Pharmacists look at how to get fentanyl off the streets

Canada's pharmacists are starting to talk about ways to keep the dangerous prescription drug fentanyl off of the streets.

Several people in Saskatchewan have died over the past year after overdosing on the drug

A new study found fentanyl-related deaths are on the rise in Canada, with one Canadian dying every three days from the prescription opioid. (CBC)

Canada's pharmacists are starting to talk about ways to keep the dangerous prescription drug fentanyl off of the streets.

It's a move the mother of one overdose victim may welcome.

"Policy makers have to step up," said Maria Agiortis. "What have we done for prevention and awareness in our country? In our communities?"

Fentanyl is a highly potent and addictive synthetic opioid. It is most often administered in a skin patch to treat severe chronic pain in people for whom other opiates such as morphine no longer work.

Fentanyl can be fatal to someone not used to taking it, causing them to stop breathing.

An arrested drug dealer told the CBC people are stealing fentanyl patches, and extracting the drug for use on the street.

Patch-for-patch system 'on radar'

Fentanyl, a synthetic opioid painkiller, is flooding the illegal drug market and has been involved in a rash of drug overdoses across Canada. (CBC)

Now, according to a memo obtained by the CBC, there is talk of introducing a fentanyl patch-for-patch program. Patients would turn in their used patches when they go to get new ones at the pharmacy.

It's "being considered in both provincial and federal legislation", wrote Glen Doucet, a vice-president with the Canadian Pharmacists Association.

Here in Saskatchewan, the registrar of the College of Pharmacists Ray Joubert said the idea "is on our radar".

He said in used patches, there is still some residual amount of the drug, which can be extracted and abused.

Joubert said it's still unknown how widespread this practice is, although he confirmed the patches are widely available across the province through pharmacies.

Nor does he know yet if fentanyl is being stolen directly from pharmacies. Those are both questions that require more research, he said.    

Still, he thinks the patch-for-patch program is worth considering.

'Fastest growing problem of drug abuse in Canada'

"The Canadian Centre for Drug Abuse released a bulletin recently that suggests that fentanyl abuse is the fastest growing problem of drug abuse in Canada, so we need to pay attention to that and see what we can do," Joubert said.

He is trying to initiate a discussion with partners in Saskatchewan's prescription review program.

It monitors the prescription of drugs such as fentanyl, to make sure they are used properly.

One of those partners is the College of Physicians and Surgeons. Its registrar, Dr. Karen Shaw, said some patients are already required to exchange their patches if they have a history of drug abuse, although there is no formal program established so far.

But, it's on the agenda for a meeting coming up with the College of Pharmacists, she said, along with other possible steps to prevent fentanyl overdoses.

A patch exchange is only a partial solution to the street trade in fentanyl, Shaw observed. It doesn't stop the flow of fentanyl from illicit sources "and we (the college) have no ability to control that," she said.

Naloxone antidote to fentanyl 

Kelly Best (left) of Saskatoon, died from a fentanyl overdose. His older brother Kayle introduced him to the drug. (Submitted by Marie Agioritis )

Meanwhile, groups such as the Canadian Pharmacists Association are also talking about making an antidote to fentanyl, Naloxone, more readily available.

In Saskatchewan, paramedics trained to use it have Naloxone "readily available to them on an ongoing basis", a Ministry of Health spokesperson wrote in an email to the CBC.

But as for making it available through pharmacies, "no decisions have been made yet".

Joubert said legislation that would allow pharmacists to administer Naloxone, which is given by injection, has not yet come into effect.

The antidote "is just one step in trying to resuscitate a patient that has had an overdose," Shaw said.

They may need help breathing, for instance, "so I'm not sure that just having it available by a pharmacist would be a timely enough response," Shaw said.

Naloxone is also a subject for more discussion before her organization takes a position, she said.