Harm reduction for the opioid crisis


The opioid crisis continues to rattle Canada, taking approximately 21 lives per day in 2022. Opioids are drugs derived from opium, a narcotic in the poppy plant. Opioids are highly addictive drugs and can easily lead to an overdose. In response to the crisis, the federal government introduced the Good Samaritan Drug Overdose Act in 2017 — a law that ensures anyone who experiences or witnesses a drug overdose will receive medical assistance and not be charged with possession. The act’s purpose is to provide legal protection for the person overdosing as well as bystanders. The act’s goal is to encourage people to phone for help without fear of repercussions.

During the first two years of the pandemic, there was a 91 per cent increase in apparent opioid toxicity deaths, and a student-led initiative at the University of Waterloo hopes to tackle these troubling statistics. Students Supporting Opioid Stewardship (SSOS) held a naloxone training seminar on November 8 to teach students about naloxone, commonly known as Narcan. Naloxone is a harm reduction measure; it is a drug that temporarily disables the effect of opioids and is used to prevent overdoses. Although naloxone is publicly funded in Ontario and available for free at pharmacies, most people don’t know when or how to use it. The naloxone training seminar, taught by Dr. Ashley Cid, sought to dispel myths and educate the audience on the correct use of naloxone in life-threatening situations. One of the main topics covered was opioid-induced respiratory depression (OIRD). OIRD is the leading cause of opioid-related death. During an overdose, respiratory drive decreases, and the brain “forgets” to breathe. Symptoms include purple lips, unconsciousness, and death. Naloxone’s primary purpose is to reverse OIRD symptoms for a short period. When it comes to an opioid overdose, timing is everything.

Over 40 people attended the session, and more joined remotely. Dr. Cid started the talk by discussing different types of opioids and how they affect a person, then delved into naloxone. Students learned how to administer the Narcan nasal spray — commonly used in Ontario, and familiarized themselves with the contents of naloxone kits. 

After the talk, Kelsey Mar, the outreach coordinator for SSOS, commented on her experience attempting to educate people about naloxone. Through UW Pharmacy, Mar and co-organizer SooMin got in touch with Dr. Cid to run the talk about harm reduction. Mar did not have a personal story about opioids but said, “In high school, we would hear all about the opioid epidemic, where everyone is losing their mothers, fathers, and their children or friends.” She was first introduced to naloxone as a pharmacy student and believes more education is needed to prevent opioid-related deaths.

This sentiment was shared by students attending the talk as well. A student from Wilfrid Laurier University said, “I have had friends who have had OIRD symptoms, and some have had OIRD. Thankfully, nothing permanent happened, but I thought it would be useful to know how to prevent it if anything ever happens again.” The student chose to remain anonymous but appreciated SSOS for organizing the talk so he could learn how to assist someone if needed. 

The talk also covered how to administer naloxone with CPR in emergency situations. UW student, Veronica Guglietti, attended to boost her understanding of addiction and gain more insight into the topic as a minor in mental health and public policy. “I thought that having extra knowledge would be beneficial for me in my co-op terms or my classes. I’m also CPR certified, and so I felt that the additional knowledge was beneficial to me.”

Dr. Cid’s closing remarks touched on the lack of public knowledge about this topic. “The problem is that naloxone carries a lot of stigma, and so the purpose of these training sessions and seminars is to normalize it and get people to access naloxone as they need it in their pharmacies.” She said that if people access naloxone as needed, it will remain publicly funded and readily available. If people use it as required, it will decrease the number of opioid deaths. SSOS plans to host more training seminars and hopes to reach an even larger audience to ensure everyone has access to these life-saving supports.