Pharmacists are calling on the provincial government to cover the costs of a life-saving opiate overdose antidote, as New Brunswick braces for a wave of illicit fentanyl.
A dose of naloxone, delivered through injection, can bring someone on the brink of death back to life.
But officials with the Department of Health say there are no plans to start paying for naloxone kits.
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At the same time, New Brunswick is preparing to launch a long-promised prescription monitoring program, which could restrict the supply of over-the-counter opiates, such as Dilaudid and Oxycontin.
When that happens, critics say addicts are likely to turn to heroin and fentanyl to get their fix, putting more people at risk of overdose.
"We're going to be doing something that's potentially going to contribute to driving people to a fentanyl market, if you will," said Paul Blanchard, the executive director of the New Brunswick Pharmacists' Association.
"We really need to be planning for that likelihood now."
Last fall, officials in Nova Scotia gathered at a summit to build a plan to tackle the opiate addiction problem in that province.
But officials in New Brunswick haven't shown the same sense of urgency.
In December, the province's top public health official said the government is working "behind the scenes" to prepare for the arrival of fentanyl in New Brunswick.
"But we have not been invited or asked to participate in any other broader discussions on this," Blanchard said.
"The response has been muted from the department."
While illicit fentanyl has travelled as far east as Ontario, Blanchard said New Brunswick has the luxury of time to prepare.
Before that clock runs out, he said officials should gather pharmacists, first responders, community groups and others together to make a plan.
That should include a plan to cover naloxone, which is already free for people who need it in Ontario and British Columbia, he said.
"This is life saving," Blanchard said.
"This is very important."
Cost, time barriers to distributing kits
Anyone can now get naloxone without a prescription, thanks to changes made by Health Canada.
But cost and time are preventing the kits from getting into the hands that need them the most.
New Brunswick pharmacies aren't required to carry the drug. If they decide to order it, they have to assemble the kits, which include two vials of the drug and supplies such as syringes, by hand.
A person who wants a kit will have to pay about $40 to get one.
Then a pharmacist needs to spend about half an hour training that person on how to administer an injection.
Alistair Bursey, the owner and pharmacist at the Jean Coutu on Fredericton's north side, has been dispensing naloxone at his pharmacy since 2015.
Bursey, who is also the chair of the Canadian Pharmacists Association, would like to see New Brunswick follow Alberta's lead by putting pre-assembled kits into community pharmacies.
That would make the drug more accessible to addicts and their families no matter where they are, he said.
"We're still waiting on a plan from the New Brunswick government on how this is going to be funded and how we're going to basically put these throughout the community, especially with the opiate tsunami that's coming across this country right now," Bursey said.
'A big worry'
Without funding from the province, community groups like AIDS Saint John are relying on donations to buy naloxone kits.
The organization bought 10 kits last year and plans to buy another six this year.
It has also worked with nurses to train peer helpers and family members of addicts on how to respond to overdoses.
According to a drug overdose database compiled by CBC News, at least 63 per cent of accidental drug-involved deaths in Saint John have involved opiates since 2005.
Diane Kerns, AIDS Saint John's needle exchange program co-ordinator, said she believes naloxone could have saved some of those lives.
Kerns said she worries the problem will get worse once the prescription monitoring program launches, and people migrate toward heroin and fentanyl.
Heroin is "not typically available daily on the street here," Kerns said.
"That would change if the supply of pills dries up. That's a big worry and naloxone would be all the more important if that's the case."
At least one drug dealer in Saint John has been selling fentanyl, she said.
RCMP in New Brunswick have said the drug is circulating in counterfeit Oxycodone pills and in patch form.