Like our neighbours to the south, Canada is experiencing an opioid epidemic due to the overprescription of pain medications. This has led to the increased use of illicit fentanyl, a potent opioid that we commonly use in the hospital, by many patients addicted to prescription opioids. There were an alarming 247 deaths in Alberta in 2015, due to fentanyl overdoses.
An imperfect solution to this problem has been to increase the availability of a well-known blocker of opioid medications, Naloxone (Narcan®). Here is what patients need to know about take home naloxone (THN) in Alberta.
What is Naloxone?
Naloxone is a medication that blocks the receptors that opioids activate in the body. By blocking opioid receptors naloxone reverses the sedating, blood pressure reducing and respiratory reducing effects of opioid drugs.
For years, naloxone has been used in hospitals to manage opioid overdoses and to quickly reverse the effects of opioid after surgery. THN is now available across Canada without a physician prescription.
Who Qualifies for Take Home Naloxone?
Anyone who uses or plans on using opioids—like fentanyl—can receive a prescription for THN. It is important that their family and friends are aware of the availability of the THN kit so that they can administer it in case of a fentanyl overdose.
Where Can I Get Take Home Naloxone?
Since 2015, Alberta Health Services and Alberta Health have been working to make naloxone available in walk-in clinics, pharmacies, and hospital emergency departments. Check-out this interactive map of THN availability in Alberta.
What to Tell the Pharmacist
If you have decided to request a THN kit from a pharmacy, call ahead to make sure a qualified pharmacist can sell you the kit. As of May 13, 2016, naloxone for use in the emergency treatment of opioid overdose outside the hospital, has moved to what is called “Schedule 2”. This means naloxone does not require a prescription, but can be sold by pharmacists. It will continue to be behind the counter so you must speak with the pharmacist to request THN.
You will need to inform the pharmacist if you use opioids or are at risk of a fentanyl overdose. You should also inform the pharmacist if you have ever had a bad reaction to the any ingredients in naloxone, including methylparaben or propylparaben. Also disclose to the pharmacist if you are pregnant or breastfeeding.
What is Included in the Naloxone Kit
The kit should contain two vials of naloxone (0.4 mg/mL), two syringes, two alcohol swabs, gloves, a rescue-breathing mask, and instructions for use.
Your pharmacist will review the contents of the kit and the proper administration of the medication into your muscle. They should also review the signs of a fentanyl overdose and when to administer a second dose.
Currently in Canada, medical professionals only have injectable vials of naloxone. Other countries have auto-injectors (think of an Epi-pen) or nasal sprays. Maybe we’ll see alternatives available soon since these methods can facilitate rapid administration of naloxone.
Stopping A Fentanyl Overdose
Naloxone is a small part of the solution to our opioid epidemic. Making THN kits available in pharmacies, without the need for a prescription, is an example of how pharmacists can practice harm reduction and increase accessibility to a life-saving antidote for a fentanyl overdose.