Tuesday January 10, 2017

Ontario prepares for fentanyl crisis as the drug moves eastward

Toronto Mayor John Tory addresses the media while city officials meet with organizations to share information and come up with ideas to keep opioid users safe. Toronto has been told to 'be ready' for fentanyl.

Toronto Mayor John Tory addresses the media while city officials meet with organizations to share information and come up with ideas to keep opioid users safe. Toronto has been told to 'be ready' for fentanyl. (Chris Young/The Canadian Press)

Listen 19:20

Read story transcript

Politicians and health officials have warned that fentanyl abuse is a growing crisis in Ontario.  

On Monday, Mayor John Tory announced Toronto will work toward increasing the availability of naloxone kits, and will press for month-to-month data of overdoses and death. Last week, police warned of the dangers of fentanyl in Ontario's Red Lake and Ear Falls.

Leaders are calling for a co-ordinated strategy to prepare for a spike in fentanyl consumption.

Toronto prepares for fentanyl overdoses2:19

 

But painkiller addiction is nothing new, and Dan Malleck, a medical historian and associate professor in health sciences at Brock University, says we can learn from earlier prescription drug crises.

"When morphine was isolated in the middle of century, physicians didn't know how much stronger it was then opium. And people were having overdose deaths — or at least overdose crises — when doctors started prescribing it incorrectly."

These users tended to be middle-class people who had access to medical care and became addicted by drugs prescribed by doctors.

We're seeing similar trends with fentanyl.

Oxycodone, morphine, codine, heroine, fentanyl — many of the drugs with a troubled history of overdose fatalities— are opioids, otherwise known as painkillers.

Fentanyl was introduced as a fast-acting, surgical painkiller.

naloxone kit grh

Naloxone kits are effective in counteracting the effects of a number of opioid drugs, including fentanyl. (Grand River Hospital)

Malleck says to stop opioid epidemics we have to improve our understanding of pain management.

"Pain management is something that we need to talk about, because the fentanyl crisis is the end process of needing pain treatment of some kind  — whether physical pain, or dealing with emotional, or spiritual, or psychological pain."

"What is driving so much pain?" asks Malleck.  

He speculates circumstantial factors, like the inability to pursue health needs when they arise, could be the source of problems, but stresses the likely influence of an overburdened health system.

'People get painkillers for immediate problems until they can get to the more sophisticated treatment, and by that point they may be hooked.' - Dan Malleck

Malleck says that in order target these underlying problems, we need to become more comfortable talking about addiction, and seriously confront the role of stigma. 

"What type of behaviours do the stigmas around drug use drive? Not only among users ... what does that stigma do for physicians?"

"If people are hiding use — if it's so far in the shadows — then it's really hard for it to be viewed and treated if needed. And then we end up in cases where people are accessing heroine cut with fentanyl, or fentanyl and they don't quite know the dosage.  All of these things that lead to death."

Listen to the full conversation at the top of this post. 

This segment was produced by The Current's Sujata Berry and Willow Smith.