B.C. paramedics concerned about misuse of naloxone

Opposing overdose trends in B.C. Interior perplex health officials

The Ambulance Paramedics of B.C. (APBC) are raising concerns that naloxone kits are being misused by illicit substance users and dealers. 

Bronwyn Barter, the president of the APBC, says drug users have developed a false sense of security with naloxone or narcan, the antidote to the overdose of drugs such as fentanyl, carfentanil, heroin, morphine, and oxycodone.

"A lot of the people with addictions are doing different things with those kits. For example, some have a false sense of security, and what they can do is something called yo-yo-ing.  They'll drop a little bit of the naloxone, and they'll drop a little bit of their choice of drug and they think that that will stop them from overdosing," said Barter.

"The latest thing we've seen is some of the known drug dealers are carrying narcan themselves and administering narcan to the people they just sold the drug to and doing that before we get there, almost preserving their clientele," said Barter.

Barter says B.C. paramedics have also seen people using the syringes from naloxone kits for other drugs, leaving them without a syringe for the antidote. 

"It's pretty alarming to us because then we see the numbers of deaths increasing and not decreasing, and I think this has a lot to do with it," says Barter.

Naloxone works by overpowering the attraction that opioids have on the brain's opioid receptors, temporarily reversing the effects of an overdose for between 30 and 90 minutes. 

However, after that time symptoms of an overdose could return, and so it is essential that anyone administering naloxone call 911 immediately. 

Proactive versus reactive

Naloxone kits are available in B.C. from a pharmacy without a prescription. Those who use or have a history of using illicit substances can get take-home kits at no cost, as can their family and friends. 

Last year the B.C. Centre for Disease Control distributed 21,945 naloxone kits, compared to 5,210 from 2013 to 2015. 

In 2017, there have been 5,487 kits handed out as part of B.C.'s take-home naloxone program through March 5.

Barter says the government needs to take a more proactive approach to the opioid crisis, instead of reactive measures like naloxone kits. 

"I think everyone needs to realize that the injection sites and the handing out of naloxone kits is not the shiny solution. It's not the saviour of this crises. And that the government needs to collaborate with health agencies to deal with the underlying addictions issue," said Barter.

"When patients are calling 911 for the ambulance service they basically have jumped off the cliff, and they're not knowing what their landing is going to be. Are they going to live or are they going to die? And, there is so much more that we believe that could be done before then."