INTRANASAL NALOXONE: ELIMINATING PREVENTABLE BARRIERS FOR USE (2022)
THE SAFEST RESPONSE TO TRADE INDUSTRY OVERDOSES IS RIGHT UNDER YOUR NOSE
The toxic drug supply in BC and overdose deaths has impacted lives and livelihoods of many in BC. There are tools available that could combat these preventable deaths; however, barriers exist for individuals to receive life-saving help. Intranasal Naloxone is a tool used that is efficient and easy to use.
Intranasal Naloxone is currently only available to health care professionals and pharmacies. It is not included in the BCCDC Take Home Naloxone kit, which only has the needle option available. The BC Government has a duty to do everything it can to fight the overdose crisis, and that includes providing the intranasal naloxone kit to other organizations that can help.
If administered to businesses that have a disproportionately larger demographic that requires the use of Naloxone, lives could be saved.
Background
According to the 2021 BC Coroner’s Report on Illicit Drug Toxicity Deaths in BC, 71% of people who died of illicit drug overdose last year were between the ages of 30 and 59, and nearly eight-in-ten were men. More than half (56%) of people died in private residences.
A 2018 Fraser Health report, based on the more detailed demographics available at that time, noted that of those experiencing overdose “a disproportionate number of men were currently or formerly employed in trade industries.”[1]
As organizations representing industry across British Columbia – including many businesses in the trades – the issue of illicit drug toxicity and opioid overdose is not only a social issue, but a very prescient one for business continuity and productivity. Recruitment and retention of skilled workers, especially in trades and technical fields, is an issue of top concern from a local to an international level.
The Province of British Columbia should use every tool at its disposal in the fight against the opioid overdose crisis. To that end, we strongly urge the government to immediately make nasal naloxone accessible throughout B.C. at no charge.
B.C. has made tangible strides to combat the opioid crisis through community-based grants, increasing support at Overdose Emergency Response Centres, and by supporting mental health and addictions care in British Columbia. However, we know that the province can be doing more to save lives and that includes making intranasal naloxone free of charge at pharmacies and for front line agencies.
Currently, British Columbia makes intramuscular (injection by needle) naloxone available throughout the province through the Take Home Naloxone program[2]. Since that program was launched, intranasal naloxone has become available in Canada. Currently Ontario[3] and Quebec[4] offer intranasal naloxone as an option along with an intramuscular option. In those provinces, the intranasal naloxone option is overwhelmingly favoured by those who are needle-hesitant, who don’t have the training, or who have dexterity issues.
BCCDC Take Home Naloxone kits are not currently available for private businesses, however, both intranasal and injectable formulations and supplies can be purchased from a community pharmacy.[5]
Usability research has shown that 0% of untrained (and about 60% of trained) users know how to administer a full dose of injectable naloxone, while more than 90% of untrained users were able to administer a full dose of Narcan nasal spray.[6]
Even for those who are experienced in administering the life-saving medication, it can be difficult to do so properly in that moment; much less for a typical bystander, colleague, friend, or loved one who is not adept at the process. “Having access to the medicine in the form of nasal spray could save more lives than the injectable form, because it requires less training and skill to administer, according to Vera Horsman, a nurse at the Portland Primary Care Clinic. "It's so simple. Even for professionals like myself,you're panicking, it's a high intensity situation, your hands are shaking, it can be very difficult to draw up the dose."[7]
The Province of British Columbia must be doing everything possible to limit the deaths of residents because of toxic drug use. Intranasal naloxone is an efficient and easy to use tool to add to the province’s toolbox when it comes to building responses to the opioid epidemic and improving the ability for all British Columbians to help save lives.
Businesses can partner with healthcare and government to develop a collaboration on training and resources for employers to support workers who are struggling with substance use disorder and who may be experiencing overdose.
THE CHAMBER RECOMMENDS
That the Provincial Government:
- Make intranasal naloxone available at no cost via BC pharmacies, similar to the Ontario and Quebec models; ensuring its availability to both individuals and businesses,
- Engage business associations (such as Chambers of Commerce and Boards of Trade) and local Community Action Tables (CATs) in planning effective development and deployment of training and resources to affected businesses in their communities, and
- Provide annually updated disaggregated reporting on the demographics of those experiencing overdose events in order to ensure that these strategies are effective in reaching their appropriate demographics.
[1] 20180122_hidden_epidemic_overdose_emergency.pdf (fraserhealth.ca)
[2] Nasal Naloxone Available at No Cost to First Nations in BC | College of Pharmacists of British Columbia (bcpharmacists.org)
[3] Funding of Naloxone Nasal Spray Kits through the Ontario Naloxone Program for Pharmacies (ONPP) and Updates to the Existing Program (gov.on.ca)
[4] Quebec Government makes NARCAN™ Nasal Spray free to anyone 14 years or older through Free naloxone program (newswire.ca)
[5] Naloxone | Toward the Heart
[6] (PDF) Comparative Human Factors Evaluation of Two Nasal Naloxone Administration Devices: NARCAN® Nasal Spray and Naloxone Prefilled Syringe with Nasal Atomizer (researchgate.net)
[7] High price of naloxone nasal spray makes distribution of vital drug difficult | CBC News