First, take a deep breath.

If you remember being a teenager and going to the drug store to buy condoms, then you have all the experience you need to get a Naloxone kit. At first, I was nervous to ask, but the pharmacists were professional and non-judgemental.

A Naloxone kit is a first-response, opioid overdose reversal kit. They are provided free at most pharmacies, and only require a short consultation to make sure you know how to use it if an overdose occurs. You can find a searchable list of pharmacies that provide kits here.

What’s going on?

Opioid overdoses are on the rise in Canada and Ontario, so I decided to look into the situation. Prior to 2012, oxycodone was the big killer in overdoses, so pharmaceutical companies reformatted the medication to make it harder to abuse. Because of this, other drugs began to replace oxy as the big killers they are today. Front and centre as our nationwide issue is fentanyl.

Fentanyl is a very powerful drug originally intended for those in terrible pain who wouldn’t survive long enough to experience side effects. It is cheap to make, and can be put into anything. It’s showing up in pills being sold in Ontario high schools, and in cocaine that casual users purchase. It’s everywhere. It is especially dangerous for those who don’t use opioids intentionally. It has also been found in marijuana. Just a few grains can kill.

Who are we talking about?

There are many factors that lead to illicit drug use in Canada, too many to address here. Poverty and untreated mental illness are certainly some of them, but that’s not the end of the list. Many people hurt their back raking leaves or have a hockey injury, a car accident, or a slip and fall. Their doctors reach into their toolkits and commonly prescribe a low-level opioid, often Percocet.

The problem with opioids is that they are never enough. Over time the body grows accustomed to them and more is needed for the same result. Patients typically receive prescriptions for higher and higher doses of stronger opioids. At some point if their need becomes too great, they might turn to unregulated sources for relief. You might even know someone who has done/is doing this for relief.

A kick in the pants.

Social media brought me the story of an old friend in Vancouver getting a kit and consequently saving a stranger’s life the next day. Because of that, I finally decided it was my turn. I had talked about getting one for a long time, but always thought “maybe tomorrow.” Here is my experience.

The old Novack's building at King and Clarence, where LondonFuse is located.
LondonFuse headquarters at King and Clarence.

3:05 pm

I leave the LondonFuse office, located at King and Clarence, in the old Novack’s building.

3:10 pm

I arrive at Shopper’s Drug Mart, at Richmond and Carling. I proceed to the prescription drop-off counter. There, I am met by a young pharmacist who asks what he can do for me. “I, uh, would like to get a Naloxone kit” I say in a shaky voice, unsure of how it will be received. “Is it for you?” he asks. “It’s, uh, for, just generally.” He understands what I mean, and I’m directed to the waiting area. I sit down while he gathers the paperwork and kit, before he invites me into the private consultation room.

Shoppers Drug Mart pharmacy, at the corner of Richmond and Carling.
Shoppers Drug Mart at Richmond and Carling.

3:16 pm

After making introductions I ask him if I can record our conversation in order to write about it, and he agrees. His name is Kai. He is a student pharmacist, and I can tell we are both a tad bit nervous to do this right. He explains what Naloxone is, an “opioid antagonist.” That doesn’t mean it’s the bad guy in a novel, it just means that it isn’t an antidote.

You still need to call 911 first, give the Naloxone, then begin CPR as trained. The kit contains blue sterile gloves and a rescue-breathing mask. We cover how to use the kit, from the vials to the syringe to safe disposal. If you have a sharps container you can use that, otherwise bring the kit back to the pharmacy to have it disposed of safely, and replaced.

You don’t have to worry about finding a vein or anything like that. Naloxone should be given intra-muscularly. That means into a large muscle, either the upper thigh or the meaty part of the shoulder. The syringes that come in the kit are called VanishPoint. That means once you inject the Naloxone, you will hear a click. That click is the needle retracting automatically into the syringe so there is no danger of getting poked.

The free kits are part of the Ontario health care system, and therefore you must be an Ontario resident to get one. So I provide my Health Card, my name, address, and phone number. These records are to track the program. They do not give this information to police, or anyone else. I get my kit, a few pages of handouts, and certificate saying I’m trained. The certificate also includes my kit’s expiry date.

3:28 pm

Yes, that’s 18 minutes later. 18 minutes after I arrived at the pharmacy. We shake hands and I leave the consultation. I head back to the office.

3:33 pm

I arrive back at the LondonFuse office, 28 minutes after I left. I’m a bit more knowledgeable and ready to possibly save a life should an overdose occur.

The contents of a Naloxone overdose reversal kit. The kit includes 2 vials of the drug, 2 non-reusable syringes, sterile gloves, a rescue breathing mask, 2 alcohol wipes, vial opening devices and an insert containing visual instructions for using the kit.
The contents of a free Naloxone kit. Not pictured: visual instructions insert, and rubber sleeves for breaking open vials.

Do I really need to care?

In February of this year, London Police Service arrested two individuals for possession of fentanyl. You had better believe they weren’t the only ones with this deadly drug in London. It’s here. It’s in Toronto. It is widespread. Just because you don’t know, or don’t think you know an opioid user, doesn’t mean it can’t affect your life.

The experience of getting the kit was painless, quick and judgement-free. I hope I’ll never have to use it, but if I do I’ll be happy I got one. It could be at a house party with friends of friends, or a live music event, or walking down the street to grab a snack. This is an epidemic, and it will touch us all unless we work together. Let’s make sure these kits are out there. Everybody is somebody’s child.

Feature photo by Dave Knill.

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