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PCN nurses have role in reducing fentanyl overdose risks

Donna McKown, RN, is the first Bow Valley PCN nurse to receive training in providing access to Naloxone take-home kits.

This summer, Alberta Health reported that in the first six months of this year, 153 people in Alberta died from apparent drug overdoses related to fentanyl, up from 139 fentanyl-related deaths during the first six months of 2015* and six deaths in 2011**.  ​The increase reflects a pattern that has been seen across Canada.  In the Bow Valley deaths have been reported in ER departments in both Banff and Canmore.  In the Calgary Zone (of which the Bow Valley is part from a reporting point of view) ER visits and calls to Health Link have steadily increased.  As part of its efforts to decrease deaths due to overdose, this year, the Provincial government made naloxone kits available, without prescription and free of charge, through pharmacies, family medicine clinics and other health services locations. Naloxone is an injectable drug that can reverse symptoms of fentanyl overdose and acute opioid poisoning. The injection can be given by a healthcare provider, usually in a hospital ER, or by a layperson using the take-home, hand-held, automatic injection kit. 

Training for primary care nurses and pharmacies

Within this initiative, some Bow Valley PCN nurses are receiving training so they can provide access to naloxone kits and education on their use. The kits contain instructions on how and when to administer the drug, two vials of naloxone, syringes, alcohol swab, latex gloves and a one-way rescue breathing mask.  Donna McKown, RN, based at Bear Street Family Physicians in Banff, is the first Bow Valley PCN nurse to receive this training.  PCN nurses in Canmore Associate Medical Clinic and Ridgeview Medical Centre in Canmore are slated to receive training shortly. As well, the PCN has partnered with local pharmacies which also have trained staff to dispense kits.

Fentanyl is estimated to be 100 times stronger than other opioids such as morphine, heroin, or oxycodone. When prescribed by a doctor and taken as directed, delivered through patches or pills that release the drug slowly, fentanyl is used to treat severe pain when other analgesics have not been effective.

Illicit recreational drug

Drug dealers often 'push' fentanyl as a recreational drug, sold illicitly.  Buyers typically take it to get high. Street names for fentanyl include apples, beans, friend and dance fever.  Illicit fentanyl is both highly addictive and toxic and a small amount can be deadly. Fentanyl that's made illegally may also contain other substances like cocaine, heroin, and xylazine (a powerful veterinary drug), putting users at higher risk of being poisoned.

 "Fentanyl can only be taken safely if it's prescribed by a doctor. It's essential to follow the directions and take only the recommended dose," Donna McKown explains.  "Drugs bought on the street are never safe."  Although kits are available at the clinic, she feels her role in spreading the message about the dangers of fentanyl misuse and illicit drugs in general is just as important in combatting the problem. This includes how to recognize the symptoms of overdose and how to respond by seeking professional help or using a kit.

Education role

The PCN's Medical Director, Dr. Nancy Blaney, also based at Bear Street Clinic, continues, "Naloxone take-home kits can save lives. The PCN's inter-professional team has an important part to play in community education, recognizing addiction problems, and in directing patients to programs and health professionals trained to help address addiction and mental health issues. Ask your doctor or PCN team member if you have concerns about yourself, family or friends who use narcotics and where to access kits in the Bow Valley."

*Fentanyl and the take-home naloxone program:  http://www.health.alberta.ca/health-info/AMH-Naloxone-Take-home.html 

**Canadian Centre on Substance Abuse: Canadian Community Epidemiology Network on Drug Use (CCENDU) Bulletin, August 2015. Deaths Involving Fentanyl in Canada, 2009–2014

Useful contacts:

Staff at these locations are trained to counsel and distribute the kits and have kits on site:

Banff Mineral Springs Emergency Department

Gourlays Pharmacies, Banff and Canmore

IGA Pharmacy, Banff

Shoppers Drug Mart, Canmore

 

Health Link 811: https://myhealth.alberta.ca/811

Addiction & Mental Health 24 Hour Helpline: 1-866-332-2322.

The Poison and Drug Information Service (PADIS), 1-800-332-1414  A free, confidential, 24/7 service. Staff are trained in the assessment and management of exposures to drugs such as fentanyl: