A sign in Vancouver, B.C.’s Downtown Eastside warns of heroin cut with fentanyl on Aug. 12, 2015.DARRYL DYCK/The Globe and Mail
After an unprecedented spike in overdose admissions to Surrey Memorial Hospital over the weekend, health authorities are stepping up a program to provide more drug users with overdose kits.
The move comes along with a call from Surrey-Newton MP Sukh Dhaliwal for "an emergency summit" to discuss an alarming increase in the number of overdoses in British Columbia.
"It is a crisis," said the Liberal MP, who on Monday was sending invitations to health officials, police and regional politicians to join him for a brain-storming session on how to address the problem.
"I want to get them all in one room and see how we can deal with this," said Mr. Dhaliwal, who heard on the weekend from constituents alarmed about the soaring number of overdoses in Surrey.
Victoria Lee, chief medical health officer for Fraser Health, said 43 people were treated at the hospital for overdoses between Friday and Sunday, but none of them died because most received naloxone before they arrived at the emergency room.
"If we did not have the amount and dedicated support in having naloxone available across our community … we would be seeing [fatality] trends worse than what we currently see," Dr. Lee said. "We believe … we have effectively reversed overdoses that could have been fatal."
Since last fall, Fraser Health authorities have handed out nearly 900 take-home naloxone kits. The drug can reverse or blunt the effect of an opioid overdose.
Across British Columbia, opioid users with a naloxone prescription can pick up kits for free at 146 locations under a program that has trained more than 6,300 people and distributed more than 5,500 kits. It is credited with reversing hundreds of overdoses across the province.
Earlier this year, firefighters in Vancouver and Surrey became the first in British Columbia to carry the antidote.
Over the past year, the Fraser Health region has had 127 overdose deaths, part of a provincial and national trend that is tied to the increased use of fentanyl and other potent drugs. Doctors prescribe fentanyl, which is 50 times more powerful than heroin, for chronic pain, but illicit versions are increasingly being sold on the street, sometimes mixed with other drugs.
Crack cocaine that contains fentanyl appears to be behind Surrey's recent increase in overdoses, Dr. Lee said.
"With this specific event, we are suspicious that crack cocaine has been contaminated," she said. "A lot of our patients on the street as well as in the hospital have told us that they were taking what they believed to be crack cocaine. However, when we did testing, many of those have come back as fentanyl … which can be toxic and lethal."
Dr. Lee said surges in overdoses have happened before in the province, "but not such a large spike in such a short time and [not one] that's requiring such a significant amount of naloxone."
She said the contaminated crack cocaine could still be in circulation, and overdoses may happen in places other then Surrey.
"We don't know what the distribution looks like," she said. "We do know this is not an isolated event in terms of overdoses overall and that this is part of . . . an alarming increase in overdoses that we're seeing provincially and in other jurisdictions outside of Canada."
She said Fraser Health is stepping up its overdose strategy "through additional targeted education, focused engagement with our communities and enhanced access to naloxone."
Neil Barclay, emergency network regional medical director for Fraser Health, said that, among other things, health workers will try to make sure anyone who comes to an emergency room for an overdose will leave with naloxone.
"Our goal is to provide take-home naloxone to every patient who leaves the hospital having survived an overdose. While we encourage them to seek treatment, take-home naloxone equips them with a potentially life-saving preventative measure they can utilize if required," Dr. Barclay said.
Fentanyl has been a growing problem across North America. In the United States last year, the Drug Enforcement Agency issued a nationwide alert, describing fentanyl as a threat to health and public safety. The Canadian Centre on Substance Abuse reports that between 2009 and 2014, Canada had at least 655 deaths in which fentanyl was the main or a contributing cause.