Surge in opioid ODs on Coast

Fentanyl

A recent wave of overdoses has brought home the fact that the Sunshine Coast isn’t isolated from B.C.’s growing fentanyl crisis.

Police, first responders, Vancouver Coastal Health (VCH) and local doctors have been seeing the signs since late December, according to Const. Har-rison Mohr of Sunshine Coast RCMP.

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“The Sunshine Coast was initially affected to a lesser degree,” he said. “We saw a few isolated cases of overdose or possible fentanyl-related deaths in 2016, but in recent weeks we’ve seen what, for our community, is a sudden spike in fentanyl-related overdoses.”

Mohr also said investigators suspect drugs seized during a major bust in Sechelt Dec. 21 included fentanyl, but lab tests are still needed to confirm that.

As recently as Jan. 5, VCH was reporting that there had been only one fatal opioid-related overdose at its rural hospitals in Sechelt, Powell River, Bella Coola and Bella Bella since tracking began last June. The BC Coroners Service, meanwhile, recorded nine overdose deaths tied to fentanyl in North Shore/Coast Garibaldi, which includes the Sunshine Coast, between Jan. 1 and Oct. 31, 2016.

Dr. Ron Mundy, a GP and anesthesiologist in Sechelt who also works in the Mental Health and Addictions Clinic and the Sechelt ER, said those numbers are misleading.  He estimates the Sunshine Coast alone has seen many more opioid overdoses and as many as six deaths in the past year – mainly caused by fentanyl.

According to Mundy, there are several reasons the official numbers are lower, including hospital staff not always knowing if a patient who comes in with cardiac or respiratory arrest, or DOA, has used drugs, and the fact that not every person who dies is autopsied. It’s also not yet routine to test for fentanyl.

“Our urine drug screen doesn’t include fentanyl,” Mundy said. “I and others have been pushing to make sure that we include that.”

Mundy also said many of the opioid overdoses involve people who aren’t regular injection drug users, or even seeking fentanyl or other opiates.

“A substantial number of the overdoses are casual users – young people – who may or may not know they’re getting fentanyl, may not think they’re getting an opiate, and they’ll often die alone,” Mundy said. “Very few people are out to seek fentanyl. It’s cut into virtually everything these days.”

Mundy believes that could also include marijuana, but the evidence isn’t conclusive.  “It would appear we’re seeing fentanyl in some of the pot on the Coast and we don’t know why. We’re seeing fentanyl in urine [tests] that shouldn’t be there from people who say ‘the only thing I’m buying is marijuana.’ It does make us concerned.”

Mohr, meanwhile, said even dealers may not be aware they’re selling contaminated drugs.

“Let me be clear,” he said. “If you use or handle any drugs that are not obtained from a legitimate source, you are at risk of being exposed to fentanyl.”

While it might be easy to dwell on the fact that overdoses and deaths are on the rise, there’s also been a marked increase in the number of people reaching out for help, and there’s more help available.

Kendrah Rose is the addictions nurse at VCH’s Mental Health and Addictions Clinic in Sechelt, and she said they’ve gone from a client base in the mid-40s to more than 80, with as many as a half-dozen new intakes every week.

The clinic focuses on a low-barrier approach providing methadone and suboxone substitution therapy, counselling, outreach and support. And, given the fentanyl crisis, a lot of that outreach and support involves making people aware of the danger.

“The overdoses that are happening right now are obviously really shocking to the community,” Rose said. “Our role here is that we have open communication with people who are still in their addiction. We talk to clients who potentially could have relapses and educate them about the risks that are happening right now. … There’s a lot of fear right now in the community, so it’s more important than ever to be a safe and good reliable resource.”

That includes distributing naloxone kits and teaching people how to use them.

“The kits are available to people who are at risk of overdose themselves or they’re available to family and friends of people who know somebody,” Rose said. “I’ll even stretch it as far as to say if you just want to be prepared. If you feel as a community member you’d like to be ready if this [an OD] happens, then it’s not going to hurt to have another kit out there, another set of eyes and another person who knows what to do in the event of an emergency.”

VCH has also made the kits available through the Sechelt Hospital ER and the Gibsons Health Unit. RCMP officers and BC Ambulance Service crews also carry the kits. Mohr said given the potency of even small amounts of fentanyl, the kits are for the protection of the officers themselves as well as OD cases. He said they’ve been used only rarely so far. The BC Ambulance Service says Sechelt crews have administered 15 naloxone doses in the past year.

Mohr, Rose and Mundy all emphasized the importance of education and getting the word out to regular drug users, occasional users and even people who aren’t involved with drugs at all.

Awareness is one of the three planks of the strategy the Sunshine Coast RCMP detachment is working on, Mohr said. They’re calling it ACT – the C and the T stand for “cooperation and collaboration” with partners such as VCH, and targeted enforcement.

Mundy said the medical community is also doing its best to stay up to speed, and share knowledge.

“A large part of the role of those of us who are familiar with it is to keep bringing it up to make sure our colleagues who aren’t involved in it are aware on a constant basis,” he said. “Nobody here on the Coast is not going to be touched by this.”

Rose said it’s a dangerous time for almost anybody using any kind of substance. “I tell my clients you have to prepare. This [drug] is something you don’t know how it’s going to affect you. You have to make sure you’re not alone, you’re not going to use as much as you normally use. … That’s the harm reduction approach.”

Rose added the other piece is making sure people know the opportunities for getting help. “I want to make sure people know there’s always hope, and that it’s never too late to ask for help,” she said. “We are definitely a non-judgmental place to start that journey.”

The Addictions Clinic is open Monday to Friday, 8:30 a.m. to 4:30 p.m. and can be reached by phone at 604-885-8678.

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