FATAL-OVERDOSE PREVENTION PLAN IN WORKS FOR DOWNTOWN EASTSIDE HEROIN ADDICTS

Emergency kits would contain new nasal spray formulation of antidote

Vancouver drug addiction experts are considering a plan to equip
injection drug users and others living or working on the Downtown
Eastside with emergency antidote kits that can be used to rescue
addicts from potentially fatal drug overdoses.

The kits would likely contain a new nasal spray formulation of the
drug naloxone, which is usually injected. The nasal spray is now
being tested at the Insite supervised injection site before a
potential Downtown Eastside rollout.

Addiction experts hope that people who live or work in the Downtown
Eastside can be trained to use the drug and act as first responders
when they witness an overdose. They would spray the antidote up the
nostrils of unresponsive addicts as a life-saving measure.

The naloxone nasal spray has been used by Insite nurses 10 times
since it was introduced to the facility two months ago. Previously,
nurses injected the drug (also known as Narcan), but the locally
compounded nasal formulation is considered preferable since it avoids
potential needle injuries that may lead to HIV or other infections.

Liz Evans, co-director of the Portland Hotel Society, which helps
operate Insite, said that from September 2009 to September 2010
Insite nurses witnessed 202 drug overdoses, 69 of which required
naloxone injections.

Opioids like heroin depress the urge to breathe and naloxone quickly
reverses overdose symptoms. Paramedics and hospital emergency
departments routinely use it for that purpose.

"In the injection site, we often use oxygen to revive people, before
[using] naloxone. Out in the public realm, such as at the Carnegie
Centre, in an alley, or on the street, there is no access to oxygen,
so naloxone is more important out on the street," Evans said.

A study published last week from researchers at the B.C. Centre for
Excellence in HIV/AIDS showed that since Insite -- North America's
first medically supervised injection facility -- opened in 2003, drug
overdose deaths have been dropping. In 2008, there were 159 in B.C.,
with 30 to 40 of those occurring in the Downtown Eastside.

Mark Townsend, co-director of the Portland Hotel Society, said the
nasal drug is being enthusiastically embraced by nurses at Insite. He
said the next step would be to distribute emergency kits to needle
exchange vans, alley patrollers, the Carnegie Community Centre,
Downtown Eastside hotels and other sites where drug addicts congregate.

"Ideally, it would be nice if people weren't addicts. But since there
are many who are, wouldn't it be great if someone could save some
mother's child's life?" he said.

Anne McNabb, a director of mental health and addictions for Vancouver
Coastal Health, said the topic of intervention has been discussed but
until the nasal spray was developed, emergency intervention kits
weren't as viable.

"Deaths are deaths and we want to prevent them," she said, adding:
"Now that there is an intranasal formula, we can reconsider."

Thomas Kerr, a co-author of the overdose deaths study, said: "Any
preventable deaths are a concern. The view that people who are drug
addicts shouldn't be saved is indefensible. Are we supposed to
condemn people who have a well-defined medical condition to death?"

Kerr, an assistant professor at the University of B.C. department of
medicine, supports PHS's effort to have members of the Downtown
Eastside community trained to administer the drug.