Nasal Spray Helps to Prevent Death from Accidental Opioid Overdose
Prevention and Treatment Accidental opioid overdose kills thousands of Canadians per year, yet access to lifesaving treatment is impeded by the negative stigma associated with opioid users.
About 4,000 Canadians died last year from accidental opioid overdose. Many of these were from prescription pain medications such as codeine, morphine, and OxyContin, which are often used to treat conditions such as cancer, neuropathy, or chronic pain caused by permanent physical injury or disability.
Many situations can lead to an accidental opioid overdose. “It can come from a loss of tolerance, medication mismanagement, and even kids getting access to it by mistake,” says Mark Barnes, an Ottawa-based pharmacist and vocal advocate on the dangers of fentanyl abuse and other opioid addictions. “Accidental overdose can also occur when patients are initially prescribed a dose that is too high for their tolerance level, or if they have additional medical problems, such as asthma, chronic obstructive disorder (COPD), and/or other breathing difficulties,” he says.
Nasal spray for emergency opioid overdose
Because people who overdose on opioids are unconscious and unable to breathe, it’s critical that they receive immediate emergency treatment. The drug naloxone, an opioid antagonist, counteracts the life-threatening effects of opioid-related overdose. One form of administration is by injection, which requires some skill and training and is typically used by first responders. Thanks to the nasal spray form of Naloxone called NARCAN, available since 2016, the drug can also be given more easily by anyone, including family, friends, and caregivers. “NARCAN is like an EpiPen for opioids, but in a nasal spray form,” says Barnes. “All you need to do is place it into the nostril of a non-breathing opioid overdose and spray,” says Barnes. The drug temporarily reverses the overdose effects until paramedics arrive.
NARCAN Nasal Spray is currently available free of charge at pharmacies in Ontario and Quebec. Barnes would like to see free access to NARCAN across the country for anyone who is at risk or knows someone at risk. “It should be similar to what we do for people with heart disease, where we give them their nitro spray and heart pill,” says Barnes. “If you get an opioid, you get a NARCAN kit.”
Better understanding of opioid use and addiction needed
Barnes believes one of the biggest roadblocks to free patient access to NARCAN is the stigma surrounding opioid use, addiction, and treatment. “People don’t really understand why people use opioids and that it’s not a social choice,” says Barnes. “They use opioids to kill the pain, which is often more mental than physical. It could be used for post-traumatic stress disorder from the military or from being first responders,” he says.
To reduce the stigmas associated with people perceived to use opioids, Barnes believes we need to elevate the conversation beyond what it is today. This can be done by having more medical professionals talk about misuse of opioids, providing better education for pharmacists on how to approach people at high risk for opioid addiction, instituting mandatory dispensing of NARCAN with opioid prescriptions, and raising public awareness. “You can’t use NARCAN on yourself, so we need to help people realize that this is really a toolkit they should have in their house just in case of accidental cross-contamination or overdose,” says Barnes.
Canadians can do their part to help reduce deaths from accidental opioid overdose by advocating for better access to life-saving NARCAN Nasal Spray through their provincial health coverage and by requesting a kit at their pharmacy.