Fighting the fentanyl epidemic

Adelle Ellis
Times Reporter

Kevin Link – Photo

 

Under a new ministerial order, non-regulated medical first response (MFR) agencies, such as law enforcement and firefighters, are now permitted to carry and administer naloxone to fentanyl overdose patients.
The order was announced on Feb. 7 in response to an increase in opioid- and fentanyl-related drug-induced deaths.
“We see more (call outs for drugs) than we used to, it’s an increasing trend. Opium overdoses, and particularly fentanyl, is becoming more common,” said Kevin Link, paramedic and operations manager with Wheatland Emergency Medical Services (EMS).
Naloxone is a highly effective drug that reverses the effects of any opiates such as fentanyl, codeine, oxycodone, morphine, Percocet and heroin. The drug is extremely safe to use and only works on opiate overdoses. If someone was to be administered naloxone even if they were not overdosing on an opiate, it would not harm them as it exhibits essentially no pharmacologic activity.
Though as with any medication, some rare but serious side effects, including death, can persist so the administrant of the drug must weigh the potential side effects with the potential benefits.
The government of Alberta is providing interested MFR agencies free training about opioid overdoses and how to administer naloxone. The naloxone kits are being provided to MFR agencies at no cost. There are two versions: an intermuscular injection (most common) or a nasal spray injection.
“I think it’s quite proactive that they are allowing injectable medications to be given by first responders,” said Link. “As paramedics, we have a lot of training and a lot of experience delivering a multitude of injectable medications. It was quite thoughtful of the province to put this ministerial order forward so that (first responders) can use (naloxone).”
Naloxone kits are also available at all pharmacies for the public to pick up, at no cost to them, if they believe they or a family member is at risk of a fentanyl overdose. Training on how to determine an opioid overdose as well as how to administer naloxone will be given by the pharmacists to individuals wishing to take home a naloxone kit. Take-home naloxone kits are only available as intermuscular injections.
MFR agencies are not required by law to carry and administer naloxone in the event of an opioid overdose; they remain free to make their own operational decisions regarding carrying and administering naloxone.
Several local MFR agencies are choosing to be proactive regarding potential fentanyl overdoses in Strathmore and Wheatland County by receiving training and carrying the naloxone kits.
“What brings it to the forefront [for us] is in the last six months our department has responded to two drug overdose cases. On one of the cases, we saw naloxone administered by the ambulance system, we saw the ease of administering the drug and we were able to witness how fast the patient responded to naloxone,” said Rockyford firefighter Darcy Burke.
Although exact fentanyl overdose and death statists aren’t available for Wheatland County, in 2016, 149 people died from fentanyl-related deaths within the Calgary region, which runs all the way from Banff towards the eastern borders of Wheatland County. A total of 138 deaths were within the City of Calgary limits, meaning 11 deaths took place in rural communities. It is unknown the exact number of overdoses not resulting in death.
“(Fentanyl overdoses are) not a huge, huge problem here but we do respond to several overdoses a month,” Link said. “Our crews have done a great job with saving many people in our community.”
He added that the trend of fentanyl use is growing and it is affecting more people.
Strathmore’s deputy fire chief agrees.
“(Fentanyl use is) an epidemic. The (Alberta) government has started to realize that and that’s why they’re working with agencies such as ours to be able to roll (this program) out,” said Bas Owel. “Obviously, the best thing is prevention and education. For the case where we need to administer (naloxone) we want to be prepared as well.”
He added that the Strathmore fire department is in the process of implementing the program and that firefighters are currently receiving training for naloxone and are attending lectures on fentanyl.
The Strathmore Wheatland and Addictions Team (SWAT) stated that it firmly believes in education and prevention. SWAT is a community focus group and outlet used to educate community members about addictions. In the past, they have run a few educational programs in Brentwood school and they hope to expand to teach more students about the dangers of drugs, although “it is difficult to get into schools and to fit into their current program schedules,” said SWAT representative Jeff Cyr.
Although SWAT doesn’t deal with programs for people with addictions, they do have connections and the ability to refer addicts to groups with more addiction-related programs and resources.
“We deal with drugs and addictions on a more preventative note,” said Cyr, who added that the group is looking for individuals with a strong drive to get involved so they can start offering more programs and education sessions to the community.
Offering naloxone training and naloxone kits to MFR agencies also helps keep first responders safe as well. Not only can MFR agencies now administer potentially lifesaving treatment to fentanyl overdose patients, but they can also administer it to fellow first responders if they encounter the drug during a callout.
“For us it is about protecting ourselves as well. Without (this program) we wouldn’t be able to protect ourselves if we had an exposure. Because of our emergency response nature, we don’t know what we are going to run into,” said Owel, who added that it only takes two milligrams of ingested fentanyl to be lethal and that carfentanyl can be lethal just by touching it.
“We wanted to do this (program) two-fold: one reason is for patient care, and the other is for our own health and safety,” he said.
As the rate of fentanyl usage and fentanyl-related death increases in Alberta, it is more important now than ever to be vocal about the dangers of drugs.
“(You) need to be scared and respect the dangers of trying street drugs even one time, because the one time you try it might be your last time,” said Link. “The sad thing about this is I think it will eventually affect every family and every household in the province. You never know when it is going to hit, no one is immune from it.”