsed onto the floor.

“I immediately recognized it as an opioid overdose,” says LeBlanc, an ex-user himself.

LeBlanc says as soon as he administered naloxone, his friend – who had been lying unresponsive on the floor – was conscious and lucid in a matter of minutes.

Every year in Ottawa, there are approximately 40 drug overdose deaths, a figure that has remained fairly stable from 2000 to 2014, according to Donna Casey, spokesperson for Ottawa Public Health.

Naloxone is used to combat opioid overdoses. This includes drugs from painkillers like Percocet to illegal substances like heroin.

Until recently, naloxone was only available by prescription, and even then it was only accessible to those who  are using opiates or have in the past. LeBlanc was able to get prescriptions for kits, but he says he has received emails from mothers trying to get these kits for their children – with no success.

Provincial naloxone programs in British Columbia, Alberta and Ontario train groups of people to use the kits and have them available, but even with those efforts, access to the medication is still limited.

On March 22, Health Canada officially delisted Naloxone kits, meaning they can be sold over-the-counter across the country. But the final decision still rests with each province on how sales will be regulated.

If the provincial governments get on-side and the health coverage gets on-side, it could save a lot of people’s lives.

British Columbia was the first province to regulate Naloxone kits after the Health Canada announcement. Alberta is next, with the provincial government now working with the Alberta college of pharmacists to draft regulations for distribution.

“It’s great,” says LeBlanc. “But unfortunately there’s still a lot of problems with buying the drug itself, like which drug company is going to supply it and how it’s going to be dispensed.”

It was a long road to reach this point.

In the last few years, Canada has seen a large number of deaths due to overdoses on the opiate fentanyl. From 2009-2014, there were at least 655 deaths in Canada where fentanyl was either the main cause, or a contributing cause.

To combat this, groups like the Drug Users Advocacy League began to push for naloxone kits to be made available without prescriptions.

DUAL was founded by LeBlanc in 2010 to give a voice to drug users in the community. The group was incorporated in 2011, and has now seen more than 300 drop-ins.

DUAL’s argument favours a harm-reduction strategy. Essentially, addiction is going to happen. People are going to continue to become addicted to dangerous substances, no matter the legalities surrounding those substances. By legalizing prescription-free access to an overdose medication, the harm that could be caused by these addictions is lessened.

This new government is more receptive, but we still don’t know how receptive they’re going to be towards other issues.

According to a study published in Science Daily, naloxone reversed opioid overdose 96-99 per cent of the times it was administered. In this study, researchers specifically tested naloxone on heroin overdose, but researchers from the National Addiction Centre at King’s College, London, hypothesized the medicine would have similar effects on other opioids. With other studies mirroring similar success rates, advocates are arguing access to this medicine will lower rates of overdose deaths significantly.

“It’s a relief,” says Jordan Westfall, a policy analyst for the Canadian Drug Policy Coalition. “If the provincial governments get on-side and the health coverage gets on-side, it could save a lot of people’s lives.”

Within provinces, there have been city-wide pushes to raise awareness about overdosing and to train volunteers on how to administer medicines like naloxone.

In 2012, the City of Ottawa launched the Peer Overdose Prevention Program on International Overdose Awareness Day. At that time, 22 people in Ottawa were taught how to use the Naloxone kits and were given kits ready to administer when needed.

“During the Harper years, they were so anti-harm reduction,” says Westfall. “The response was cold, and heartbreaking because so many people died. This new government is more receptive, but we still don’t know how receptive they’re going to be.”

The College of Physicians and Surgeons of Ontario drew likeness to the EPI pen with naloxone kits. They see the naloxone kits as having the potential for good samaritans to intervene when they find other people in dire circumstances.

The common counter-argument is this: if naloxone kits are available to purchase in pharmacies for anyone, will it encourage drug addiction because it reduces the risks? Harm reduction fights against that argument, but advocates also stress proper use of the kits.

“It makes sense to have naloxone available over the counter,” says Westfall. “But also a lot of education towards [using naloxone] is needed.”

While the debate goes on between advocating accessible take-home kits and ethical implications, the final say still lies with the provincial governments.

In the meantime, groups like DUAL will continue to push for harm reduction for opioid overdoses and other dangers facing users.

“I’ve been in a situation where I’ve not had them,” says LeBlanc, “and I’ve lost people, you know? So, obviously having a kit is a great victory.”