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Dr. Norm Buckley on opioid addiction

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Dr. Norm Buckley on opioid addiction 35:22

High-ranking medical officials, police and educators are preparing to unveil new guidelines in Hamilton to curb prescription drug misuse, including the proposed use of a type of “Epipen for addicts" called prophylactic Naloxone.

Prophylactic Naloxone is administered in much the same way as an Epipen — an automatic injection device that administers epinephrine to counter a severe allergic reaction.

Prophylactic Naloxone can reverse the effects of an overdose of prescription opiates like oxycodone, fentanyl, percocet and morphine for about 10 minutes.

Norm Buckley

Doctor Norm Buckley is the professor and chair of the Department of Anaesthesia at McMaster's DeGroote School of Medicine. (Adam Carter/CBC)

“It’s long enough to get someone to hospital instead of watching them die in front of you,” said Dr. Norm Buckley, director of Hamilton Health Science’s pain clinics.

On Thursday, U.S. regulators approved the device to treat painkiller overdoses, in a move to combat the rise of opioid-related deaths and abuse of the painkillers. According to the New York Times, the attorney general’s office is pushing for a kit with the drug and training to use it that would be given to every state and local officer in New York.

Prophylactic Naloxone is just one of the ideas in a new “template for action” that officials have banded together to create to fight a growing prescription painkiller problem in Hamilton. Officials hope this template can be used across Canada.

A rapid rise in illegal opioid use has driven doctors, police, pharmacists, the coroner’s office and addictions counsellors to form a special task force to find ways to better combat the growing problem.

The group began meeting just over a year ago. All the stakeholders have seen the same issue the last five years — increased use and abuse of prescription painkillers in Hamilton. But the tricky part is curbing illegal prescription drug misuse while allowing patients medically needed access to opioids.

Withdrawal program admission 2nd highest in province

According to statistics obtained by CBC Hamilton from the Drug and Alcohol Treatment Information System, admission rates for local opioid withdrawal programs are now the second highest in the province, behind northern Ontario.

In 2002, one in 10 people who entered a withdrawal management program at St. Joseph’s Healthcare was an opioid patient. In 2012, the rate was one in four. The number of female opioid withdrawal patients at St. Joseph's is more than double the provincial average.

As well, opiate deaths make up over half of all acute drug-related deaths in the city, according to the coroner’s office. Years ago, heroin was the most common opioid doctors saw. Now, it’s prescription pills.

“We’re hoping this really is a practical, local set of guidelines,” Buckley told CBC Hamilton. “This is getting it to a front-line practitioner and patient to make a difference.”

Other proposed practices laid out in the group’s drug guidelines include:

  • Physicians reporting all incidences of illegal activity.
  • Pharmacists promoting the return of unused medication to pharmacies.
  • The coroner’s office calling any physician to learn about deceased patients or medication found at the scene of a death.
  • Police notifying doctors when medication with their name on it is seized.
  • More data gathering from hospitals, community groups and drug manufacturers.

'We don't talk to each other'

Some of those proposed practices seem like common sense, but most of the big players in drug prescribing and enforcement rarely talk to each other. That leads to people slipping through the cracks, and a more rampant abuse of the system.

Communication between agencies is currently severely lacking. Under the guise of “privacy concerns” to protect patients and the law enforcement process, many organizations are reluctant to release any information about a person involved in a drug case or abuse situation, Buckley says.

Under current guidelines, if someone is convicted of trafficking prescription medication and Buckley’s name is on the bottles, he wouldn’t be called unless he was part of the investigation.

“And right now, if a patient of mine dies, I almost never hear from the coroner,” Buckley said. That’s part of what he’s hoping to change.

Most groups — especially law enforcement — seem “very keen” on the project, Buckley said. The hope is that come Friday evening, the group will have created a set of guidelines ready to be implemented across the city that will help save lives.

“This has the potential to be a really impactful thing.”