Sector News

  1. International Overdose Awareness Day – August 31st

    “Time to Remember. Time to Act” International Overdose Awareness Day (IOAD) is a global event held on August 31st each year and aims to raise awareness of overdose and reduce the stigma of a drug-related death. It also acknowledges the grief felt by families and friends remembering those who have met with death or permanent injury as a result of drug overdose.

    International Overdose Awareness Day spreads the message that the tragedy of overdose death is preventable. The silver badge or the purple wristband are symbols of awareness of overdose and its effects. Wearing these reinforces the infinite value of each human being, and helps to nullify presumption, prejudice and stigma towards people who use drugs.

    To learn more, visit:  International Overdose Awareness Day

  2. Naloxone as Treatment for Opioid Overdose

    Summary

    • Between 1999 and 2012, opioid-related deaths over tripled from 1.4 to 5.1 per 100,000.
    • Opioid painkillers are the most common prescription medication related to overdose deaths.
    • A drug called naloxone can treat opioid overdoses. Administration of the treatment is easy because it can be sprayed into an unconscious person’s nose, does not require intravenous access, and reduces needle prick risks.
    • Many states have reduced restrictions of naloxone use by emergency responders and have developed programs for naloxone distribution to opioid abusers in order to reduce opioid-associated mortality. There are at least 188 programs that currently distribute naloxone throughout the U.S.
    • Over 10,000 successful opioid overdose reversals were reported between 1996 and 2010 by naloxone distribution programs. This shows that naloxone can prevent overdose death when administered by bystanders with limited training.
    • Amended laws in 30 states now make it easier for medical professionals to prescribe and dispense naloxone, and for bystanders to administer it, by removing or reducing liability if something goes wrong.
    • Good Samaritan Laws allow bystanders to call 911 to report an overdose without fear of arrest (Law Atlas The Policy Surveillance Portal, 2015).
    • A community-based prevention program, Project Lazarus, partnered with local physicians and provided naloxone as part of their routine medical care to both suspected opioid abusers and pain patients who were at high risk for overdose. They also provided enhanced education for prescribing physicians. In that program, opioid-associated deaths decreased by 50% in one year.

    In the last two decades, opioid prescribing has increased considerably in the U.S. This is partly due to significant changes in clinical practice guidelines for improved pain control. This may have lead to broader opioid prescribing for chronic pain leading to increased availability of opioids, and increased marketing of opioids. Naloxone is a therapeutic drug used for opioid overdose reversal currently used by first responders and hospitals. Overall, naloxone distribution and training programs have shown to be effective in reducing opioid associated mortality.

    Coe, M.A., and Walsh, S.L. (2015).Distribution of naloxone for overdose prevention to chronic pain patients. Preventative Medicine. 80:41-43.

  3. Good News for Good Samaritans!

    The Good Samaritan Overdose Act is now law in Canada.

    This will help to save lives.  To learn more, see News Release from Health Canada.

  4. Perceived Risk of Opioid Overdose

    Background

    Globally, opioid use is on the rise. Opioid dependence is estimated as the largest contributor to the global burden of disease from drug dependence. In the United Stated, over 25 million people began using nonmedical opioids between 2002 and 2011. During this time, the drug-poisoning mortality rate more than doubled.

    Method

    The authors surveyed 172 opioid users in San Francisco to assess predictors of risk perception for opioid overdose.

    Findings

    • Older individuals and those who injected more frequently were less likely to see themselves at a high risk for opioid overdose. However, the literature indicates that those who are older are actually more likely to die from overdose.
    • Those who injected more frequently were less likely to perceive themselves as high risk for overdose.
    • Interestingly, although concurrent use of opioids and alcohol was associated with a high-perceived risk of overdose, concurrent use of opioids and benzodiazepines or cocaine was not. Yet previous research shows that concurrent use of these substances is linked to opioid overdose.
    • Participants who experienced a past overdose, used heroin and mixed opioids and alcohol more frequently were more likely to see themselves as high risk for overdose. This finding is consistent with the literature, which shows previous overdose to be the strongest predictor of overdose and overdose death.
    • HCV positive participants were more likely perceive themselves at high risk for overdose. However this association was not found amongst HIV positive participants, despite the risks. This suggests a gap in risk perception amongst this particular population.

    Conclusion

    There are gaps in awareness between real overdose risk factors and perceived overdose risk amongst opioid users. The authors highlight the need for educational interventions.

    Rowena, C., Santos, G.M., Behar, E., and Coffin P.O. (2016). Correlates of overdose risk perception among illicit opioid users. Drug and Alcohol Dependence. 159: 234-239.

  5. Deindustrialization and Overdose Risk

    Background

    “In 2013, more Americans died from overdoses than car crashes” – Hilary Clinton in 2015 on the growing need to address the epidemic of drug overdose.

    • Opiate- and opioid-type drugs have been associated with a rising proportion of overdose deaths – from over 38% in 2004 to just under 52% in 2013 in the United States.
    • The initial rise in mortality was due to an in crease in prescription opioid (PO) abuse, but more recent data shows that heroin use has risen in popularity partly due to the attempts to control prescription drug misuse.
    • In 2008, heroin represented approximately 30% of overdose deaths. By 2014, heroin accounted for 61%, making it the most prevalent substance associated with overdose deaths.
    • Recent research has considered how the shifting dynamics of the U.S. illicit drug market have heightened overdose risk in places newly supplied with cheaper, more potent Colombian heroin.

    Study Setting

    • Small cities across the Monongahela River Valley have lost ‘‘90 percent of everything’’ – residents, jobs, and businesses – over the past three decades
    • According to the Allegheny County Medical Examiner (ACME), fatal overdoses nearly tripled from 2000 to 2014, from 109 to 307.
    • Case-level mortality data from Allegheny County shows an obvious spatial association between deadly overdose and poverty, with the highest fatality rates clustered in the region’s deindustrialized communities and Pittsburgh’s inner-city neighbourhoods.

    Risk environments =‘‘spaces – whether social or physical – in which a variety of factors interact to increase the chances of harm occurring’’ (Rhodes, 2009).

    Approach

    In a survey, participants described their own most recent overdose event and/or the last overdose they had personally witnessed. They were also asked to speculate upon the roots of the local overdose epidemic, while suggesting possible remedies.

    Findings

    • Participants viewed overdose and addiction as part of life in a poor city.
    • Participants lacked access to prevention education and free naloxone (for treating overdoses) from the county needle exchange program due to transportation barriers.
    • Several participants sold heroin in order to support their own drug use and many feared the criminal consequences of a buyer having a fatal overdose.

    Conclusion

    The authors suggest that the road into drug use is shaped by a deindustrialized context. Lack of opportunity, social support, and hope are met by the expanding illicit drug market, which offers both employment and recreation. Due to this, policy makers should be aware of the underlying factors and future overdose interventions should take into account that drug-related risks are complex and multifaceted when designing accessible programs for low/no-income individuals.

    McLean, K. (2015). ‘‘There’s nothing here’’: Deindustrialization as risk environment for overdose. International Journal of Drug Policy. Vol. 29. Pp. 19-26.

    Rhodes, T. (2009). Risk environments and drug harms: A social science for harm reduction approach. International Journal of Drug Policy. 20: 193–201.

  6. National Day of Action on the Overdose Crisis

    On February 21, 2017, a first national Day of Action will be held across Canada to demand different levels of government take meaningful and concrete action to address the opioid overdose epidemic devastating communities across the country. The demands include an end to the war on drugs, the removal of barriers to health care including immediate improved access to naloxone and opiate substitution therapy, and the implementation of policies that are informed by real life experiences of people who use drugs. Actions are taking place in Vancouver, Victoria, Edmonton, Ottawa, Toronto, Montreal, Halifax and other communities across Canada.

    Local organizations are seeking endorsements for their lists of demands. To sign on to the demands, or to find out more information about the actions taking place closer to you, visit https://www.facebook.com/events/371308773235925/?active_tab=about or contact admin@capud.ca.

  7. International Overdose Awareness Day

    International Overdose Awareness Day (IOAD) is a global event held on August 31st each year and aims to raise awareness of overdose and reduce the stigma of a drug-related death. It also acknowledges the grief felt by families and friends remembering those who have met with death or permanent injury as a result of drug overdose.

    Overdose Day spreads the message that the tragedy of overdose death is preventable. Wear Silver to show your support.

    For more resources, visit the International Overdose Day website.

  8. CCENDU Bulletin: Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs

    CCENDU Bulletin
    A new CCENDU Bulletin has been issued that describes some of the novel synthetic opioids that have appeared or might appear in counterfeit pharmaceuticals or be mixed into other illicit street drugs. These opioids include fentanyl and its analogues, and W-18*, U-47700, AH-7921 and MT-45. The bulletin also provides a brief overview of some of the counterfeit pharmaceuticals and other illicit street drugs that have been found to contain novel synthetic opioids, as reported in the media and elsewhere in Canada and the United States.
    Finally, the bulletin includes a discussion of the implications of this phenomenon for those working in:
    • Public health and harm reduction
    • Emergency medical services and emergency response services
    • Laboratories
    • Poison control centres
    • Law enforcement
    About CCENDU
    The Canadian Community Epidemiology Network on Drug Use (CCENDU) is a nation-wide network of community-level partners who share information about local trends and emerging issues in substance use and exchange knowledge and tools to support more effective data collection.
    *Emerging evidence suggests that W-18 is not an opioid. However, due to its analgesic effects and because it has been mixed in drugs
    sold illicitly as opioids, we have included it in this bulletin.

  9. Good Samaritan Law

    There is a movement afoot to call upon the Government of Canada to amend the Controlled Drugs and Substances Act (‘Good Samaritan Law”) to exempt individuals with possession when seeking emergency medical or law enforcement assistance for themselves or another person following and overdose on a controlled substance. To assist, consider signing the petition and encouraging members of your community to sign. The online petition is open for signature until August 13th, 2016 at 5:09 pm.

    Sign The Petition

    Did you know that:
    • Canada is the world leader in per-capita prescription opioid consumption. Deaths related to opioid overdose are a public health crisis;
    • Naloxone is a medication that has been used in Canada for over 40 years to reverse the effects of opioid overdose, has virtually no side effects and has no abuse potential;
    • Most accidental overdose emergencies involving illicit substance use occurs in the presence of another witness;
    • A study in Ontario has identified that only 46% of those involved in an emergency overdose would call 911. This compare with over 90% who would call for a cardiac arrest; and
    • A primary barrier to calling 911 in an overdose has been identified as being fear of police presence and the potential for criminal charges.

  10. Fentanyl – Patch 4 Patch Program

    Oxford County Public Health, OPP Oxford, Woodstock Police Services and Ingersoll Pharmasave consolidated efforts, in a Four-Pillar approach, to address Fentanyl related overdoses in their community. Is your community experiencing Fentanyl related overdoses? Follow this link to watch a 30 minutes informative video, released January 19, 2016 by Rogers TV Oxford, on how the Fentanyl Patch 4 Patch Program started in Oxford County and what is being done to address Fentanyl misuse in their community.