Sector News

  1. International Overdose Awareness Day

    Since 2001 this day of recognition occurs each year on August 31st. Harm reduction agencies around the globe organize events to raise awareness about this important issue. If your program is hosting an event for International Overdose Awareness Day, please register your event. To view events that have already been registered, look here.

     

    In 2016 there were at least 2,946 apparent opioid-related deaths in Canada with another 2,923 occurring between January and September 2017. These reports do not include deaths caused by drugs other than opioids, so the total number of drug-induced deaths will be somewhat higher. Source: https://www.canada.ca/en/public-health/services/publications/healthy-living/national-report-apparent-opioid-related-deaths-released-march-2018.html

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    World Hepatitis Day – Saturday July 28th

    Every year on July 28th we raise global awareness of viral hepatitis. This year’s theme, Finding the Missing Millions, is aimed at finding the estimated 300 million people worldwide who are unaware that they are living with viral hepatitis. To find out more or to get involved, CLICK HERE.

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    International Harm Reduction Awareness Day, May 7th

    This year’s theme is YOU, Harm-reductionist Heroes:
    Peer Drug Users, Professional, Volunteers.
    Get communicating: Tweet using the hashtag #IHRD18 & #HarmReductionHeroes to help build momentum for the day and add a Twibbon to your Facebook & Twitter profile picture

    The Yellow Cross was created in Denmark by a civil society and indicates a drug consumption room and that harm reduction is practiced here.

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    World AIDS Day

    World AIDS Day, December 1st, which also launches the start of Aborigianl AIDS Awareness Week in Canada, is a time for reflection: on what we have achieved with regard to the national and global response to HIV, and what we still must achieve.

    World AIDS Day is a day dedicated to commemorate those who have passed on and to raise awareness about AIDS and the global spread of the HIV virus. On a national scale, the Public Health Agency of Canada estimated that 65,040 Canadians were living with HIV in 2014, of whom an estimated 52,220 were diagnosed. This means that an estimated 20% of people in Canada with HIV are undiagnosed and unaware they are living with HIV.

    To learn more, visit: CATIE

  5. 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

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    World Hepatitis Day – July 28th

    Friday, July 28, 2017 marks World Hepatitis Day. This initiative is in response to the May 2016 World Health Assembly’s where 194 governments  adopted the World Health Organization’s Global Strategy on Viral Hepatitis, which includes a goal of eliminating hepatitis B and C in the next 13 years.

    Last year’s theme was “NOhep” while this year’s theme is “Show Your Face.” This campaign invites you to share a photo of yourself accompanied by your own personal “I AM” message to help put a human face to the elimination of viral hepatitis.

  7. Methadone Injection in a Canadian Context

    Background

    • According to the Substance Abuse and Mental Health Services Administration (2012), 669,000 people used heroin in the previous year in the United States. As well, the number of heroin users increased every year for five years in a row.

    • Although methadone is an effective treatment for patients with opioid use disorder and chronic pain, fatalities have continued to rise due to illicit methadone use.

    • The authors aimed to look at the factors associated with methadone injection in an urban Canadian setting where access to methadone prescribed through primary care physicians is common.

    Approach

    The authors used two prospective cohorts of individuals who use drugs in Vancouver (Vancouver Injection Drug Users Study (VIDUS), and AIDS Care Cohort).

    Findings

    • Approximately 7% of participants injected methadone over the study period. The authors found this behaviour to be associated with socioeconomic vulnerability and other addictions.

    • Methadone injection was not associated with enrolment in a methadone program. Interestingly, the findings of this study contrast with other studies, which propose that enrolment in a methadone maintenance program is associated with injection of methadone. Due to this, the authors suggest that these individuals may represent a sub-population of PWID “for whom evidence-based addiction treatment services remain out of reach.”

    • The rates of diversion (transfer of legally prescribed drugs from the patient to another person for illicit use) show a need to implement tools that enhance the flexibility of program rules for patients at low risk of diversion. , while at the same time ensuring that patients at risk of selling their medication ingest their medication at the time it is provided.

    • However, the authors also note that PWID may be purchasing and using street methadone as a means to reduce their heroin consumption and self-treat opioid withdrawal symptoms.

    Conclusion

    The injection of methadone is associated with several other high-risk behaviors. Due to this, access to methadone programs should be optimized while also making efforts to limit diversion of methadone to the street.

    Tucker, D., Milloy, M.J., Hayashi, K., Nguyen, P., Kerr, T., and Wood, K. (2015). Factors Associated with Illicit Methadone Injecting in a Canadian Setting. The American Journal on Addictions. 24:532-537.

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    Declines in Assisted Injection

    Background

    • Research shows that those who get assistance injecting are an especially vulnerable subgroup of people who inject drugs (PWID).
    • However, an injection by another person is common amongst PWID. A previous study found that 41% of PWID in a Canadian city reported assisted injecting within the last 6 months.
    • Those who receive assisted injection are at significant risk of several negative health outcomes. Usually people who help others inject use the same syringe. As well, there is an association between requiring help with injection and syringe sharing, which puts theses individuals at a great risk for blood-borne illnesses.
    • Assisted injecting is strongly associated with HIV and HCV.
    • A previous Canadian study found that those who get assistance with injecting are at over twice the risk of acquiring HIV.
    • Women who inject drugs may be more likely than males to require assistance with injection. Although the reasons for injection assistance may be gendered, other reasons for assisted injecting include a lack of viable veins, reliance upon jugular injection, being in withdrawal, and a lack of knowledge of how to inject.

    Approach

    The authors conducted a gender-based analysis among 1119 people who inject drugs (PWID) in Vancouver to look at trends in the rates of requiring assistance with injection.

    Findings

    • The authors found that rates of assisted injection in last 6 months declined between 2006 and 2014 for both males (21.9 to 13.8 %) and females (37.0 to 25.6 %).
    • However, syringe borrowing remained positively associated with assisted injecting females and in more recent years among males.
    • For women, daily heroin injection, anxiousness and dope sickness emerged as reasons for requiring injection assistance.
    • The most frequently listed reasons for assisted injecting were similar between males and females. The reasons included: jugular injection; bad veins/no veins; and being anxious/dope sick.
    • The amount of both men and women who reported a lack of injection technique as a reason for assisted injection decreased in recent years.
    • However, rates of assisted injection continue to be high despite the decline shown in this study. This is particularly true for females as they have higher rates of assisted injecting in comparison to males.
    • A troubling finding is that the association between assisted injecting and syringe borrowing seems to have strengthened in recent years.
    • For both men and women, injecting in public was continually associated with assisted injecting.

    Conclusion

    The rates of assisted injection among people who inject drugs is declining. Possibly, this may be related to increased awareness of the risks associated with assisted injecting due to improved access to harm reduction information and interventions. However, it is important to recognize that, overall, assisted injecting remains high, particularly among women.

    Pedersen, J.S., Dong, H., Small, W., Wood, E., Nguyen, P., Kerr, T., and Hayashi, K. (2016).Declining trends in the rates of assisted injecting: a prospective cohort study. Harm Reduction Journal. 13:2.

  9. 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.

  10. 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.