New Brunswick opioid report: a glimpse into a larger picture of drug use

·5 min read
Naloxone kits are available in Moncton from a vending machine outside Ensemble Moncton's office. (Sarah MacMillan/CBC - image credit)
Naloxone kits are available in Moncton from a vending machine outside Ensemble Moncton's office. (Sarah MacMillan/CBC - image credit)

New Brunswick's latest numbers are out and they show more naloxone is being used, and being dispensed to the public, than ever before.

The department of Public Health released its quarterly report, Opioid Related Harms in New Brunswick: Deaths, Overdoses and Take Home Naloxone Kits.

The information in the report was gathered from Ambulance New Brunswick, the Chief Coroner's office, non-government organizations, detoxification centres, correctional centres and hospitals.

The report states, "in August and September, the number of individuals administered naloxone reached an all-time high."

In 2019, 253 people were administered naloxone by a paramedic, that number grew to 317 people in 2020.

But while more people were administered naloxone by emergency medical staff, fewer people responded to it. According to the report, "naloxone only has an effect if opioids were consumed."

Dr. Sara Davidson said when people with a drug use disorder can't access opioids, they may turn to stimulants like crystal meth and speed to ward of withdrawal symptoms.
Dr. Sara Davidson said when people with a drug use disorder can't access opioids, they may turn to stimulants like crystal meth and speed to ward of withdrawal symptoms. (Gary Moore/CBC)

Dr. Sara Davidson, medical director at River Stone Recovery Centre, and family physician at the Fredericton Downtown Community Health Centre said this could mean that paramedics are seeing the signs of overdose, but patients are in crisis because of a different substance.

Davidson said most illicit opioids come from "diverted prescriptions," and during the lockdowns of 2020, those substances were most likely harder for people to access from their usual sources like walk-in clinics, doctors or people who sell their prescriptions.

"People may have been turning to stimulants, especially things like crystal meth and speed as alternate drugs to use to stay out of the feeling of withdrawal," said Dr. Davidson.

"That's usually the driver for continued opiate use, is just wanting to stay out of withdrawal."

But even of the people who were using opioids, most were using other substances at the same time.

The report states that, of the 158 people who died from an apparent opioid-related overdose between January 2016 and September 2020, nearly 99 per cent had consumed opioids alongside one or more other substances like alcohol, with benzodiazepines and antidepressants among the most commonly used.

The report also shows, more take-home naloxone kits are out in the public than ever before.

A new report from the department of public health shows that between the start of 2016 and September 2020, there were 289 drug-related deaths, with opioids suspected as being the cause in over half.
A new report from the department of public health shows that between the start of 2016 and September 2020, there were 289 drug-related deaths, with opioids suspected as being the cause in over half. (Eric Baradat/AFP/Getty Images)

Between Ensemble Moncton, Avenue B in Saint John, AIDS Fredericton, eight detoxification centres and three correctional centres, 267 take-home naloxone kits were distributed in 2018, while that number was 694 in 2019 and a steadily increased to 737 in 2020.

The report, in part, credits a dispensing machine installed outside of Ensemble Moncton late last year with the surge. The machine dispenses tools to make drug use safer by giving tools like clean syringes, crack and meth pipes, condoms and naloxone kits.

Between 2018 and 2020 the number of kits dispensed in Moncton increased nearly tenfold from 28 to 253.

Debby Warren, executive director of Ensemble Moncton said she purchased the machine because COVID restrictions decreased the access the organization had to its clients.

Now, everything it has to offer is available 24 hours a day for free. Warren said 65 per cent of the people who use the machine do so when the office is closed.

"Drug use is not just done during business office hours," she said.

The report credits Debby Warren's harm reduction vending machine, set up at Ensemble in Moncton, for increasing the number of naloxone kits dispersed to people in the province.
The report credits Debby Warren's harm reduction vending machine, set up at Ensemble in Moncton, for increasing the number of naloxone kits dispersed to people in the province.(Tori Weldon/CBC)

And she added, the more naloxone kits out in the public the better, because when they're needed, they're needed.

"We've had people running down the street in their bare feet in the snow screaming for a kit because someone who they were with was in an overdose," said Warren.

The report says that in 2020, 20 kits were reportedly used, but it notes that information about the naloxone kits is done "at the client's discretion and level of comfort" so more kits could have been used, but the people using them may have not offered that information.

Of those 20 people, only half say they called 911, and "the primary reason was fear the police would come," according to the report.

Dr. Davidson said she hears the same thing in her clinic. She said she once asked a group of patients for a show of hands as to how many people had used a naloxone kit on someone they knew, "almost all of them had."

Then she asked how many had then called 911 for help, "none of them had," said Davidson.

"I'm grateful that those folks are savvy enough to help someone through, but it's still scary and really looks at how we have to have opiate use disorder or any kind of drug use disorder become a public health and physical and a mental health issue, not a legal issue."

Dr. Davidson said the police are normally sent to 911 calls reporting a suspected overdose. She says she's hoping an ambulance-only service can be developed for people who need emergency services, but are scared of criminal charges if the police also show up.

The New Brunswick government did not make anyone from Public Health available for an interview.