New Brunswick·CBC Investigates

New Brunswick 'totally unprepared' for fentanyl crisis, critic says

The New Brunswick government says it is taking the threat of a fentanyl overdose crisis seriously. But its plan to combat the crisis remains a mystery.

Province hasn't revealed its plan to tackle addiction to opioids, arrival of fentanyl

Fentanyl, a synthetic opioid painkiller, is estimated to be around 50 to 100 times more toxic than morphine. (CBC)

For months, New Brunswick has watched as provinces like Alberta and British Columbia saw hundreds of people die from fentanyl.

But the province still hasn't revealed how it has prepared for a similar overdose crisis here.

And critics say New Brunswick is running out of time to come up with a plan.

Earlier this month, RCMP seized a Percocet pill on Esgenoôpetitj First Nation that tested positive for fentanyl.

There have been six suspected overdoses in that community since April 10.

A 35-year-old woman died on Esgenoôpetitj First Nation on April 11 and police are awaiting a toxicology report to confirm fentanyl was involved.

CBC News has been keeping a database that tracks drug overdoses in New Brunswick dating back to 2008. It shows at least 18 people have died from fentanyl since 2011.

It's proof that New Brunswick isn't prepared to handle a fentanyl crisis, according to Julie Dingwell, the executive director of AIDS Saint John.

"We're totally unprepared," she said.

In Saint John, Dingwell hears about people having non-fatal overdoses from fentanyl on a daily basis.

She's worried more people will overdose, especially if fentanyl is cut into their drugs without their knowledge.

"We knew it was coming," Dingwell said. "We just failed to act."

No public plan

Dr. Robert Strang, Nova Scotia's chief medical officer of health, says the province couldn't wait to take action on the opioid crisis. (Darren Calabrese/Canadian Press)
In December, the province's acting chief medical officer of health said the fentanyl threat was being taken seriously.

Dr. Jennifer Russell said the government was working "behind the scenes" to come up with a plan.

But the government hasn't revealed that plan to the public.

Neither Russell nor Health Minister Victor Boudreau were available for an interview on Thursday.

In an emailed statement, Russell said the province has formed a "preparedness task group" that is looking at things like treatment gaps and how to collect data on overdoses.

That group hasn't consulted pharmacists, according to Alistair Bursey, chair of the Canadian Pharmacists' Association.

He wants to see the province take action on fentanyl sooner rather than later.

"The fact that we haven't had effective communication on what the plan is is very concerning," Bursey said.

'We couldn't just sit and wait'

Dr. Jennifer Russell, New Brunswick's acting chief medical officer of health, has said the province is working "behind the scenes" to prepare for fentanyl. (CBC)
That's a different approach than in Nova Scotia, where the chief medical officer of health has started rolling out the province's plan.

The province has changed the way it tracks opiate abuse, collecting monthly data on non-fatal overdoses from emergency rooms and paramedics.

"We have done a number of things knowing that we couldn't just sit and wait for everything," chief medical officer of health Dr. Robert Strang said.

Last fall, the province announced $500,000 toward funding naloxone, an opioid overdose antidote.

The drug is now supplied to community harm reduction groups for free, and Strang hopes to make it free in pharmacies for anyone who wants it.

The results are already paying off.

"In all likelihood we've had successful reversal of at least 50 overdoses, in just less than a year of having community access to Naloxone projects up and going."

AIDS Saint John executive director Julie Dingwell questions whether a doctor in a jail should be able to override the wishes of a person's family doctor or a psychiatrist. (CBC)
New Brunswick, in comparison, doesn't fund Naloxone for anyone who wants it. Boudreau has said there isn't enough need to warrant covering the cost for everyone.

That means people need to pay $35 per dose if they want it — a price too steep, Dingwell said, for most people using drugs.

"I understand that governments are always watching the bottom line," she said.

"I think we sort of have to figure out is a life worth the $35 naloxone kit."

The tip of the iceberg

Pharmacists also want the provincial government to fund naloxone.

Bursey would like to see New Brunswick copy Alberta by getting the antidote into as many hands as possible.

He believes it will save lives, as fentanyl circulates throughout the province.

Alistair Bursey, a pharmacist-owner in Fredericton and chair of the Canadian Pharmacists' Association, believes that drug monitoring will be a useful tool in fighting opioid addiction. (CBC)
"This is just the tip of the iceberg," he said.

New Brunswick's "task group" is looking at "the availability and distribution of naloxone," Russell said.

While many first responders in the province are trained on how to use naloxone, the province isn't committing to fund it for anyone — meaning groups like AIDS Saint John will need to fundraise to buy doses.

Most people in the province have private drug coverage and would be able to buy naloxone through that, Russell added.

But many of the desperate people who walk into Dingwell's office each day don't fall into that category.

"I don't know many of the people that we work with who would have $35 to get a kit."