Week 6: Opioid crisis and safe consumption sights Flashcards
Opioids
prescribed pain relief medications such as codeine (in Tylenol 3), fentanyl (duragesic), Morphine (doloral), oxycodone (oxycontin, percocet), hydromorphone (Dilaudid), and medical heroin. Opioids can also be produced or obtained illegally.
Approximately what fraction of people in Ontario filled an opioid prescription in 2015/2016 and what percent of the population is this
1/7, 14%
How many apparent opioid toxicity deaths between January 2016 and March 2023 and how many hospitalizations
deaths 38514, hospitalizations, 37697
How many deaths/day in Canada in 2023
21
Of all accidental opioid deaths from jan-march in 2023 what percent were fentanyl
81%
True or false: this crisis is bad in british columbia and alberta, middle in ontario and getting better as we go east
true
What year was the peak of opioid morbidity and mortality and what year did it decrease
2021, 2022
True or False: Disproportionally men dying from opioids
True
Causes of opioid deaths
High rates of opioid prescribing
Emergence of strong synthetic opioids (e.g., fentanyl) in the illegal drug supply (fentanyl is a cheap way to make street drugs more powerful)
Policy responses to this crisis
Provide help, in whatever form, to those taking opioids
Provide support to individuals to help stop taking opioids
Provides services to ensure opioid use is as safe as possible
Provide resources to the public to prevent opioid-related overdoses
reduce/change opioid prescribing practices
Change pharmaceutical marketing practices
Reduce the illegal production, supply, and trafficking of opioids
Eliminate/ abolish/ prohibit unhealthy or harmful practices of behaviors
‘Prevalence reduction’, often via criminalization
Harm reduction: a set of strategies to reduce the negative consequences associated with unhealthy or harmful practices of behaviors.
Examples of things to target individuals taking opioids
Wellness together canada (help line)
National overdose response service (NORS hotline)
Drug rehab services
Narcotics anonymous
Overdose intervention app
Harm reduction supplies (e.g., sterile needles)
Supervised consumption sites and services
How to target the general public
Raise awareness about opioids, overdoses, and other policies directed at reducing opioid-related harms
Opioid response training (e.g., st. john’s ambulance)
Free naloxone kits and training
Target health practitioners
Effectively allows healthcare practitioners to track opioid prescription practices
Will receive primary care reports
How many you’ve provided vs how many other prescriptions
Creating a registry, resources for healthcare providers to reduce opioid abuse
What are the substances strategies
Prevention strategies, e.g., opioid prescribing guidelines, handouts for patients
Treatment strategies, e.g., promoting evidence based approaches to treatment
Enforcement strategies, e.g., reduce controlled substances being diverted from otherwise legal activities, like pharmacies
Harm reduction strategies, e.g., safe consumption sites
Evidence strategies, e.g., systematically collect information about opioids and their harms
Funding strategies, e.g., provide grants to community-led organizations to respond to drug issues
Consultation strategies, e.g., to gather input from impacted communities
Good samaritan drug overdoes act
federal law that came into force in 2017 that provides some legal protection for people who experience or witness an overdose and call 911 or their local emergency number for help.
What does the good samaritan drug overdoes act protect individuals from
Charges for possession of a controlled substance
Breach of conditions in probation orders, parole, etc
Who does the act apply to
anyone seeking emergency support during an overdoes, including the person experiencing an overdoes
What section do you have to seek exemption from to operate a supervised consumption site
section 56.1 of the federal controlled drug and substances act
Safe consumption sites
designated sites where people can use their own drugs under the safety and support of trained personnel
AKA safe injection sites, supervised injection sites, overdose prevention sites, etc
Commonly offer a range of evidence-based harm reduction services, such as drug checking, and provide access to important health and social services, including substance use treatment
Primary objective of safe consumption sites
Help prevent overdose deaths (via drug checking and emergency medical care, and because people are not rushing or using alone)
Provide health care (e.g., wound care)
Facilitate entry into addiction treatment programs and other health and social services (e.g., housing, employment assistance, and food banks)
Reduce the spread of bloodborne infections (e.g., HIV, hepatitis C) by providing access to clean drug use equipment and safe disposal, as well as testing/screening
Reducing the strain on emergency medical service
How many sites are currently offering services in canada
39
How many visits take place everyday
2700
How many visits take place at the busiest safe consumption site
400
Between 2017-June 2023
How many visits
How many unique visitors
How many overdoses and drug related medical emergencies, with no reported on site fatalities
What percent of substances consumed were opioids
4.3 mil visits
361000 unique visitors
49000 overdoeses
70% substances
Urgent public health need sites
Similar to supervised consumption sites, but established on a temporary basis to respond to urgent needs tin a specific region or community
AKA ‘overdose prevention sites’
Class exemptions under the controlled drugs and substances act authorize the minister of health in each province and territory to establish urgent public health need sites as required
It is the minister of health’s discretion if they wish to to implement the class exemption or not
