Oct
27
2017

Province acting against opioids

Dr. Heather Morrison, Minister Robert Henderson, and Karen MacDonald, Justice and Public Safety.

The provincial government has launched an action plan to prevent overdoses and deaths to Prince Edward Island youth and adults caused by opioids.

Opioid-related overdoses and deaths linked to potent opioids like fentanyl are increasing across much of Canada. The Prince Edward Island Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths is available at www.princeedwardisland.ca/opioids.

“Potent opioids are becoming more widely available and may be hidden in other drugs, which is why we are taking action now before this becomes a crisis in our own province,” Premier Wade MacLauchlan said. “As government we have a responsibility to protect the health, safety, and well being of Islanders. This comprehensive action plan provides tangible recommendation on how we can prevent overdoses and deaths through enhancing our systems and collaborating with the community.”

The scope of the action plan includes the following areas of focus:

  • opioid-related overdose and death surveillance;
  • rapid-response protocol to address a sudden increase in opioid-related overdoses in Prince Edward Island;
  • harm reduction, including access to naloxone, opioid replacement therapy, and communications and education; and
  • collaboration on opioid supply.

“This plan outlines actions we can take to make a difference in the lives of people who are struggling under the weight of these drugs,” said Health and Wellness Minister Robert Henderson. “Our government has been working closely with our partners across the province to combat this issue and we know there is a great deal of work ahead of us. Through these recommendations we are taking targeted action to protect Islanders from the harm caused by these powerful drugs, now and into the future.”

Prince Edward Island has already made significant progress to prevent opioid-related overdoses and deaths in the province. Initiatives include:

  • a pilot take-home Naloxone program at needle exchange locations across the province;
  • ensuring  police and medical first responders and firefighters have access to Naloxone;
  • establishing opioid overdose and deaths surveillance; and
  • expanding access to the opioid replacement therapy medication buprenorphine-naloxone (e.g. Suboxone®).

“With our new surveillance measures, we will be able to better track opioid-related overdoses and deaths in the province and ensure mitigative measures are enacted,” Chief Public Health Officer Dr. Heather Morrison said. “We also want to better educate Islanders on how naloxone works, as well as the risks associated with potent opioids like fentanyl and opioid misuse.

“For those who are users, we want to ensure that the treatment options we have on PEI are accessible and effective. We want to encourage people to seek help when they are in need, and to take measures to protect their health.”

The Prince Edward Island Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths was co-led by the PEI Chief Public Health Office and the Department of Justice and Public Safety. It included consultation with individuals with lived experience, front-line providers, and government and non-governmental organizations.

Media contact:

Autumn Tremere

agtremere@gov.pe.ca

Backgrounder:

Opioids are drugs that act on the nervous system to relieve pain. They are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.

They come in tablets, capsules or liquid. Misuse of opioids can lead to physical dependence, withdrawal symptoms, overdose incidents, and deaths—even when the opioids are from a prescription. Opioids affect the part of your brain that controls your breathing. When you take more opioids than your body can handle, your breathing slows. This can lead to unconsciousness and even death.

As a result of the action plan, data on opioid related overdoses and deaths on PEI are now being tracked and publically disclosed online at www.princeedwardisland.ca/opioids. In 2016 there were 5 accidental apparent opioid-related deaths in PEI. So far in 2017 we are aware of 6 accidental opioid related overdoses in PEI and less-than 5 deaths. (To protect the privacy of individuals, case counts of less than 5 are suppressed.) All overdose and death cases reported involved mixed toxicology (i.e. one or more opioids combined with one or more non-opioid substances, such as alcohol).

An opioid overdose may be reversed with the drug naloxone. The Prince Edward Island Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths includes a recommendation for a Take-Home Naloxone Program to be developed for service providers and for individuals at high risk of an overdose. Currently a pilot project in PEI has provided take-home Naloxone kits to clients of the provincial needle exchange programs, since commencing in June 2017 150 kits have been distributed.  Naloxone is also available in emergency departments, with paramedics, medical first responder firefighters, RCMP and municipal police.

Opioid replacement therapy is a treatment option that seeks to replace dangerous opioid use with safe access to legal and less euphoric, longer-acting opioids, thus decreasing the potential health risks associated with illicit drug abuse.

In Prince Edward Island the provincial Opioid Replacement Therapy Program provides: methadone or suboxone, counselling and support services to clients who are dependent on opioid drugs. Currently 900 Islanders have benefited from this program. The replacement therapy eliminates or reduces cravings, without causing the "high" and the counselling and support services further assist individuals in reducing the harms associated with opioid dependency. If you need help with your opioid addiction, call 1-888-299-8399 toll free for the Opioid Replacement Therapy Program. Your family physician, addiction counsellor, or other health professional may also call on your behalf. The Prince Edward Island Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths includes recommendations on how to further enhance the opioid replacement treatment delivery in PEI.

Information is critical for effectively mitigating an opioid epidemic. Information on opioid-related overdoses and deaths is necessary to support the development of public policy, to identify a need for public health action and to communicate to health professionals, other departments and agencies and the general public. As a result of the Prince Edward Island Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths, the province has been establishing partnerships for data collection and sharing, and new strategies are being put in place to enhance surveillance so that we have a better understanding of what is happening on PEI.

This enhanced surveillance is necessary in order for PEI to develop and implement rapid response protocols for opioids, a recommendation of the Prince Edward Island Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths. These protocols will be a guide, so that if a crisis arises on PEI, we know how to effectively respond.

Prevention is an underlying theme of the Prince Edward Island Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths. Going forward additional communication materials will be developed to better educate the general public on opioids and the risks of drug use, additional materials will be developed to communicate harm reduction messages and treatment options for drug users.

Prevention will also be enhanced through initiating a formal prescription monitoring program (PMP), strengthening prescribing and dispensing practices and reducing diversion of prescription opioids. Health PEI already collects data on prescription dispensing of opioids; by developing a formal PMP we will be able to better review trends, and develop interventions to promote patient safety such as clinician education or the promotion of medication profile reviews.

PEI Action Plan to Prevent and Mitigate Opioid-Related Overdoses and Deaths

Area of focus

Strategic priorities

Next steps

Opioid Overdose and Death Surveillance

Establish opioid-related overdose surveillance

Establish opioid-related death surveillance

  • Initiate weekly surveillance of opioid-related overdoses by August 2017

  • Initiate quarterly surveillance of opioid-related deaths by September 2017

  • Establish policies for the sharing of surveillance data with partners and public reporting by fall 2017

Rapid Response

Establish rapid response protocol

Develop and test a rapid response protocol, including a system for early notification of stakeholders and the public, for application in the instance of an increase in the number of opioid-related overdoses or deaths by fall 2017

Harm Reduction

Support access to naloxone to populations likely to respond to or experience an opioid overdose

 

 

 

Enhance harm reduction education and communication

 

 

 

 

 

Enhance opioid replacement treatment delivery

  • Develop and implement program for equipping service providers likely to respond to an opioid overdose with naloxone by fall 2017

  • Develop and implement phase 1 of a free Take Home Naloxone program, for individuals at high risk of an overdose in PEI by fall 2017 (expanding to clients of opioid replacement clinics, the Provincial Addictions Treatment Facility, and Corrections facilities)

 

  • Develop and begin implementation of a communication plan on public safety about opioids for the general public, including the risks associated with drug use, the presence of fentanyl in illegal drug products, and to call 911 for overdoses by fall 2017

  • Develop and begin implementation of an evidence-based communication plan on harm reduction and access to treatment for people who use drugs by fall 2017

 

  • Optimize treatment delivery through collaboration among opioid replacement clinics to facilitate timely and equitable access by spring 2018

  • Propose a uniform provincial opioid replacement therapy Pharmacare program to reduce financial barriers to treatment by fall 2017

  • Strengthen outcome measurement and monitoring of opioid replacement therapy program by fall 2018

Collaboration on Opioid Supply
Initiate a formal prescription monitoring program (PMP) on PEI
 
Strengthen prescribing and dispensing practices
 
Reduce diversion of prescribed opioids
Health PEI and the Department of Health and Wellness, in partnership with professional regulatory bodies:
  • Establish a PMP oversight committee by September 2017
  • Develop de-identified practitioner/dispenser-level monitoring reports to share with relevant colleges/associations on a periodic basis by fall 2017
  • Draft Provincial Fentanyl Patch for Patch regulations by fall 2017
  • Develop and publish 1st annual prescription monitoring public report by fall 2017
  • Form a multi-stakeholder committee on clinician education involving professional regulatory bodies and associations and Health PEI by January 2018
  • Determine structure for a PMP by winter 2017/2018
  • Develop a response framework for when potential instances of diversion are identified using PMP data by winter 2017/18
  • Establish a PMP administration structure by winter 2017/2018
  • If necessary, draft and propose legislative changes by winter 2017/18
  • Develop and commence implementation of clinician education and awareness strategy by spring 2018
  • Operationalize PMP by summer 2018

For more information on the Prince Edward Island Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths or to download a copy, visit www.princeedwardisland.ca/opioids.

General Inquiries

Department of Health and Wellness
4th Floor North, Shaw Building
105 Rochford Street
Charlottetown, PE   C1A 7N8

Phone: (902) 368-6414
Fax: (902) 368-4121

healthweb@gov.pe.ca