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Drug Strategy Launches Life Saving Overdose Prevention Program

May 27, 2013 – The Thunder Bay Drug Strategy launched an Overdose Prevention Program (ODP) today, a key priority in the Strategy’s Community Report ‘Travelling the Road to Change’, released in May 2012.

With the provision of Naloxone, a lifesaving medication used to reverse an opioid overdose, S.T.O.P.P. (Superior Thunder Bay Overdose Prevention Program) will be joining only three other programs in Ontario to provide naloxone in tandem with overdose prevention training.

“The key message we want people to take away is that accidental overdose is preventable,” said Cynthia Olsen, Drug Strategy Coordinator. “Getting this information out to the general public, including those who are taking prescription opioids, licitly or illicitly, is extremely important.”

She added that these types of programs have been around in the United States since 1996, with over 150 programs operating in 19 different states.  The Centre for Disease Control estimates that between 1996 and 2010 these programs have helped reverse over 10,000 opioid overdoses.

Working in conjunction with partners from the Thunder Bay District Health Unit and AIDS Thunder Bay, S.T.O.P.P. was developed using best practices as outlined by the Ontario Harm Reduction Distribution Program.

“Thunder Bay has high rates of misuse of prescription drug such as opioids and, as a result, the risk of accidental overdose and death is high,” said Dr. Janet DeMille, Associate Medical Officer of Health, Thunder Bay District Health Unit. “The overdose prevention strategy, including the naloxone distribution program, aims to reduce this risk especially for individuals at highest risk.”

Training and a kit will be provided and focus on strategies to reduce risks, learning to recognize different types of overdose, as well as ways to effectively respond, including calling 911 and giving naloxone.

“It takes from one to three hours for someone to die from an opioid overdose, such as oxycodone or fentanyl,” said Olsen. “In many cases, there are others around who witness an overdose and are well situated to help save a life if given the education and tools to respond effectively.”

The development of an overdose prevention program was identified as a key priority in the Thunder Bay Drug Strategy Community Report Travelling the Road to Change, released in May of 2012.

Working in conjunction with partners from the Thunder Bay District Health Unit and AIDS Thunder Bay, the Superior Thunder Bay Overdose Prevention Program (S.T.O.P.P.) was developed using best practices as outlined by the Ontario Harm Reduction Distribution Program (OHRDP).

As much as two thirds of witnessed overdose deaths might be prevented if basic life support and the drug naloxone was given at the time of the overdose.

There is both an identified and an underused potential for overdose prevention programs for peers, friends, family and caregivers. These programs provide education on reducing risk (e.g. not using alone), recognizing signs and symptoms of an overdose and responding correctly to an overdose.  A quick response is necessary as there is only a short window of time to administer naloxone. Research shows that overdose from opioids most commonly occurs 1- 3 hours after use, and medical intervention is often too late. As these individuals are often the ones to encounter someone overdosing on opioids, providing this training could potentially save a life.

According to the Regional Supervising Coroner, Dr. Michael Wilson, of all 2010-2011 closed deaths, 48 were the result of motor vehicle accidents and 56 were drug related overdoses. Naloxone can save lives.


What does S.T.O.P.P. training involve?

Overdose training for S.T.O.P.P. will include three key components.

  • Reducing the risk of an overdose. For example, not injecting alone is a risk reduction strategy. Others include not mixing drugs, understanding changes in tolerance from drug to drug, always knowing the drug you are using and not switching drugs. 
  • Recognizing signs and symptoms of an overdose.
  • Responding to an overdose. This five step protocol involves identifying when an overdose is happening, calling an ambulance, injecting the naloxone, providing chest compressions and waiting for the ambulance to arrive.

What is naloxone?
Naloxone is an antidote drug that can temporarily reverse the effects of opioid drugs like Oxycontin.  When a person overdoses on opioids, they can stop breathing. When naloxone is given correctly, it will reverse the overdose effect and the person will start breathing and regain consciousness. It is still important to get medical help for the person.

How is it administered?
Naloxone can be given by injection (into the muscle or under the skin) or intra-nasal (sprayed into the nose).  In Thunder Bay, S.T.O.P.P. will be distributing injectable naloxone.  It can be given through clothing into the muscle of the upper arm or upper leg. Safety needles are provided with the naloxone kit to prevent needle-stick injuries.

Can naloxone cause harm or be abused?
Naloxone does not cause dependency and has no euphoria-inducing side effects.  It works by blocking the effects of opioid drugs or medications.  The main risk of giving naloxone to someone who is dependent on opioids is that it will cause them to suddenly go into withdrawal, which would be distressing but not fatal. Naloxone does not encourage opioid use. Although a direct cause and effect relationship has not been determined, naloxone should be used with caution on individuals with cardiovascular disease.

Naloxone is a very safe drug.  It has been approved for use in Canada for over 40 years and is on the World Health Organization List of Essential Medicines.

Is S.T.O.P.P. the only way people can have access to naloxone?
In Ontario, naloxone can be prescribed by a physician or nurse practitioner to a patient. However, the patient would have to pay for the drug as it is not covered by the provincial drug plan. In addition, there is no guarantee that the patient would receive other important overdose prevention training.

Programs like S.T.O.P.P. help overcome the cost barrier and ensure that individuals receive overdose prevention training. The Thunder Bay District Health Unit has secured a medical directive for staff from the Superior Points Harm Reduction Program and the Sexual Health Street Nursing Program to distribute naloxone to clients who meet certain criteria; a history of opioid use, attending a training session and completing the required paperwork if naloxone is administered.

There are similar overdose prevention programs in Ontario including, Wellington-Waterloo, Toronto, Ottawa and Kenora. However, the program in Wellington-Waterloo does not offer naloxone.