Province to target 'hot spots' in distributing naloxone kits

As Nova Scotia gears up to handle an expected increase in narcotic overdoses, naloxone kits will be distributed first to medical first responders in "hot spots" of the province.

Those areas have been identified as parts of Cape Breton and the Halifax Regional Municipality, said Dr. Andrew Travers, the provincial medical director for Emergency Health Services (EHS). 

In the last week, some firefighters and emergency response officials have suggested all rural fire departments should be equipped with naloxone kits.

Distributed in phases

Travers said naloxone kits are being distributed in phases. The first phase targeted paramedics while the second phase involved training the communications centre to talk people through administering a naloxone kit over the phone.

Some firefighters and volunteer firefighters, who are also known as medical first responders, are now being trained to use naloxone nasal spray kits. 

In July, the province announced it would be placing naloxone in pharmacies beginning Sept. 1. 

"I know that there's always the question with regards to, should we have naloxone in other areas of the province, with other providers. And sure, we are going to work towards that area, but we're going to do it in a controlled and evidence-based and integrated fashion," said Travers. 

"We're doing that in partnership with government and with municipalities and with the other areas that are monitoring the narcotic epidemic, and actually focussing on those hot spots first, to get those firefighters trained in naloxone delivery to bystanders." 

Travers said EHS encompasses more than 200 agencies and 3,000 volunteers. 

Less risk than first thought

In response to concerns from some firefighters about their personal safety when they might be exposed to fentanyl on the job, Travers pointed to the latest research released by scientists studying fentanyl in mid-July. 

"The risk isn't as high as what people may be thinking," he said.  

"Yes, there is an occupational risk associated with things, but it's not one that is perhaps what people are envisioning — that if you are in the same room as a dose of fentanyl, that you're going to get overdosed on it."

Can't be absorbed through skin

Previous accounts from first responders have suggested they were exposed to fentanyl by being in the same area as the drug.

But Travers said the latest research suggests exposure happens when a synthetic opioid gets into the brain through being ingested or being exposed to mucus membranes.

"Just being exposed to skin, or being in the same room as fentanyl is one where the risk is not there," he said. 

Travers said he felt if there was ever a high-risk call such as a drug lab, EHS would hold back teams until protected staff could go in and tend to the people inside safely. 

He said EHS has been looking to groups such as the American Academy of Toxicologists for guidance on practices.