What does an opioid overdose look like and feel like? Find out here.
Fentanyl, featured in Unstoppable: The Fentanyl Epidemic, is the latest and most powerful opioid drug to hit Canadian streets and has grabbed headlines for the last year as more people have taken doses that ended up being fatal. But addiction to pain killers — both prescription and black market — is nothing new.
Drug overdose is a major cause of death, and opioid overdoses are driving this epidemic.
In B.C. this year, drug overdose deaths reached an average of 64 per month, leading the provincial health officer Dr. Perry Kendall to call it a public health emergency. About half of these deaths were directly attributed to fentanyl abuse. In some parts of Canada, drug overdoses are killing more people than motor vehicle accidents. In Ontario, one in eight young adult deaths is linked to opioids.
Prescription opioids are part of the problem.
A UN report says that Canada is the second-highest per capita consumer of prescription opioids. Doctors legitimately prescribe drugs like oxycodone, fentanyl and morphine for short-term pain management after surgery or for chronic conditions like cancer. But experts say that opioids are prescribed too readily and that fentanyl, the most powerful of the three, should only be used as a last resort. New evidence is showing that other drugs — like medical marijuana — would work just as effectively for some patients with far fewer dangerous consequences.
A percentage these prescription opioid users go on to become recreational drug users and turn to the black market to purchase their drugs. Researchers are trying to find out which of these patients are more likely to become addicts so they can find alternatives for those at risk while still delivering pain treatment to those who need it.
Recreational opioid use is an even bigger problem.
According to the US National Survey on Drug Use and Health more than 75 per cent of recreational opioid users got their pills from sources other than doctors — mainly friends and relatives. Experts say that the real risk for opioid addiction is youth. Like most addictions, the majority of opioid addictions start with experimentation in adolescence or early adulthood.
Inpatient rehab and abstinence is not the best treatment for opioid addiction.
The WHO and the National Institute on Drug Abuse agree that maintenance treatment — possibly lifelong methadone use — is a better treatment for addiction to opioids. Although evidence-based treatments have been available for years, few patients receive them. But change is coming to Canada. In August 2016, the government enacted new rules that allow doctors to prescribe pharmaceutical-grade heroin to treatment-resistant addicts.
Watch, The Nature of Things documentary, Wasted for more information on evidence-based treatments for addiction.
Safe injection sites decrease overdose deaths in communities where they are available.
Vancouver’s Insite (featured in Unstoppable: The Fentanyl Epidemic) was, for a long time, the only safe injection site in North America. More are on their way; the city of Toronto has asked the federal government to approve three additional sites.
Over a decade of research from Insite has shown that safe injection sites save lives. Fatal overdoses near Insite decreased by 35 per cent compared to a decrease of 9 per cent in other areas of Vancouver. Injections sites are also effective at preventing other diseases like HIV, reducing crime in the surrounding community and serve as a bridge to detox and treatment. Fifty-seven percent of people who use them ultimately enter treatment.
Naloxone programs prolong life in communities where they are available.
Naloxone is an injectable medication that can reverse the effect of opioid drugs. Distributing naloxone and training people to use it can cut death rates by nearly half.
That's why in the spring of 2016, Health Canada changed the status of naloxone to a non-prescription drug. In many Canadian provinces, it’s now available over-the-counter in pharmacies for free so that it can be used in emergency overdose situations.
It is possible to recover from opioid addiction.
Opioid addiction is a serious problem. But so are other addictions. Research shows that it takes the average alcoholic 15 years to recover. One-third of addicts recover on their own without any treatment, a phenomenon known as ‘maturing out.’ Opioid addiction can be deadly, and addicts should most definitely seek medical treatment. But it doesn’t have to be a death sentence.