How can the East Coast cope with the cross-country march of opioids?

As the spread of fentanyl and other powerful opioids claim more lives across the country, The House looks at how the crisis has been tackled so far, and how one province that has yet to be hit hard, New Brunswick, could soon be affected.

There were more than 2,800 opioid-related deaths across Canada in 2016, including in the Maritimes

A naloxone injection kit can prevent death from a heroin, morphine or fentanyl overdose. (Monty Kruger/CBC)

As a teenager in foster care in northern Ontario, Mandy Richard began snorting Percocets and OxyContin before turning to almost anything she could get her hands on, including hydromorphone and Tylenol 3.

The relief the highs brought her were more potent than the fear of an overdose.

"Then you're looking for your next fix, and you're aching for it and you're anxious for it. You need it," she said.

Richard left her addiction in Ontario to start a new life in Fredericton when she realized her education was at stake.

"I was a role model. I was student council president," she told CBC.

Mandy Richard says she started snorting opioids when she was 16 to self-medicate. (Facebook)

She is currently finishing her last year at St. Thomas University — a world away from her home reserve in northern Ontario.

A report released this week by the federal government says opioids are killing an average of eight Canadians every day, and the scourge, as forewarned, is now moving east into Atlantic Canada.

Yet despite what's been learned in B.C., where the province declared a public health emergency almost a year and a half ago, New Brunswick is finding itself unprepared for what is landing on its doorstep. It is, for example, one of the few provinces that still doesn't offer free naloxone kits — the potentially lifesaving opioid overdose antidote — in pharmacies.

The province's chief medical officer of health admits things could get worse before they get better.

In the Maritimes, the number of publicly funded prescriptions for opioids increased by 26 per cent between 2010 and 2015, according to data compiled by the Canadian Institute for Health Information. The figures show the increase in New Brunswick was 28 per cent over that period.

Dr. Jennifer Russell says New Brunswick isn't immune to the fentanyl crisis, but it has yet to hit hard. (CBC)

But New Brunswick doesn't have the same prescription monitoring program that Nova Scotia has and some front-line workers worry that once prescription pills aren't readily available, illicit fentanyl will gain a bigger foothold.

Dr. Jennifer Russell, New Brunswick's acting chief medical officer of health, told CBC the province's response plan will be made public in the coming weeks and the province is planning a summit on the issue in November.

"I think it's probably going to get worse before it gets better. I think ramping up all of the things that we need to do to deal with the situation as it evolves is really important," said Russell.

Premier Brian Gallant and New Brunswick's new health minister, Benoît Bourque, weren't available for an interview.

Churches fundraising for naloxone 

Julie Dingwell, executive director of AIDS Saint John, said she has seen evidence that people have been using fentanyl in the province for some time now. 

"We've even had people using crack say, 'I used crack and then I slept for a day.' ... You would never normally sleep on crack," Dingwell said. "I think we're in the middle of the mess, but I don't see an end in sight at the rate we're going."

What would help, said Dingwell, is having naloxone kits readily available, but the kits are not easy to come by in the province.

Dr. Robert Strang, Nova Scotia's chief medical officer of health, says the decriminalization of narcotics needs to be discussed. (Darren Calabrese/Canadian Press)

"Our government has initiated a fentanyl overdose committee as a response to things, but a committee is not getting naloxone in the hands of the people who need naloxone," she said.

By approaching community groups and churches, her agency has raised enough money to buy about 45 of the $45 kits.

AIDS Saint John estimates that of the 328 overdose deaths in New Brunswick between 2005 and 2015, more than 60 per cent involved opioids. Deaths, she said, that may have been prevented with naloxone.

"Oh, we would need hundreds [of kits]. We would need hundreds," she said.

Nova Scotia case

The Canadian Institute for Health Information report shows that New Brunswick already has a higher rate of opioid poisoning hospitalizations than its neighbour Nova Scotia.

And that province is already implementing its own plan to deal with the crisis.

Anyone who wants a kit of injectable naloxone can get one at no cost at their local pharmacy

Dr. Robert Strang, Nova Scotia's chief medical officer, said the province is considering what to do next, including a push to decriminalize heroin and cocaine.

"Initiatives like naloxone and supervised injection sites are necessary, but they really are a Band-Aid," he said.

"Unless we're comfortable with letting large numbers of people, who are often marginalized, impoverished or in addiction for a whole bunch of reasons, unless we're prepared to essentially write those people off, we need to have this conversation [about decriminalization]."

In an interview with CBC Radio's The House, federal Health Minister Ginette Petitpas Taylor quickly shut down that possibility.

"The issue of decriminalizing drugs is not something that we're looking at. What my priorities are as health minister is right now, first and foremost, is reducing barriers to treatment for many people that are using substances that are harmful to them," she said.

Petitpas Taylor said her department is looking into making substitution therapies, like methadone, more easily available.


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