Saskatchewan to expand naloxone access as advocates call for more action

Saskatchewan's health minister says the government will expand access to the life-saving antidote naloxone as a record
number of people are dying from drug overdoses.

Although pharmacies in the province don't usually distribute free naloxone, some started to when the COVID-19 pandemic arrived to limit the number of people in hospitals and clinics.

Jim Reiter says about 12 pharmacies are providing naloxone and talks are underway to expand the service and possibly waive the cost.

"You'll see ... expansion of availability. The question is exactly how it's implemented," Reiter told The Canadian Press in a recent interview.

"The more available we can make it, the better."

The provincial coroners service has recorded 40 confirmed and 190 suspected deaths related to drug overdoses so far this year.

At a combined total of 230, that's already higher than 2018 considered the deadliest year of the past decade when there were 171 drug fatalities.

"We have seen the increases in British Columbia, and Alberta and Manitoba, and we knew this would sooner or later start to find its way into Saskatchewan," said Clive Weighill, Saskatchewan's chief coroner.

"That's exactly what's happened."

Driving the spike is the deadly opioid fentanyl and its derivatives, Weighill said. Fentanyl is often mixed with other illicit drugs like methamphetamine and cocaine, as well as alcohol, he said.

Jason Mercredi, executive director of Saskatoon-based Prairie Harm Reduction, said demand is skyrocketing for naloxone, which can reverse the effects of an overdose.

"In May, we gave out more than we had given out in all of 2019," he said.

The organization, which provides drop-in and other support services, is one of about 35 locations that distribute free
take-home naloxone kits paid for by the province.

The Ministry of Health says that to get a free injection kit a person has to identify as being at risk of an opioid overdose, or of witnessing one, at a health centre or community organization.

Since the program began in 2015 to the start of February of 2020, more than 4,800 kits had been distributed. In the last six months, it provided more than 3,642 kits.

First Nations and Inuit people can use their federal benefits to receive kits for no cost at pharmacies. For everyone else, a kit from a pharmacy costs about $40.

Unlike community pharmacies in British Columbia, Alberta, Manitoba and Ontario, those in Saskatchewan aren't equipped to distribute free kits under the provincial program, said a report last year by the Canadian Institutes of Health Research.

"We thinkthese kits should be free for everybody and people should be carrying them, especially with the way we see overdoses increasing," Mercredi said.

Myla Bulych, director of professional practice with the Pharmacy Association of Saskatchewan, said the group has been advocating for years for community pharmacies to hand out free kits more widely.

"There are over 400 pharmacies in Saskatchewan so our accessibility is huge, not only geographically, but also we have
expanded hours," she said.

"We're probably the most accessible health-care provider for naloxone."

Jenny Churchill's son, Jordan, died of a suspected fentanyl overdose in 2018. The Regina mother-turned-advocate said one barrier is that many places handing out free kits are closed evenings and weekends.

"To say, 'OK, push pause on your disease ... push pause this weekend and we'll talk about it on Monday' ... That's
unacceptable."

Churchill said she fields calls from people asking where they can get the antidote. She carries naloxone nasal spray and has somebody who provides her with kits.

"I'm out in the community a lot and I need to be able to respond to someone that calls me and says'It's seven o'clock on a Saturday night. I need a kit,"' she said. "Arrest me. I call it the 'Dallas Buyers Club."'

Naloxone availability helps, but Weighill said it's the "end of the line" in tackling the complex issue of addiction.

"I would rather see us getting ahead of it by working on the prevention, working on the intervention, working on treatment," he said. "People can come up with all kinds of plans and ideas, but there really is a psyche involved with addiction that has to be looked at."