Nikolas Hotte describes the opioid situation in Eastern Ontario as “stable.” Though he’s quick to add that doesn’t mean local health organizations and partners aren’t preparing for a possible outbreak.
Hotte is the Program Manager for substance misuse, injury prevention and tobacco control for the Eastern Ontario Health Unit (EOHU).
“Our main message we want to share with the public is that fentanyl could be in any street drugs,” he said during a presentation at the latest Committee of the Whole meeting at the United Counties of Prescott and Russell.
You’d be hard-pressed to find someone who hasn’t heard of fentanyl in the last couple of years. To give you a sense of the synthetic drug’s potency, it’s one hundred times stronger than heroin. It can come in liquid, powder, pills or patches and street drugs are often cut with it as a means to make higher production at lower cost.
Éric Larocque, Advanced Care Paramedic Superintendent with local emergency medical services, said during the presentation that the use of fentanyl patches are a problem in Prescott-Russell.
“People will cut the patch in 10 or 15 squares and it’s designed to release the medication hourly with the right dosage, but when it’s cut, the concentration isn’t equal in all sections,” he said. “One day the little square will be fine, the next it could be the square with a high concentration.”
Sadly, the number of deaths related to opioid overdose continue to grow across the country, prompting reactionary measures the try and curb the crisis. Hotte said 2018 is already on pace to be a record year for number of deaths once again.
See below for recent statistics on the opioid-related emergency visits and deaths in Eastern Ontario.
New prevention group
Hotte was reticent to say a crisis was inevitable.
“I wouldn’t necessarily forecast that. That being said, with our proximity Montreal and Ottawa, if their cases increases our cases could increase as well…. It’s something we’re looking for,” he said.
During the presentation, he outlined two scenarios for a crisis: rapid or progressive. In the former, a group could all be unknowingly using fentanyl-laced drugs at an event like a party or festival. This is akin to what happened a few years ago in Cornwall with Jimsonweed, and it wasn’t the first time. In this case, the community faces a flair-up in overdoses, but the situation will likely de-escalate very quickly as well.
In the other scenario, the drug would be introduced gradually into the larger network, which would make it much more difficult to snuff out and could overwhelm local resources. This is the case in larger cities, such as Vancouver’s Downtown Eastside.
The EOHU has partnered with dozens of other community partners in the region ranging from various police services to hospitals to fire services to create the Drug Awareness Group. The goal of the group is to streamline data sharing and communication, as well as establish an emergency preparedness plans all in the name of prevention.
One need only look at the recent drug bust in Alexandria to see prevention measures are necessary in the area.
Need for harm reduction
Harm reduction is another important aspect to controlling for an outbreak, said Hotte.
Hotte shared some harm reduction strategies:
- Don’t consume alone
- If you know you’re consuming opioids, get a naloxone kit
- Take a test dose
- Do not be afraid to call 911.
- The Good Samaritan Drug Overdose Act protects against arrest if you call in an emergency overdose situation, as long as you aren’t a producer or distributor and you don’t have an arrest warrant.
- Do not mix drugs with other drugs or alcohol
- If you’re going to use, do it somewhere where emergency services will be able to access in case of any issue
- Do not operate a motor vehicle under the influence
- Use clean/sterile needles if you consume intravenously. The EOHU has a free needle exchange program and other harm reduction services.
“People are going to use drugs, we want to show they can use them more safely,” he said. “We aren’t saying that using drugs is OK, we’re just meeting people where they’re at.”
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