Toronto bars begin carrying naloxone to help combat opioid crisis

Within days of opening her new bar in west-end Toronto, Carmen Elle had equipped the venue with what she considers a key piece of equipment: a naloxone kit.

Elle, who is also a musician, said it took time to find a pharmacy that carried the free kits, which are used to temporarily reverse overdoses from opioids including the deadly drug fentanyl.

But having one on hand — and making sure staff know how to use it — is crucial to ensure the venue, named Less Bar, is a safe space for all patrons, she said.

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"Any possible way to avoid somebody seriously OD-ing and possibly dying, I think it's the responsibility of everybody who manages and runs these spaces (to do it)," Elle said. "Why wouldn't we all just do that? It's so easy."

As public health officials across Canada seek ways to tackle what they've called a growing opioid crisis, some in the nightlife industry are taking steps of their own.

Several bars and music venues in Toronto now stock naloxone kits, and while the Ontario Restaurant Hotel and Motel Association does not have a policy on the opioid antidote, its president Tony Elenis said members are taking precautions nonetheless.

The bar owners association of Quebec, meanwhile, said it was weighing a policy on naloxone kits, with a decision expected in the coming weeks. The Alliance of Beverage Licensees of British Columbia did not immediately respond to a request for comment.

Lee's Palace, a popular music venue in Toronto, got a kit earlier this year after its assistant manager, Norm Maschke, was advised to do so by a friend who is an outreach worker.

Since then, Maschke has encouraged others to follow suit, saying the kits are "a must, not just a want."

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"People do like to party late at night at bars and music clubs and elsewhere and it would be in our best interest to make sure that if somebody does end up in a compromising position that we can at least help them as best we can. To not do it is negligent," he said.

So far, there have been no fentanyl-related incidents at Lee's, Maschke said. Still, he said, "I feel like it's inevitable and I don't want to just push it off and then be met with a situation and then I'm not prepared."

Toronto Public Health said there are no downsides to having access to the kits in bars and other venues.

"Naloxone should be available at any location where there may be people at risk of overdose," the agency said. "Additionally, anyone who needs access to naloxone should be allowed to carry and administer it, including people who use drugs, their friends and family, or others who may be in a position to administer this lifesaving medicine."

At least 2,816 Canadians died from opioid-related causes in 2016 and the country's chief public health officer predicts that number will surpass 3,000 this year.

Pharmacy-distributed kits increased

Naloxone is available without a prescription at pharmacies in several provinces, including Ontario, Quebec, Alberta, Nova Scotia, New Brunswick and Prince Edward Island.

The number of kits distributed through Toronto pharmacies has increased since they were made available by the province in July of last year, according to public health officials.

Close to 1,400 were handed out by Toronto pharmacies between January and March of this year, with another 1,039 distributed by Toronto Public Health during that time, the agency said.

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One hurdle for those interested in having a kit is that pharmacies can run out, said Elle, who said it took some searching to find one.

"It's available but it doesn't seem to be in great enough supply that you can just go into any Shoppers Drug Mart and grab one," she said.

What's more, obtaining one can be an intimidating process, she said, noting that she received what she called strange looks from those giving out the kit. It felt awful to experience even a fraction of the stigma that people who use substances must face, she said.

"I don't want that to happen at Less Bar and I'm looking to create an atmosphere where that doesn't really happen."