Opioid overdose calls are surging in 2 N.B. cities. Here's what fire chiefs are calling for

The fire chiefs in two of New Brunswick's largest cities say their departments are dealing with a spike in opioid overdose medical calls, and they're asking the province to help with the rising costs of a crisis.

Saint John's fire chief and EMO director Kevin Clifford says his firefighters had to administer about 130 doses of Narcan last year — a nasal spray of the medication naloxone, used to reverse the effects of a known or suspected opioid overdose.

That's twice as many doses as the previous year.

The Saint John Fire Department is on pace to be close to 130 doses again this year, said Clifford, who recently shared that data with the city's public safety committee.

Sometimes firefighters are sent to help the same person three times in one day, he said.

"The spike for us is unique over the last couple years, but you know Ambulance New Brunswick is administering Narcan, our police officers are administering Narcan, so when you add it all up, it's really quite a serious issue," Clifford said.

The calls have not been to homeless tent encampments, but to wealthier neighbourhoods, all over the city, said Clifford.

Most of the overdoses happen after people take fentanyl, which is 50 to 100 times more powerful than heroin, he said. Users report it's a quick high that's cheap and easily accessible.

The Moncton Fire Department has also seen about a 40 per cent jump in overdose calls over the past three years, according to chief Conrad Landry.

"Right now we're averaging between four and five overdose calls per day," with one or two requiring Narcan, at a cost of $80 per dose, said Landry.

"We used to spend maybe $1,000 of Narcan every year. Last year, the number was a little over $20,000," pushing the department's medical supplies budget over budget.

Cities are currently footing bill

The two municipalities currently cover the cost of the drug.

But Clifford and Landry say governments in other provinces, including Nova Scotia, cover the drug for fire departments as a health-care cost. They think New Brunswick should follow suit.

"Medical first response is not our primary business," said Clifford. "Medical services is more of a provincial mandate.

"We added it because we're here, we have the skills. … If somebody needs our [help] and we can be there, you know, minutes before other people, we should go."

Landry said his firefighters worry that they're responding to so many overdose calls, their response to a fire could be delayed.

Meanwhile, he suspects part of the increase could be because fire departments often arrive at the scene earlier than ambulances, due to health-care shortages or delays at hospitals.

He notes when firefighters arrive first and administer Narcan, that means paramedics don't have to, which spares costs for Ambulance New Brunswick.

"I think there should be a cost-sharing … or an exchange program, or even bulk purchase that we could have a better price," he said.

According to Clifford, a number of requests by Saint John to have Narcan covered by the province have been turned down.

Province offers take-home kits

Department of Health spokesperson Sean Hatchard said medical first response services provided by fire departments are "valuable and appreciated."

"Having said that, the Department of Health does not provide funding to fire departments," he said in an emailed statement.

New Brunswick's take-home naloxone program offers injectable naloxone kits for free to people who are at risk of an overdose, to family and friends and to anyone who is most likely to witness and respond to an opioid overdose, Hatchard noted. Kits are available for pickup from community agencies.

Between October 2018 and December 2022, a total of 6,788 take-home naloxone kits were distributed, he said.

The 3,415 take-home naloxone kits distributed in 2022 amounted to more than double the 1,670 kits distributed in 2021.

"The province monitors opioid-related harms through a surveillance system and responds appropriately, as needed, by working with its partners," Hatchard said.

Fredericton costs manageable, for now

The Fredericton Fire Department isn't facing the same kind of costs, said assistant deputy chief David McKinley. Although Narcan calls have doubled over the past couple of years, the Moncton department has more each day than his department has had so far this year, he said.

Seven doses of Narcan have been administered, up from six doses all of last year and eight in 2021.

The department's budget can handle the amount they're using for now, he said. "If that becomes harder, obviously we might have to talk to the province … and see if they could help."

If fire departments used needles to administer naloxone instead of the nasal spray, they could cut their drug costs by more than half, according to Landry.

Needles, however, come with more safety concerns for both firefighters and patients, and require more training, he said.

Narcan is a very effective tool, said Clifford. "I've heard our firefighters say the person goes from basically being seconds away from death to wide awake," he said.

The calls, though, can take a mental toll, said Clifford.

"It's very challenging because we want to help. But when you're going to the same person three times in one day, there's a deeper issue here and the person needs a different kind of help."

He says many people are working on the root issues, such as housing, and opportunities for education and work. The fixes won't be quick, but he's optimistic.

"I don't think we'll ever eradicate addiction … but I think we can get to a better place."