Vancouver – The fifth anniversary of the Take-Home Naloxone Program, which has reversed over 10,000 opioid overdoes so far, marks a bittersweet milestone for the harm reduction team at the BC Centre for Disease Control (BCCDC).
They’re proud of the lives they’ve saved—but know the opioid crisis is far from over.
The Take-Home Naloxone program launched on August 31, International Overdose Awareness Day, in 2012. In 2013, just 36 overdoses were reversed using a take-home naloxone kit. That number climbed to over 4,000 in 2016, and is already over 6,000 for 2017. But even with the programs in place, hundreds of people are still dying of illegal drug overdoses—over 780 since the beginning of 2017.
For Judy Darcy, BC’s Minister of Mental Health and Addictions, the next steps are clear. “Immediate harm-reduction programs such as Take-Home Naloxone are crucial,” she said. “But we also know we need a system of addictions care. I’ve seen first-hand the pain that mental illness and addiction can cause. If people who are suffering are going to get well, they need to be able to get help when they ask for it. They also need to feel safe doing so, which means we need to address the stigma associated with drugs.”
Dr. Jane Buxton, the harm reduction lead at BCCDC, agrees. “One of the next hurdles is reducing stigma—because it’s deadly,” she said. “While the Take-Home Naloxone Program is saving lives, it’s just one piece of the opioid response.”
Currently, most overdoses are reversed by paramedics and other health care workers, as well as loved ones of people who use drugs. The take-home kits rarely help people who use drugs on their own—a demographic that, according to BCCDC experts, may account for as much as 50 per cent of illegal drug overdoses. Among people who don’t survive overdoses, as many as two-thirds were using alone.
“People typically hide their drug use because of the stigma,” said Margot Kuo, an epidemiologist at BCCDC. “This makes them less likely to ask a friend to check on them, and less likely to seek medical attention for their addiction. They’re also much less likely to be attended by paramedics if they overdose, because there is no one to call 911. Our data clearly show that people who use alone are more likely to die. If they’re going to survive their addiction, we need to address the stigma by showing compassion rather than judgement.”
One of the primary causes of the stigma, according to Dr. Nader Sharifi, a physician with BC Mental Health and Substance Use Services, is that many people don’t understand addiction.
“Addiction is a chronic disease, not unlike high blood pressure or asthma,” said Sharifi. “It’s characterized by a loss of control, craving and compulsion to use a substance with negative consequences. But just like high blood pressure or asthma, addiction can be treated with success rates similar to the chronic diseases we typically treat. Only when we look at addiction with this lens, in a non-judgmental manner, can we remove the stigma associated with it and move forward on a path to recovery.”
Reducing stigma is one of the actions set forth in the BC Overdose Action Exchange Report, issued on August 15, 2017.
The broad expansion of the Take Home Naloxone program in 2016 and 2017 supports the work of the Joint Task Force on Overdose Response established in 2016. As part of the wide range of action, partners across the health system also continue to expand access to opioid addiction medications and treatments such as Suboxone, open more overdose prevention sites, work with Health Canada on approvals to open additional supervised consumption sites and improve the system of substance use services.
- 22,494 Take-Home Naloxone kits were distributed in 2016. So far in 2017, 25,388 kits have been distributed.
- There are currently 558 distribution sites for take-home naloxone kits, up from 407 in 2016 and 108 in 2015.
- BC Emergency Health Services paramedics responded to 7,770 illegal drug overdoses between January 1 and July 30, 2017.
- 4 per cent of illegal drug overdose deaths in 2017 have occurred inside. Of those, 57.4 per cent occurred in private residences.
- Of overdose patients in emergency rooms who were asked this year whether they had used alone, 40 per cent did not want to answer. Of those who did answer, 33 per cent said they had used alone.
- Visit com to learn more about harm reduction programs, including Take-Home Naloxone and overdose prevention sites.
- Visit bcmhsus.ca to find out about mental health and substance use services available in BC.
- Reduce stigma by using respectful, person-first language when talking about drug use.
- Watch the stories of people who have used drugs in this video series on reducing stigma by Northern Health.
The BC Centre for Disease Control, an agency of the Provincial Health Services Authority, provides public health leadership through surveillance, detection, treatment, prevention and consultation services. The Centre provides diagnostic and treatment services for people with diseases of public health importance, and analytical and policy support to all levels of government and health authorities. The BCCDC also provides health promotion and prevention services to reduce the burden of chronic disease and preventable injury. For more, visit www.bccdc.ca or follow us on Twitter @CDCofBC.
The Provincial Health Services Authority (PHSA) plans, manages and evaluates selected specialty and province-wide health care services across BC, working with the five geographic health authorities to deliver province-wide solutions that improve the health of British Columbians. For more information, visit www.phsa.ca or follow us on Twitter @PHSAofBC.