Health

'People are dying': Life-saving opioid antidote hard to find

Naloxone can reverse the effects of an opioid overdose and save a person's life. The trouble is it's still hard to find in Canada.

Naloxone 'should be wherever you think somebody might overdose,' such as high schools, nightclubs, doctor says

Sherry Issac phones pharmacies in Winnipeg as she searches for an opioid antidote called naloxone. (CBC)

Sherry Isaac is a mother on a mission.

Her 26-year-old daughter has struggled with drug addiction for half her life. She has overdosed nine times in 13 years, including once in Isaac's basement.

Witnessing her daughter's crisis has turned Isaac into an activist, a one-woman force who spends her days searching for one drug: naloxone, an antidote that reverses the effects of an opioid overdose.

"This drug has the potential to save a life, not just my child but so many children," she said.

Isaac has called or visited most of the pharmacies in Winnipeg. She's phoned dozens more just outside of the city. She asks the same question over and over again: "Do you carry naloxone?"

Most of the drugstores don't.

"I am not sure if it is about supply and demand or people wanting to stick their heads in the sand, and perhaps drugstores don't want addicts coming into their pharmacies requesting this because the stigma and the shame behind addiction is just disgusting," she said.

'Problem all across the country'​

Access to naloxone is a problem in other cities, too. 

Dr. David Juurlink, a drug safety researcher at Toronto's Sunnybrook Hospital, went on his own search for naloxone in pharmacies. When he couldn't find any, he took to Twitter.

"I mean people are dying," he said. "Dozens every week. All them, in theory, revivable by the early administration of naloxone."

Opioids include prescribed painkillers such as fentanyl and OxyContin, which are also sold on the streets, as well as illicit drugs like heroin.

Health Minister Jane Philpott has called the increase in opioid overdoses a "national health crisis."

Between January and October, 622 people died of unintentional overdose from illicit drugs in B.C., the coroner's office said.

Police in Ontario estimate there were 700 deadly opioid overdoses in the province last year — a bigger killer than car crashes.

In June, the Ontario government announced naloxone would be available free without a prescription at pharmacies across the province.

But Juurlink says so far most pharmacies aren't stocking it.

"I think what I am alarmed most by is the sheer number of them that seem not to have it," he said. "You can understand why the occasional pharmacy here or there wouldn't have it, but really, this is a problem all across the country in every province in every city and every town."

Access to naloxone is a patchwork across Canada. (Cameron MacIntosh/CBC)

Dr. Aaron Orkin, an emergency room physician at Mount Sinai Hospital in downtown Toronto, has noticed the problem firsthand.

"Most corner drugstores you walk in and you say, 'I need a naloxone kit.' They will give you a little bit of a sideways stare and not be sure of what you are even talking about."

The Canadian Pharmacists Association says getting thousands of kits into pharmacies is a massive challenge. The group says pharmacists aren't reluctant to dispense the drug, but they do need to be trained on how to do so properly.
This drug has the potential to save a life, not just my child but so many children.- Sherry Isaac

Besides Ontario, Alberta also provides naloxone for free through pharmacies and emergency services, and B.C. and Quebec do so for high-risk individuals. The kits retail for around $35.

RCMP officers and first responders in Manitoba are now equipped with the life-saving kits. 

Newfoundland and Labrador and Nova Scotia have set up targeted distribution programs through public health agencies. There are also training programs that teach how to use the naloxone kits. 

'Naloxone saves lives'

Juurlink argues distribution through pharmacies and public health agencies isn't enough to battle the epidemic.

"Naloxone saves lives, it saves them quickly and it should be wherever you think somebody might overdose," he said.

"It should be in nightclubs, it should be in high schools, it should be in gas stations, it should be in corner stores and it should be free or available at very little cost."

Firefighters Jason Lynch and Jay Jakubec try to revive a man who has already had two doses of naloxone after overdosing on fentanyl in Vancouver’s Downtown Eastside. (CBC)

Naloxone has been around since the 1970s. It's safe and cheap, Juurlink says.

He says the opioid crisis was fuelled in part by doctors over-prescribing the potent painkillers, much of which was paid for by public health plans. Those same governments, he says, should find the money to make naloxone widely available. 

"I mean the alternative ... is not finding the money and people will continue to lose their sons and daughters and brothers and sisters."

Back in Winnipeg, Sherry Isaac is optimistic.

She got a text the other day from her daughter. The message said she's been drug-free for nine days.

But Isaac is also a realist. She keeps a naloxone kit on hand, hoping she'll never have to use it.