The Works – Toronto Public Health CPSO October … · The Works – Toronto Public Health . CPSO...
Transcript of The Works – Toronto Public Health CPSO October … · The Works – Toronto Public Health . CPSO...
A harm reduction approach to overdose prevention
The Works – Toronto Public Health CPSO October 2012
Overview of Session
• Timeline of >POINT (Prevent Overdose in Toronto) program
• Overview of components of Naloxone training • Next steps….
What is the POINT (Preventing Overdose in Toronto)Program?
POINT is a service of The Works, needle exchange program, Toronto Public Health
Peer led overdose intervention program Provide take home naloxone kits to people who use
opioids
What is the risk? Opioid Overdose deaths in 2009 in Toronto – 74
(preliminary Coroner data) Oxycontin delisting Prison release New dealer Periods of abstinence illness
Where does POINT fit in?
The POINT Program is just a small part of the overdose awareness work that is happening in the City of Toronto
The Harm Reduction Task Force in conjunction with TPH is providing overdose training for drug users, family members, peers and front line workers.
“The 1st Seven minutes” video released by Toronto’s Harm Reduction Task Force – assists agencies in looking at components in creating a formal overdose response plan
Naloxone Globally • In 1995, England and Germany became the first
countries to distribute Naloxone to opiate users. • The United States started distributing naloxone in
1999 and as of 2010, 150 programs were operating in 19 states.
• In Turin, Italy Naloxone is available over the counter. • In Scotland Patient Group Directives (PGD) allow
Naloxone to be prescribed by appropriately qualified nurses and pharmacists
Naloxone in Canada and Ontario Edmonton street outreach program first to operate
take home naloxone in Canada August 31, 2011 Toronto Public Health the first health
unit in Canada to operate naloxone program August 31, 2012 Ottawa Public Health and the BC CDC
begin programs Other programs looking at ways to operate
Naloxone :
Opioid antagonist A prescription medication 1 supplier in Canada – Sandoz Average cost: $11.35/ ampoule Not on the provincial formulary Not covered by EAP (Exceptional Access Program)
How does Naloxone Work?
Naloxone has a stronger affinity to opioid receptors than opioids like heroin and fentanyl, so it knocks the opioids off the receptors for a short time. This allows the person to breathe again and reverses the overdose.
Opioid receptor on brain
Naloxone Naloxone
Opioid
Prescription Process Naloxone Medical
Directive AMOH
Registered Nurses and Counsellors at The
Works are certified to dispense Naloxone
Criteria for Dispensing
• Has a history of or is currently using opiates • Is at risk for overdose • Willing to take the overdose training • Willing to complete the follow-up evaluations • No previous hypersensitivity to Naloxone
The Training Overview: Overdose risks and prevention tips (don’t use alone,
new dealer, alcohol/benzos, ) Overdose myths – what not to do How to recognize opiod overdose 5 steps to intervening
Nurse or Counsellor and client complete Overdose History Form
Drug Categories
Recognizing an Overdose
Practice (with water ampoule), breaking ampoule, drawing up & administering
Chest Compressions
Overdose response myths
Review what not to do Encourage the correct process
Reviewing Contents of the Naloxone Kit
Naloxone Kit Syringes -Safety engineered
2 ampoules of Naloxone(.4mg/1cc/amp)
Alcohol swabs (assist with breaking ampoule)
Prescription identifier Card
Overdose Response steps pamphlet
Pamphlet
Prescription Identifier Card
Locations of trainings • Drop-in at The Works • Mobile service • Outreach to agencies (Shelters, housing..)
Length of Training 20-40 minutes
EVALUATION 2 phases – Phase 1 (completed) 1st impressions of staff, management, clients of the
program, demographics Phase 2 (applied for funding) Retention of training information, more on
demographics, experiences, etc.
Since August 31 2011…….
475 Naloxone Kits distributed!
45 reported Naloxone kits used for an opioid overdose!
Gender of Participants Gender
Male
Female
Trans
David’s Story
Next steps/work to be done: • Obtain funding for a formal research project • Lobbying to put Naloxone on the formulary • Explore options for the development of a epi-pen like
device/intra nasal device • Advocate to reach a wider audience(prisons, etc),
methadone clients, Family Health Teams, etc. etc…..