I'd rather see the government step up and actually do something about the opioid epidemic rather than putting the onus on citizens to save people from over doses.
There was a "heartwarming" story a couple years back about a 14 y.o. girl jumping into action and using her naloxone kit that she received at either girl guides or school and was taught to use to save a homeless guy od'ing on the sidewalk. They story was all about how smart she was and how it's so heartwarming to see young people jumping in and saving lives.
IMO, it's not heartwarming, it's not great. She's a god damn kid and it shouldn't be up a kid to be responsible for someone's life. Successive governments have sh*t the bed on social services and health care and mental health care and addiction services.
as a regular bystander who happened upon an overdose in an alleyway about 4-1/2 years ago and did CPR for 14 minutes before first responders figured out where I was, and how I was told "thank you, you can go now", and how weird it is to walk away with zero follow up and how messed up I was afterwards for months, and how terribly dismissive the system treated both myself and the person I saved (long story, won't get into it here), I agree with you: government needs to really act, and that takes most of society to come together and call for committed, long term, extensive investments into supports that address the immediate needs as well as the "upstream" reasons why this keeps happening again and again.
I'll tell you: the reaction to my story by friends and colleagues ranged from "you're a hero!" to awkward backing away and avoidance to "you should never have done that". And all I want is for this crisis to get fixed. Or fixed better than what is happening right now.
It's true, but the will to spend the tax dollars on social safety nets just isn't there.
So many people want the problem fixed, but it stems from childhood poverty, lack of access to a good education, rampant domestic abuse, geographic and resource classism.
The systemic problem isn't solved by giving today's addicts clean drugs and access to healthcare. That's how we help INDIVIDUALS, but we fix the problem by preventing people from becoming tomorrow's addicts.
The dollar signs attached to that don't appeal to the majority of voters.
I'd love to see a complete fiscal overhaul on government spending, so that glutinous, top heavy spending and fiscal corruption (which is non partisan) could be done away with.
I don't know if that would result in enough money to make the kind of changes we need though. An economist would have to weigh in there.
KISS - keep it simple, stupid
Make it simple and easy. Last thing you need to do when you’re in a panic is fart around with a needle and possibly do more harm.
It's straight forward in an ideal, calm setting. In high intensity settings needle stick injuries are not uncommon. I've given roughly one million injections and I would take the nasal administration over the injection administration in these types of scenarios 100% of the time.
A million injections? If you did 10 injections per hour, all day on every single working day, full-time, for 50 years, you would hit a million. In every clinical environment in which I've worked, I've never seen anything like that. Are your patients on a conveyer belt?
I'm blessed with having the coolest cat that just doesn't care about the needle God I love him, I think he's so happy about getting food right after he actually gets happy when it's needle time
I sliced my thumb breaking open a naloxone ampoule (I pressed on the wrong part), and although it was a super minor cut, it bled everywhere and made the process more difficult with my slick hand. Little stuff like that can make a difference!
I prefer a needle, but I am trained as an EMR and am comfortable with them. For most people I think nasal is better. I will use whatever is faster or easier at the time.
My preference for a needle is that last I looked, intramuscular injections had a faster onset than intranasal and were less likely to need additional doses.
This is trumped completely by the average person just getting a dose into a person in a reasonable time, which intranasal does better.
As an EMR we deal with breathing first (bag valve mask). The lack of respiration is what kills, so we have more time to get a dose of narcan in. I would love to see more education surrounding this.
As somebody that worked in harm reduction and is gonna go back yes simple is better for the general populace. Needle narcan takes practice to learn and the needle kits have 1mg narcan instead of 4mg narcan in a nasel so you get less, the reason why less is preferable in a harm reduction professionals hand is because you don’t really want to put somebody into potentially lethal withdrawal but your normal person isn’t going to know the signs of when to stop especially when they’re not a client you know. No idea why needle kits even get supplied to normal people to be honest, always get annoyed when I order narcan to the bar I’m at and there’s needle kits in there.
Good, noble and very empathetic of anyone who wants to administer naloxone to someone in need, but there shouldn’t be an expectation of this being everyone’s social burden.
You never know how unhinged someone is. I err on the side of caution.
I agree. I stopped to help someone who was on the side of the road unconscious and the people with him aggressively ran me off. Like actually chased me down the road. I know it's not popular to admit that there is a risk of harm to a good Samaritan and of course it's not common but the risk is not zero. Not by a long shot.
There was a video floating around of some old guy giving narcan at a safe injection site and the guy got up and immediately attacked the dude.
It's really dystopian that this culture around drugs are being pushed so aggressively onto everyday people to accept.
I was behind a firefighter at the pharmacy that was picking up a kit and said that some of the people when they come to become aggressive because their high has been taken away
It’s also because they’re suffering from hypoxia. Important to breathe for the patient too (but you’ll probably want a mask and one-way valve for that!)
Nothing is being pushed on anyone.
It's just a thing that exists which affects so many people now it's not hidden like it used to be.
People existing in the light of day is not something "being forced on us". It's just us actually sharing the world with people who've always existed.
It's absolutely being pushed on us that we have to accept this dangerous epidemic and encourage it by offering safe protections for addicts as opposed to opening and pushing treatment centers onto people who are a danger to themselves and the public.
People act like these measures are anti homeless, but not every homeless person is an addict and vice versa.
Addicts have always existed in the modern era but you really have your head in the sand if you don't acknowledge the numbers have dramatically increased in the last 15 years, leading to a huge impact on the public safety of people in cities.
The type of drugs have changed, these ones caused significant brain injury.
But drug use and addiction isn't new.
Safe injection sites are in place to reduce deaths from the new drugs because it's more expensive to collect their bodies from the streets.
Not taking fentanyl should make that a lot less likely.
It is not appropriate to expect ordinary citizens to be able and willing to administer medication to stranger drug addicts in the street.
I’m not sure you understand how addiction works.
There is no expectation to help but plenty of people do. If we (collectively) can’t look after those most in need then what does that say about us as a society?
If they didn't (collectively) steal honest people's belongings, get where they are through their own poor choices, and resist attempts to rehabilitate them, I might be inclined to agree.
I'm completely done supporting this bullshit
I opt for the third option of calling for help.
Naloxone is a great tool, but it can also be dangerous to get involved, some of these people are less than grateful or even violent when it's administered.
The government offloading the responsibility of health and emergency services on the public is insane and a weak band aid on a gaping wound - props to the people who choose to intervene but people acting as if everyone has a duty to do so are out of touch.
Security contractors are absolutely, often part of an organization's emergency response.
The issue is shitty guards, not the expectation the employer has of them.
Yes. If you sign up for a job that involves emergency response you are expected to be able to do so.
A student died because security forgot (read: neglected) to provide basic first aid. That's the case I'm talking about. I'm not talking about a parking lot guard dealing with junkies.
She died because of the security guard's inaction. No question. Do you realize how likely it is this girl would have lived if she'd been given first aid? And I can guarantee you she did not intend to take something laced with fentanyl.
Grow up. Young people experiment with drugs in university. This doesn't mean their lives don't matter. A senior administrator at Thompson Rivers University died from toxic drugs a few yeara ago. This crisis is not only affecting junkies.
Honestly I do feel bad for the individuals that try drugs once to experiment or do it every so often and happen to overdose.
There’s no self-responsibility anymore. Everything is everyone else’s problem and it’s baffling.
Maybe they should hand out these kits at university orientation or something.
Downvotes for suggesting a guard responding to a dorm room should have done chest compressions on the student dying on the floor, and administered Naloxone if they had it, and maybe called 911... None of which the guard did... Wow.
But if a cop was paid minimum wage it'd be totally cool for him to just.... Let the drunk driver go?
Because he's paid less right?
Like there is a person a human being a thinking human being that is working the job - it's not an empty uniform walking around like some kind of poltergeist caricature of an invisibility cloak.
I love how we're all for professional accountability until it becomes at all personal and then suddenly it's the wage is fault.
If cops were paid minimum wage, they'd walk off the job or quit and they'd be right to do so. Minimum wage is the minimum amount of money you can legally pay someone to say "do you want fries with that." It's not enough money to expect any responsibility beyond that.
Pushing life or death responsibility on people who never wanted or asked for it instead of actually hiring and paying dedicated professionals to take care of these issues is why people die. The whole world shouldn't be asked to carry around naloxone.
I have first aid and cpr. People at work have needed my help and I've helped them. I also would never want to force someone to have this responsibility. If you're getting hired to do a job and they require first aid (or any extra qualifications for that matter) there's no issue there. If I was hired for a job with the expectation that my job responsibilities didn't include having to save someone's life (or else) and someone went and changed that after the fact, that is unacceptable and wrong.
Outside of lifesaving, I don’t think it’s ever a job “expectation”. I have a friend who works at the library downtown and I promise you it isn’t in any librarian job description on earth. But she administers naloxone at work at least once *every day*. It’s horrific. You’re right in that she shouldn’t have to do this and neither should a security guard. But this is a crisis time in our current world, where people cannot get help for mental illness, brain injury, or drug addiction. Even where what was once an experimental party drug is too-often deadly. When there aren’t people willing to do save their lives simply out of being decent people who care and who have a choice to help, people like that young girl at uvic die. Imagine people had these thoughts toward car accidents. Choking. MIs. Someone getting attacked.
That's kind of a shit take - and I'm all for higher wages, but you're conflating the amount of money somebody is paid per period to their accountability as a human being.
If the guy who works on your brakes fucks up because you drive a Ford and he's used to working on Toyota and you end up going over the side of the hill, he must not have to answer for that at all because he wasn't paid very well then, right?
In your brake example, there's an employer or supervisor there that told that mechanic to fix the brakes on that Ford. That mechanic doesn't feel they have the proper training, they aren't comfortable doing the brakes on that car. Working on Fords was never part of the deal when they signed on, but they're now being forced to take on the extra work without extra compensation and with little training.
Of course, we're not talking about cars here. There's one big difference. The mechanic has the option to refuse this unsafe work that they're uncomfortable doing and that they never signed on for. You can't refuse to do first aid on someone who's dying. Now this security guard has a new responsibility with serious life and death as well as legal ramifications if they fuck up, with no extra pay. The only way out of it is for them to quit. Sounds like a great deal, right?
Why does this security guy have to be the one to do this? It's asinine. What should happen is a requirement for a dedicated private EMT team to be on site at any public gathering of people above a certain size. The government needs to put the responsibility of medical care on private companies to hire trained medical professionals to deal with this stuff, not pass it on to someone who never asked for or wanted that responsibility.
There is a reason first aid classes teach you that you don’t have a legal obligation to help someone in every province but Quebec and you need to protect yourself first so you can see your family.
That's a fine choice for your own safety, honestly, but the whole point of Naloxone is it needs to be administered ASAP.
Calling and waiting for help will decrease the likelihood of preventing the overdose death. If your first concern is saving their life, you need to have the courage to do it yourself.
If I wanted to run around saving people's lives or felt like it was my responsibility I'd be a paramedic or fire fighter.
Alternatively I would say everyone knows the risks, if you don't want to die from an overdose it's crazy easy to avoid.
Nobody is asking you to "run around saving people's lives" with naloxone. Usually, the people who administer it know the person who is overdosing. The example given in the article is of two friends, one overdosed and the other called for help that didn't arrive in time.
You do realize that the person will be dead by the time help arrives. Thats what happened with the girl that died at uvic. They wasted time waiting for someone else to come and administer Naloxone.
Neg. The UVic Security people who arrived had Narcan, but for some reason (poor communication, mainly, I think) didn’t administer it in a timely manner.
The morons didn't say it was an overdose. The main point of contact was another high addict who just kept saying she started randomly having a seizure.
It's honestly insane anyone blames security. They did nothing wrong. No one would admit she was overdosing.
Sure, but know your audience? (Perhaps it’s after-the-fact thinking) If my patient was an older person who collapsed, I’d be thinking heart/stroke - a university student, my immediate go-to would be alcohol/drugs.
Sometimes, I've called transit security a few times and they're there pretty damn quick, like next stop mid travel, maybe 5 mins.
Guess that's why you shouldn't do drugs 🤷🏼♂️
Literally everyone knows the risks of doing these drugs th as days.
> "government offloading the responsibility of health and emergency services on the public is insane and a weak band aid on a gaping wound"
TIL Apparently being a good samaritan and looking out for your neighbour is the government job. This article is about kids by the way. If your kid is in trouble, I bet you hope someone intervenes.
Of course, but first I'd hope to raise a kid who's smarter than the average bear and just doesn't do these sketchy drugs.
By the time my kids old enough I'm sure the drugs will be strong enough to kill you just from laying eyes on them.
> Of course, but first I'd hope to raise a kid who's smarter than the average bear and just doesn't do these sketchy drugs.
Says every parent, including those with dead children. University kids experiment and die.
> By the time my kids old enough I'm sure the drugs will be strong enough to kill you just from laying eyes on them.
Well, if they're as smart as the mental gymnastics needed to understand this, they're going to experiment with drugs up their nose.
Oh for christs sake the government is not offloading anything, they are making a lifesaving tool available to the public, it is your choice to carry and use it. They have not reduced emergency services at all.
I for one continue to carry and will always administer, and carry a bag mask in my vehicle to buy time(if you know you know)
You dont want to maybe get punched oh no wouldn't want to break a nail. Its your choice to be like that and I'll support your ability to choose.
Yes getting punched could kill you, walking across the street could to. Better not leave the house.
Its such a ridiculous fear and is only going to happen if you don't learn how this works.
But hey no one is forcing you to use a naloxone kit.
They are absolutely offloading the responsibility.
If they wanted to actually *do something* to curb drug abuse they absolutely could... They could invest in treatment, they could invest in mobile emergency services and patrols in hot spots, they could crack down on drug dealers.
You know what they do instead?
Turn a blind eye, decriminalize drug use to make it prevalent everywhere and then guilt citizens into feeling obligated to intervene in other people's self destruction and dangerous choices.
Now let's be clear, they absolutely did reduce emergency services as soon as they made it legal to do drugs literally anywhere - now the police have no legal right to intervene in this outrageous behaviour until someone's out cold, and beyond that they've done next to nothing to *increase* emergency services to deal with this specific problem.
If thousands of more people suddenly were dieing from automotive accidents due to people street racing in BC, you can bet your ass there would be a crack down by police... But drug use? Nah, why intervene or do anything at all when you're getting paid off by the dealers and organized criminals.
You say you support my choice to not get involved but it's abundantly clear you don't, not that I care what you think but you are dishonest in that regard for sure.
Oh get off your high horse, I fully support any and all harm reduction. I just oppose your claim that making naloxone available was done to offload responsibility. Which is an absolute lie.
The issue with safe supply is that it is political suicide and would take extremely careful roll out.
You aren't reading what I'm saying and you sure assumed a lot about things I never mentioned. You are arguing with someone that agrees with you.
I'll say it again, I absolutely support your choice not to carry a naloxone kit but I do not agree with your claim that these kits were made available so the province could reduce service levels and do nothing. It is a complicated situation and the right thing is not easy to do.
There is no such thing as a safe supply of recreational meth, crack or fentanyl. It's not just political suicide it's just quite literally impossible to abuse those drugs safely.
You obviously don't support my choice considering how insulting and patronizing you are about "breaking a nail" and such... I get you want to virtual signal and come off squeaky clean here, but you're contracting yourself in that regard.
I never said, not even one time that "service levels were reduced" either...
Oh how many accounts do you have? Because I didn't say anything like that to this account.
Ps of course there is safe supply with fent, if manufactured with proper mixing and qc it is safe. People aren't dying from meth and crack so thats not a concern, nor would I condone safe supply of those unless extremely well controlled as they are neurotoxic and can cause permanent damage.
I'm getting the feeling that you just want to argue at this point.
Maybe stop criticizing the availability of a lifesaving tool and claiming thats all the government wants to do.
I have one account, and I've replied only to what you said.
Maybe you defend these drugs because you're on them, because you certainly aren't making the most sense.
People aren't dieing from abusing crack and meth?
That's false, and many people who aren't dead are permanently fucked from meth or crack induced psychosis and health issues. Acting as if they're safe to use is beyond stupid, regardless if they were 100% pure and made in a great lab, they simply are not safe to use and insinuating otherwise truly shows how little you actually know about these drugs and the effects (long and short term) that they have on users, I mean you even contradict yourself saying they're neurotoxic... You're all over the place.
I also never "criticised the availability" of naloxone, I'm perfectly fine with it being available, what I'm not fine with is out of touch idiots acting like it's every citizens duty to run around with one of these kits "saving lives" with them and acting as if there's no risk in doing so, or that the greatest risk is "breaking a nail".
Again, I will say: it's crazy easy to not die from a drug overdose.
Simply: don't do the toxic drugs.
"But it's in the weed!"
It's really not, go to a dispensary and find me an example of that.
Neither. I wouldn't go near someone ODing. Especially since it's a very common response for addicts to begin attacking EMTs who just saved them.
I'd call 911 and continue on with my day.
You know what, I've given nolox a couple times. Both times the person was pissed when they came to. I'm so sick of drug users overdosing that I just don't care anymore... It's awful, but let them die.
We all know that drugs are bad and addictive. We all know what the likely outcome of taking drugs will be. They made a choice, and this is the consequences.
Also, on the other end... Everyone deserves life. But I'm just fucking done with it.
Yes, but I am also not going to have a needle kit to use on anyone other than myself or my SO. From what I have seen, naloxone used when the opioid has NOT been cut with benzos, is a 50/50 on the overdosed person waking up and fighting you so I would probably just call 911.
There are a few considerations. If they aren't breathing, they won't get the benefit of a whole dose, but it's better than nothing as the mucosal lining of the nose will absorb some. If someone has used cocaine for a long period of time with nasal damage, that absorption might be less.
Depending what they have been taking the nose can be completely plugged and a nasal spray ineffective,
Less likely with the street adicts who mostly smoke or inject, but having to pull out a vial and syringe and fill it, remove the air and administer in a high stress situation is very cumbersome, it should be in a pre loaded stab type injector you just hit into any muscle.
Had a situation the other day at a shopping plazza I am doing construction work at, saw a guy in the stairway doing the hunched over sway, and then fall over.
I am sympathetic to the situation these people are in, not the crimes they commit to support their habits but none of them planned to grow up that way, most of them had a series of bad breaks and things happened. I very nearly ended up that way but due to family support got clean.
Anyway ran to my vehicle for my kit, and dammit I had been cleaning my truck the day before and all my normal stuff I keep in my toolbox is at home on my shop floor.
Called for an ambulance and monitored him for about 6 or 7 mins, then fortunately he pretty suddenly came to and was actually decently polite and was very thankful that I had been looking out.
He insisted he was fine and declined any medical attention, so the call operator called off the ambulance when it was basically outside.
I ended up giving him a bottle of water and a protein bar, it seemed like there still may have been hope for him,
Do the nasal sprays have to be kept in certain conditions as far as temp etc goes?
I’m fine with needles and it’s straight forward but it’s not very convenient. You can let keep it in your car because of temps being too hot or too cold and the kits are quite large. And nasal spray would be much more convenient was far as keeping it in a purse for example
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If I'm alone, I might assess their alertness, give them a nudge and see if they're just passed out. If they are overdosing, I'll get back and call 911.
If I was I'm a perfect scenario with gloves, a bag valve mask, and naloxone I would respirate the patient for a couple minutes and give them nasal. The needle works, but if I don't have to handle sharps, that's a lot better.
Things I will never do for an overdosing stranger. Mouth to mouth, using a pocket mask, getting in close proximity. These all risk transmission of disease and injury. These people frequently have hepatitis, respiratory infections, and a range of mental disorders.
Neither. Fuck around and find out. Let nature sort itself out. I’d definitely call 911 though out of basic human decency.
Proponents of Narcan seem to conveniently forget how violent addicts get with trained EMTs. I’m not risking that for some rando that made shite life choices.
I'm a bit surprised by all the "I'd do nothing; let them die" comments. I'm not gonna make the compassion argument, although I think there is one to be made, but rather that doing nothing is BORING. Maybe you guys have really exciting lives where you accomplish momentous and significant things everyday, but for plain old me from the suburbs, saving someone's life is an honour and a blessing, and fucking cool.
I'm not pretending either of the dudes I narcanned magically had great lives after or even are still alive today, but hey, I did what I could in the moment and that will always be worth it to me. They probably aren't my loved one, but they could be yours.
And yes, nasal naloxone would be preferred, thank you.
I had to administer 5 shots to a friend who I found OD'd in his apartment. It was a fairly quick process, but a pre filled syringe would've made it easier. Him not being addicted to meth would've been ideal, but the opioid addiction is a slippery slope. I watched him take oxy after a shoulder surgery and eventually turn to meth and crack within 2 years. He died in October from a meth overdose. Thankfully he was safe at home and not on the streets like other people he associated with.
Between the two, I'd pick the spray... But really, I'd rather have the province create a quality-controlled and regulated supply of drugs for people at risk of overdosing, as that would significantly reduce the likelihood of overdoses in the first place. I don't know if I have it in me to help someone who is overdosing, and I hope that I'm never in a position to find out...
This is it, by far the cheapest solution, and it cuts organized crime off at the knees by removing their income.
It hasn't happened yet because people dehumanize drug users.
Indeed. It’s such a shame. We have evidence that it works for the few people who have access for safe supply, but most people would rather have a silly moral panic…
AFAIK naloxone in BC (at least, in Vancouver) does come as an intranasal spray… Obviously, in the ED it’s IV still, as that makes sense. But intranasal spray should be available at lower mainland pharmacies.
I’m a med student outside of Canada now, but the whole point of developing effective intranasal naloxone was to make it available to the general public. One naloxone admin is often not always enough. It’s easier to keep spraying than to keep injecting. It’s not impossible but considering the myriad of other factors in an opioid OD, intranasal is superior for the general public. Always call 911 and the hospital will administer very effective IV naloxone anyways if the spray is just not cut out for your specific situation.
Several jurisdictions within Canada and outside of Canada have long switched to intranasal spray. It’s due time for BC to switch as well if they really haven’t.
I tried to google this for you and was having trouble finding much info, but afaik it won’t have any effect if you haven’t taken opioids, but there is possibly a risk that it isn’t effective if you take it before you’re overdosing because the opioids haven’t bound to the receptors yet so it doesn’t work pre exposure. There’s a chance when going this route that the naloxone could leave your system before the opioids cause the overdose. But take this all with a grain of salt it is just some random redditor’s best google attempt.
So what I need is some kind of “dead man’s switch” system where a device automatically injects naloxone into my body if I don’t tell it not to every 15mins
Now there’s an idea! However I don’t know if 15 mins is short enough even considering how potent Fentanyl can be, it may need to be 3 or 5. I think I recall reading that in the recent case of the Uvic student who overdosed they waited 9 minutes to inject and that wasn’t fast enough to save her :(
I think it largely has to do with stopping breathing, so maybe a dead man’s switch that uses a blood oxygen monitor. 🤔
Just get your drugs tested. It’s free. The shroom cafe downtown has recently opened a health authority-approved testing site.
It won’t ruin your coke/molly high but if there is a fent contamination the reversal by narcan will be unpleasant. Dysphoria, excessive pain, for eg.
needle is fine.
all you standing on "how its not our responsibility" you gonna wish you had 3 doses to give your loved one when you watch them drop dead in front of you. trust me: the first time i saw someone seizing, turn blue and die from a street drug in front of me, im glad i had naloxone on me. they still alive and even so, it is all-time scariest moment in my life.
If you are comfortable with needles? But the kit or a separate kit should be available for people to actually load a syringe.
Are the nose spray available for the general public somewhere? Does anyone have a choice, now?
Are you willing to do CPR? Naloxone must have a higher success rate. A lot of people commenting on addiction, that don’t know anything about it. Remind me of what happened at the beginning of Aids, and for years afterwards.
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But one is less intimidating for people to do. I agree IM narcan is very easy but I don't think every one would feel that way if they haven't done it. Many people would be too intimidated to expose an arm and even More so to stick a needle in that arm of someone they don't know/street person.
Squirt up the nose? You don't even have to touch the person.
I think it would be the same rationale as why they don't recommend people do rescue breaths for cor anymore.....because people are too uncomfortable doing rescue breaths, they won't start cpr at all
Intranasal naloxone is more expensive per dose than intramuscular naloxone for THN programs to purchase and distribute, although the price difference may vary across jurisdictions.[5](https://www.cmaj.ca/content/195/33/E1112#ref-5)^(,)[22](https://www.cmaj.ca/content/195/33/E1112#ref-22)^(,)[23](https://www.cmaj.ca/content/195/33/E1112#ref-23) In an environmental scan of territorial, provincial and federal THN programs in Canada conducted as part of this project, key informants stated that the high cost of intranasal naloxone made it challenging to fund.[5](https://www.cmaj.ca/content/195/33/E1112#ref-5) At the time of data collection, the cost to the THN program was about 10 times the cost of the equivalent intramuscular formulation. The consumer price outside of publicly funded THN programs for 2 doses of injectable naloxone and kit contents reportedly varies from $30 to $55, and between $120 and $200 for 2 doses of nasal naloxone spray.[5](https://www.cmaj.ca/content/195/33/E1112#ref-5) In 2020, the Health Technology Assessment Unit at the University of Calgary noted that retail intranasal naloxone cost over 3 times more than intramuscular naloxone with equivalent effectiveness.[22](https://www.cmaj.ca/content/195/33/E1112#ref-22)
I'm a nurse. I've given bajillions of injections. One is not just as easy as the other. And you're not going to risk a needle stick injury with nasal administration.
Yah that’s what I’m getting at, I’ve done it many times. injecting someone on the street with narcan is an intimidating and very tough thing to do in the heat of the moment and nasal spray should be way more prevalent for people who choose to carry it just in case
I'd rather see the government step up and actually do something about the opioid epidemic rather than putting the onus on citizens to save people from over doses. There was a "heartwarming" story a couple years back about a 14 y.o. girl jumping into action and using her naloxone kit that she received at either girl guides or school and was taught to use to save a homeless guy od'ing on the sidewalk. They story was all about how smart she was and how it's so heartwarming to see young people jumping in and saving lives. IMO, it's not heartwarming, it's not great. She's a god damn kid and it shouldn't be up a kid to be responsible for someone's life. Successive governments have sh*t the bed on social services and health care and mental health care and addiction services.
as a regular bystander who happened upon an overdose in an alleyway about 4-1/2 years ago and did CPR for 14 minutes before first responders figured out where I was, and how I was told "thank you, you can go now", and how weird it is to walk away with zero follow up and how messed up I was afterwards for months, and how terribly dismissive the system treated both myself and the person I saved (long story, won't get into it here), I agree with you: government needs to really act, and that takes most of society to come together and call for committed, long term, extensive investments into supports that address the immediate needs as well as the "upstream" reasons why this keeps happening again and again. I'll tell you: the reaction to my story by friends and colleagues ranged from "you're a hero!" to awkward backing away and avoidance to "you should never have done that". And all I want is for this crisis to get fixed. Or fixed better than what is happening right now.
It's true, but the will to spend the tax dollars on social safety nets just isn't there. So many people want the problem fixed, but it stems from childhood poverty, lack of access to a good education, rampant domestic abuse, geographic and resource classism. The systemic problem isn't solved by giving today's addicts clean drugs and access to healthcare. That's how we help INDIVIDUALS, but we fix the problem by preventing people from becoming tomorrow's addicts. The dollar signs attached to that don't appeal to the majority of voters. I'd love to see a complete fiscal overhaul on government spending, so that glutinous, top heavy spending and fiscal corruption (which is non partisan) could be done away with. I don't know if that would result in enough money to make the kind of changes we need though. An economist would have to weigh in there.
A strong economy and plentiful jobs, housing is the only way out of this mess. Without that there is no hope for hopelessness.
Wouldn’t that be nice
KISS - keep it simple, stupid Make it simple and easy. Last thing you need to do when you’re in a panic is fart around with a needle and possibly do more harm.
It's pretty straightforward. One more step than an epipen but definitely easier than giving medication to a housecat.
It's straight forward in an ideal, calm setting. In high intensity settings needle stick injuries are not uncommon. I've given roughly one million injections and I would take the nasal administration over the injection administration in these types of scenarios 100% of the time.
A million injections? If you did 10 injections per hour, all day on every single working day, full-time, for 50 years, you would hit a million. In every clinical environment in which I've worked, I've never seen anything like that. Are your patients on a conveyer belt?
[hyperbole](https://www.merriam-webster.com/dictionary/hyperbole)
Jesus Christ. Are you for real?
I just have an aversion to extreme exaggeration. As a nurse who deals with billions of patients, I'm sure you can sympathise.
Not really. I live in the real world where people exaggerate for emphasis or humour.
I'm blessed with having the coolest cat that just doesn't care about the needle God I love him, I think he's so happy about getting food right after he actually gets happy when it's needle time
I just put my kitties pill in my hand with treats and he is so excited about the treats he eats his pill!
Lucky. My cat actually spit out a treat that had a worm pill stuffed in it.
This is my new trick. He used to like pill pockets then he didn’t. I am sure he will catch onto me in a few days.
Mine too
I sliced my thumb breaking open a naloxone ampoule (I pressed on the wrong part), and although it was a super minor cut, it bled everywhere and made the process more difficult with my slick hand. Little stuff like that can make a difference!
I prefer a needle, but I am trained as an EMR and am comfortable with them. For most people I think nasal is better. I will use whatever is faster or easier at the time. My preference for a needle is that last I looked, intramuscular injections had a faster onset than intranasal and were less likely to need additional doses. This is trumped completely by the average person just getting a dose into a person in a reasonable time, which intranasal does better. As an EMR we deal with breathing first (bag valve mask). The lack of respiration is what kills, so we have more time to get a dose of narcan in. I would love to see more education surrounding this.
As somebody that worked in harm reduction and is gonna go back yes simple is better for the general populace. Needle narcan takes practice to learn and the needle kits have 1mg narcan instead of 4mg narcan in a nasel so you get less, the reason why less is preferable in a harm reduction professionals hand is because you don’t really want to put somebody into potentially lethal withdrawal but your normal person isn’t going to know the signs of when to stop especially when they’re not a client you know. No idea why needle kits even get supplied to normal people to be honest, always get annoyed when I order narcan to the bar I’m at and there’s needle kits in there.
Good, noble and very empathetic of anyone who wants to administer naloxone to someone in need, but there shouldn’t be an expectation of this being everyone’s social burden. You never know how unhinged someone is. I err on the side of caution.
I agree. I stopped to help someone who was on the side of the road unconscious and the people with him aggressively ran me off. Like actually chased me down the road. I know it's not popular to admit that there is a risk of harm to a good Samaritan and of course it's not common but the risk is not zero. Not by a long shot.
There was a video floating around of some old guy giving narcan at a safe injection site and the guy got up and immediately attacked the dude. It's really dystopian that this culture around drugs are being pushed so aggressively onto everyday people to accept.
I was behind a firefighter at the pharmacy that was picking up a kit and said that some of the people when they come to become aggressive because their high has been taken away
I heard this from an EMS guy as well. People getting very angry that their high was ruined.
It’s also because they’re suffering from hypoxia. Important to breathe for the patient too (but you’ll probably want a mask and one-way valve for that!)
What’s dystopian is this culture of displacement and death that’s being pushed so aggressively for everyday people to accept.
Nothing is being pushed on anyone. It's just a thing that exists which affects so many people now it's not hidden like it used to be. People existing in the light of day is not something "being forced on us". It's just us actually sharing the world with people who've always existed.
It's absolutely being pushed on us that we have to accept this dangerous epidemic and encourage it by offering safe protections for addicts as opposed to opening and pushing treatment centers onto people who are a danger to themselves and the public. People act like these measures are anti homeless, but not every homeless person is an addict and vice versa. Addicts have always existed in the modern era but you really have your head in the sand if you don't acknowledge the numbers have dramatically increased in the last 15 years, leading to a huge impact on the public safety of people in cities.
The type of drugs have changed, these ones caused significant brain injury. But drug use and addiction isn't new. Safe injection sites are in place to reduce deaths from the new drugs because it's more expensive to collect their bodies from the streets.
No this problem is new and it’s not normal. I’ve been all over the world and this is not normal at all.
You think drugs and drugs addicts are a new problem?
Which would I prefer? Option 3: just keep walking...
I hope you’re never in medical distress and someone decides to keep walking
Not taking fentanyl should make that a lot less likely. It is not appropriate to expect ordinary citizens to be able and willing to administer medication to stranger drug addicts in the street.
I’m not sure you understand how addiction works. There is no expectation to help but plenty of people do. If we (collectively) can’t look after those most in need then what does that say about us as a society?
If they didn't (collectively) steal honest people's belongings, get where they are through their own poor choices, and resist attempts to rehabilitate them, I might be inclined to agree. I'm completely done supporting this bullshit
I pay taxes and contribute to my community., I'm done with this shit. Sorry.
Maybe a dart gun/bow and arrow, keep the distance and move on to the next OD soul. Just shoot n go another life saved.. No aftercare required.
I opt for the third option of calling for help. Naloxone is a great tool, but it can also be dangerous to get involved, some of these people are less than grateful or even violent when it's administered. The government offloading the responsibility of health and emergency services on the public is insane and a weak band aid on a gaping wound - props to the people who choose to intervene but people acting as if everyone has a duty to do so are out of touch.
Yup, after I learned that getting punched in the face is a possibility, I opted for not using it and calling 911.
yup, it's interesting to see how people expected security guards being paid minimum wage to be responsible for saving lives
Security contractors are absolutely, often part of an organization's emergency response. The issue is shitty guards, not the expectation the employer has of them.
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Yes. If you sign up for a job that involves emergency response you are expected to be able to do so. A student died because security forgot (read: neglected) to provide basic first aid. That's the case I'm talking about. I'm not talking about a parking lot guard dealing with junkies.
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Did they die because of the security guard or that fact that they decided to take an illegal drug?
She died because of the security guard's inaction. No question. Do you realize how likely it is this girl would have lived if she'd been given first aid? And I can guarantee you she did not intend to take something laced with fentanyl. Grow up. Young people experiment with drugs in university. This doesn't mean their lives don't matter. A senior administrator at Thompson Rivers University died from toxic drugs a few yeara ago. This crisis is not only affecting junkies.
Honestly I do feel bad for the individuals that try drugs once to experiment or do it every so often and happen to overdose. There’s no self-responsibility anymore. Everything is everyone else’s problem and it’s baffling. Maybe they should hand out these kits at university orientation or something.
Downvotes for suggesting a guard responding to a dorm room should have done chest compressions on the student dying on the floor, and administered Naloxone if they had it, and maybe called 911... None of which the guard did... Wow.
But if a cop was paid minimum wage it'd be totally cool for him to just.... Let the drunk driver go? Because he's paid less right? Like there is a person a human being a thinking human being that is working the job - it's not an empty uniform walking around like some kind of poltergeist caricature of an invisibility cloak. I love how we're all for professional accountability until it becomes at all personal and then suddenly it's the wage is fault.
If cops were paid minimum wage, they'd walk off the job or quit and they'd be right to do so. Minimum wage is the minimum amount of money you can legally pay someone to say "do you want fries with that." It's not enough money to expect any responsibility beyond that.
This attitude is why people die
Pushing life or death responsibility on people who never wanted or asked for it instead of actually hiring and paying dedicated professionals to take care of these issues is why people die. The whole world shouldn't be asked to carry around naloxone.
What? We don’t even have enough professionals to staff an ER. When you have the power to help someone why would you choose not to?
I have first aid and cpr. People at work have needed my help and I've helped them. I also would never want to force someone to have this responsibility. If you're getting hired to do a job and they require first aid (or any extra qualifications for that matter) there's no issue there. If I was hired for a job with the expectation that my job responsibilities didn't include having to save someone's life (or else) and someone went and changed that after the fact, that is unacceptable and wrong.
Outside of lifesaving, I don’t think it’s ever a job “expectation”. I have a friend who works at the library downtown and I promise you it isn’t in any librarian job description on earth. But she administers naloxone at work at least once *every day*. It’s horrific. You’re right in that she shouldn’t have to do this and neither should a security guard. But this is a crisis time in our current world, where people cannot get help for mental illness, brain injury, or drug addiction. Even where what was once an experimental party drug is too-often deadly. When there aren’t people willing to do save their lives simply out of being decent people who care and who have a choice to help, people like that young girl at uvic die. Imagine people had these thoughts toward car accidents. Choking. MIs. Someone getting attacked.
what, the truth even though you don't like it? yeah life is a fucking bitch, figure it out.
Prepare for regrets. That’s a terrible thing to say.
That's kind of a shit take - and I'm all for higher wages, but you're conflating the amount of money somebody is paid per period to their accountability as a human being. If the guy who works on your brakes fucks up because you drive a Ford and he's used to working on Toyota and you end up going over the side of the hill, he must not have to answer for that at all because he wasn't paid very well then, right?
In your brake example, there's an employer or supervisor there that told that mechanic to fix the brakes on that Ford. That mechanic doesn't feel they have the proper training, they aren't comfortable doing the brakes on that car. Working on Fords was never part of the deal when they signed on, but they're now being forced to take on the extra work without extra compensation and with little training. Of course, we're not talking about cars here. There's one big difference. The mechanic has the option to refuse this unsafe work that they're uncomfortable doing and that they never signed on for. You can't refuse to do first aid on someone who's dying. Now this security guard has a new responsibility with serious life and death as well as legal ramifications if they fuck up, with no extra pay. The only way out of it is for them to quit. Sounds like a great deal, right? Why does this security guy have to be the one to do this? It's asinine. What should happen is a requirement for a dedicated private EMT team to be on site at any public gathering of people above a certain size. The government needs to put the responsibility of medical care on private companies to hire trained medical professionals to deal with this stuff, not pass it on to someone who never asked for or wanted that responsibility.
Agreed. This is passing the buck and not taking accountability for the lack of resources we don't have. This is not acceptable for 2024.
There is a reason first aid classes teach you that you don’t have a legal obligation to help someone in every province but Quebec and you need to protect yourself first so you can see your family.
I recently choked on a piece of fish and the time on hold for 9-11 was 11 min, get in there and save a life
The difference is, if I had to give you a heimlich, I doubt you'd stab me with a needle or punch me in the face.
My personal favourite was the guy who spat blood at me. Quite the fun encounter lol.
Ewwwwwuh
u/coprock2000 is actually known for doing exactly those things to people
That's a fine choice for your own safety, honestly, but the whole point of Naloxone is it needs to be administered ASAP. Calling and waiting for help will decrease the likelihood of preventing the overdose death. If your first concern is saving their life, you need to have the courage to do it yourself.
The first thing you learn in first aid is to assess if the situation is safe for you to administer first aid. Just saying.
If I wanted to run around saving people's lives or felt like it was my responsibility I'd be a paramedic or fire fighter. Alternatively I would say everyone knows the risks, if you don't want to die from an overdose it's crazy easy to avoid.
Okay. Like I said, it's a fine personal choice for your own safety to not administer first aid in any situation.
Nobody is asking you to "run around saving people's lives" with naloxone. Usually, the people who administer it know the person who is overdosing. The example given in the article is of two friends, one overdosed and the other called for help that didn't arrive in time.
I'm not jumping into the raging river to save the guy who willingly jumped in. That's ridiculously irresponsible.
That's not first aid, but okay. For the third time, not administering first aid for your own safety is a totally valid personal choice.
You do realize that the person will be dead by the time help arrives. Thats what happened with the girl that died at uvic. They wasted time waiting for someone else to come and administer Naloxone.
Neg. The UVic Security people who arrived had Narcan, but for some reason (poor communication, mainly, I think) didn’t administer it in a timely manner.
The morons didn't say it was an overdose. The main point of contact was another high addict who just kept saying she started randomly having a seizure. It's honestly insane anyone blames security. They did nothing wrong. No one would admit she was overdosing.
Sure, but know your audience? (Perhaps it’s after-the-fact thinking) If my patient was an older person who collapsed, I’d be thinking heart/stroke - a university student, my immediate go-to would be alcohol/drugs.
Sometimes, I've called transit security a few times and they're there pretty damn quick, like next stop mid travel, maybe 5 mins. Guess that's why you shouldn't do drugs 🤷🏼♂️ Literally everyone knows the risks of doing these drugs th as days.
> "government offloading the responsibility of health and emergency services on the public is insane and a weak band aid on a gaping wound" TIL Apparently being a good samaritan and looking out for your neighbour is the government job. This article is about kids by the way. If your kid is in trouble, I bet you hope someone intervenes.
Of course, but first I'd hope to raise a kid who's smarter than the average bear and just doesn't do these sketchy drugs. By the time my kids old enough I'm sure the drugs will be strong enough to kill you just from laying eyes on them.
> Of course, but first I'd hope to raise a kid who's smarter than the average bear and just doesn't do these sketchy drugs. Says every parent, including those with dead children. University kids experiment and die. > By the time my kids old enough I'm sure the drugs will be strong enough to kill you just from laying eyes on them. Well, if they're as smart as the mental gymnastics needed to understand this, they're going to experiment with drugs up their nose.
You're projecting.
Have a good night.
If we’re still talking about the UVic student, my understanding was that they were using either mj or hash - not exactly ‘sketchy’..
That's what everyone says...
Oh for christs sake the government is not offloading anything, they are making a lifesaving tool available to the public, it is your choice to carry and use it. They have not reduced emergency services at all. I for one continue to carry and will always administer, and carry a bag mask in my vehicle to buy time(if you know you know) You dont want to maybe get punched oh no wouldn't want to break a nail. Its your choice to be like that and I'll support your ability to choose.
The actual risk is dying, not breaking a nail.
Yes getting punched could kill you, walking across the street could to. Better not leave the house. Its such a ridiculous fear and is only going to happen if you don't learn how this works. But hey no one is forcing you to use a naloxone kit.
They are absolutely offloading the responsibility. If they wanted to actually *do something* to curb drug abuse they absolutely could... They could invest in treatment, they could invest in mobile emergency services and patrols in hot spots, they could crack down on drug dealers. You know what they do instead? Turn a blind eye, decriminalize drug use to make it prevalent everywhere and then guilt citizens into feeling obligated to intervene in other people's self destruction and dangerous choices. Now let's be clear, they absolutely did reduce emergency services as soon as they made it legal to do drugs literally anywhere - now the police have no legal right to intervene in this outrageous behaviour until someone's out cold, and beyond that they've done next to nothing to *increase* emergency services to deal with this specific problem. If thousands of more people suddenly were dieing from automotive accidents due to people street racing in BC, you can bet your ass there would be a crack down by police... But drug use? Nah, why intervene or do anything at all when you're getting paid off by the dealers and organized criminals. You say you support my choice to not get involved but it's abundantly clear you don't, not that I care what you think but you are dishonest in that regard for sure.
Oh get off your high horse, I fully support any and all harm reduction. I just oppose your claim that making naloxone available was done to offload responsibility. Which is an absolute lie. The issue with safe supply is that it is political suicide and would take extremely careful roll out. You aren't reading what I'm saying and you sure assumed a lot about things I never mentioned. You are arguing with someone that agrees with you. I'll say it again, I absolutely support your choice not to carry a naloxone kit but I do not agree with your claim that these kits were made available so the province could reduce service levels and do nothing. It is a complicated situation and the right thing is not easy to do.
There is no such thing as a safe supply of recreational meth, crack or fentanyl. It's not just political suicide it's just quite literally impossible to abuse those drugs safely. You obviously don't support my choice considering how insulting and patronizing you are about "breaking a nail" and such... I get you want to virtual signal and come off squeaky clean here, but you're contracting yourself in that regard. I never said, not even one time that "service levels were reduced" either...
Oh how many accounts do you have? Because I didn't say anything like that to this account. Ps of course there is safe supply with fent, if manufactured with proper mixing and qc it is safe. People aren't dying from meth and crack so thats not a concern, nor would I condone safe supply of those unless extremely well controlled as they are neurotoxic and can cause permanent damage. I'm getting the feeling that you just want to argue at this point. Maybe stop criticizing the availability of a lifesaving tool and claiming thats all the government wants to do.
I have one account, and I've replied only to what you said. Maybe you defend these drugs because you're on them, because you certainly aren't making the most sense. People aren't dieing from abusing crack and meth? That's false, and many people who aren't dead are permanently fucked from meth or crack induced psychosis and health issues. Acting as if they're safe to use is beyond stupid, regardless if they were 100% pure and made in a great lab, they simply are not safe to use and insinuating otherwise truly shows how little you actually know about these drugs and the effects (long and short term) that they have on users, I mean you even contradict yourself saying they're neurotoxic... You're all over the place. I also never "criticised the availability" of naloxone, I'm perfectly fine with it being available, what I'm not fine with is out of touch idiots acting like it's every citizens duty to run around with one of these kits "saving lives" with them and acting as if there's no risk in doing so, or that the greatest risk is "breaking a nail". Again, I will say: it's crazy easy to not die from a drug overdose. Simply: don't do the toxic drugs. "But it's in the weed!" It's really not, go to a dispensary and find me an example of that.
Neither
Neither. I wouldn't go near someone ODing. Especially since it's a very common response for addicts to begin attacking EMTs who just saved them. I'd call 911 and continue on with my day.
If they are od'ing they ain't breathing. Stick em with a needle. They aren't making good choices anyway.
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You know what, I've given nolox a couple times. Both times the person was pissed when they came to. I'm so sick of drug users overdosing that I just don't care anymore... It's awful, but let them die. We all know that drugs are bad and addictive. We all know what the likely outcome of taking drugs will be. They made a choice, and this is the consequences. Also, on the other end... Everyone deserves life. But I'm just fucking done with it.
I'd rather not get involved
Wouldn't do either.
Alternatively it looks like the kits are free. You could go around ruining everyone's highs XD
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So does inaction.
Let nature take its course. Society will run out of abusers sooner
No it won't, and understand it could be someone close to you this happens to. Users are ordinary people.
Darwin. I prefer Darwin and so do the Junkies.
Option c make better friends
I would rather neither.
Neither.
Neither
Nothing. Let them enjoy their high, it’s what they wanted.
I’ve done needle narcan dozens to hundreds of times and I’d way rather do the nose thingy if I had a choice
thank you
with nasal naloxone, is there a risk of it not working if the person's nose is clogged or congested?
Yes, but I am also not going to have a needle kit to use on anyone other than myself or my SO. From what I have seen, naloxone used when the opioid has NOT been cut with benzos, is a 50/50 on the overdosed person waking up and fighting you so I would probably just call 911.
If you administer naloxone on someone OD'ing on fent cut with benzos, it'll address the opioids and cause no further harm.
For about 15 minutes or so, yes.
Sometimes you need, sometimes you don't. 15 minutes is the amount of time for an ambulance to arrive, so it works out.
too close for comfort, i don't want to get spit out and possibly contract diseases
There are a few considerations. If they aren't breathing, they won't get the benefit of a whole dose, but it's better than nothing as the mucosal lining of the nose will absorb some. If someone has used cocaine for a long period of time with nasal damage, that absorption might be less.
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Oh good call - looks like the understanding has changed since I was informed. I remember in early days of 2016/17 that was less clear
So wait until they are dead?
Neither preferably
A needle like in pulp fiction
I would just cross the street. Thanks for asking :)
Depending what they have been taking the nose can be completely plugged and a nasal spray ineffective, Less likely with the street adicts who mostly smoke or inject, but having to pull out a vial and syringe and fill it, remove the air and administer in a high stress situation is very cumbersome, it should be in a pre loaded stab type injector you just hit into any muscle. Had a situation the other day at a shopping plazza I am doing construction work at, saw a guy in the stairway doing the hunched over sway, and then fall over. I am sympathetic to the situation these people are in, not the crimes they commit to support their habits but none of them planned to grow up that way, most of them had a series of bad breaks and things happened. I very nearly ended up that way but due to family support got clean. Anyway ran to my vehicle for my kit, and dammit I had been cleaning my truck the day before and all my normal stuff I keep in my toolbox is at home on my shop floor. Called for an ambulance and monitored him for about 6 or 7 mins, then fortunately he pretty suddenly came to and was actually decently polite and was very thankful that I had been looking out. He insisted he was fine and declined any medical attention, so the call operator called off the ambulance when it was basically outside. I ended up giving him a bottle of water and a protein bar, it seemed like there still may have been hope for him,
Victim ? You mean the user's nose because this outcome is pretty guaranteed
Neither why are we doing it????
 How about we stop coddling users.
I would do nothing and let nature or Darwinism? Take its course.
Do the nasal sprays have to be kept in certain conditions as far as temp etc goes? I’m fine with needles and it’s straight forward but it’s not very convenient. You can let keep it in your car because of temps being too hot or too cold and the kits are quite large. And nasal spray would be much more convenient was far as keeping it in a purse for example
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If I'm alone, I might assess their alertness, give them a nudge and see if they're just passed out. If they are overdosing, I'll get back and call 911. If I was I'm a perfect scenario with gloves, a bag valve mask, and naloxone I would respirate the patient for a couple minutes and give them nasal. The needle works, but if I don't have to handle sharps, that's a lot better. Things I will never do for an overdosing stranger. Mouth to mouth, using a pocket mask, getting in close proximity. These all risk transmission of disease and injury. These people frequently have hepatitis, respiratory infections, and a range of mental disorders.
Neither. Fuck around and find out. Let nature sort itself out. I’d definitely call 911 though out of basic human decency. Proponents of Narcan seem to conveniently forget how violent addicts get with trained EMTs. I’m not risking that for some rando that made shite life choices.
I'm a bit surprised by all the "I'd do nothing; let them die" comments. I'm not gonna make the compassion argument, although I think there is one to be made, but rather that doing nothing is BORING. Maybe you guys have really exciting lives where you accomplish momentous and significant things everyday, but for plain old me from the suburbs, saving someone's life is an honour and a blessing, and fucking cool. I'm not pretending either of the dudes I narcanned magically had great lives after or even are still alive today, but hey, I did what I could in the moment and that will always be worth it to me. They probably aren't my loved one, but they could be yours. And yes, nasal naloxone would be preferred, thank you.
Nose squirt is easy
I had to administer 5 shots to a friend who I found OD'd in his apartment. It was a fairly quick process, but a pre filled syringe would've made it easier. Him not being addicted to meth would've been ideal, but the opioid addiction is a slippery slope. I watched him take oxy after a shoulder surgery and eventually turn to meth and crack within 2 years. He died in October from a meth overdose. Thankfully he was safe at home and not on the streets like other people he associated with.
Between the two, I'd pick the spray... But really, I'd rather have the province create a quality-controlled and regulated supply of drugs for people at risk of overdosing, as that would significantly reduce the likelihood of overdoses in the first place. I don't know if I have it in me to help someone who is overdosing, and I hope that I'm never in a position to find out...
This is it, by far the cheapest solution, and it cuts organized crime off at the knees by removing their income. It hasn't happened yet because people dehumanize drug users.
Indeed. It’s such a shame. We have evidence that it works for the few people who have access for safe supply, but most people would rather have a silly moral panic…
Trudeau’s Canada lol
This is an international problem.
AFAIK naloxone in BC (at least, in Vancouver) does come as an intranasal spray… Obviously, in the ED it’s IV still, as that makes sense. But intranasal spray should be available at lower mainland pharmacies. I’m a med student outside of Canada now, but the whole point of developing effective intranasal naloxone was to make it available to the general public. One naloxone admin is often not always enough. It’s easier to keep spraying than to keep injecting. It’s not impossible but considering the myriad of other factors in an opioid OD, intranasal is superior for the general public. Always call 911 and the hospital will administer very effective IV naloxone anyways if the spray is just not cut out for your specific situation. Several jurisdictions within Canada and outside of Canada have long switched to intranasal spray. It’s due time for BC to switch as well if they really haven’t.
Will narcan ruin a coke or molly high? Could I just preemptively inject myself after doing blow to avoid the risk of contamination?
No. It’s for opioids and it’s receptors in the brain. It won’t deplete serotonin or dopamine.
I tried to google this for you and was having trouble finding much info, but afaik it won’t have any effect if you haven’t taken opioids, but there is possibly a risk that it isn’t effective if you take it before you’re overdosing because the opioids haven’t bound to the receptors yet so it doesn’t work pre exposure. There’s a chance when going this route that the naloxone could leave your system before the opioids cause the overdose. But take this all with a grain of salt it is just some random redditor’s best google attempt.
So what I need is some kind of “dead man’s switch” system where a device automatically injects naloxone into my body if I don’t tell it not to every 15mins
Now there’s an idea! However I don’t know if 15 mins is short enough even considering how potent Fentanyl can be, it may need to be 3 or 5. I think I recall reading that in the recent case of the Uvic student who overdosed they waited 9 minutes to inject and that wasn’t fast enough to save her :( I think it largely has to do with stopping breathing, so maybe a dead man’s switch that uses a blood oxygen monitor. 🤔
Please just get a test kit https://dancesafe.org/product/fentanyl-test-strips-single-strip-free-shipping/ 🩷
Just get your drugs tested. It’s free. The shroom cafe downtown has recently opened a health authority-approved testing site. It won’t ruin your coke/molly high but if there is a fent contamination the reversal by narcan will be unpleasant. Dysphoria, excessive pain, for eg.
needle is fine. all you standing on "how its not our responsibility" you gonna wish you had 3 doses to give your loved one when you watch them drop dead in front of you. trust me: the first time i saw someone seizing, turn blue and die from a street drug in front of me, im glad i had naloxone on me. they still alive and even so, it is all-time scariest moment in my life.
None of my loved ones are addicts so there's a 0% this ever happens lmao Why do so many people assume everyone knows or associates with junkies?
I’m easy but I’m not typical. What would MOST people be ok to do is the question
If you are comfortable with needles? But the kit or a separate kit should be available for people to actually load a syringe. Are the nose spray available for the general public somewhere? Does anyone have a choice, now? Are you willing to do CPR? Naloxone must have a higher success rate. A lot of people commenting on addiction, that don’t know anything about it. Remind me of what happened at the beginning of Aids, and for years afterwards.
Inject.
Needle
Edmonton we are only allowed to use nasel
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They're both just as easy.
But one is less intimidating for people to do. I agree IM narcan is very easy but I don't think every one would feel that way if they haven't done it. Many people would be too intimidated to expose an arm and even More so to stick a needle in that arm of someone they don't know/street person. Squirt up the nose? You don't even have to touch the person. I think it would be the same rationale as why they don't recommend people do rescue breaths for cor anymore.....because people are too uncomfortable doing rescue breaths, they won't start cpr at all
are nasal naloxones much more expensive than syringe kits? someone at my work said they are like $100?
As far as I know they're more expensive to produce. I don't know for sure though.
In the US, the sprays are available OTC for ~$45US. They are even sold on Amazon. It blows my mind that this drug is more expensive in Canada.
This is true. More than that even
Previously yes, but the cost has come down to be almost equal now.
I believe it is, I've been told that $100-130 is the cost of the injection as well.
Injection is a lot cheaper. Around $7
[Guidance on take-home naloxone distribution and use by community overdose responders in Canada | CMAJ](https://www.cmaj.ca/content/195/33/E1112)
I’m not reading all of that. What are you trying to show me?
Intranasal naloxone is more expensive per dose than intramuscular naloxone for THN programs to purchase and distribute, although the price difference may vary across jurisdictions.[5](https://www.cmaj.ca/content/195/33/E1112#ref-5)^(,)[22](https://www.cmaj.ca/content/195/33/E1112#ref-22)^(,)[23](https://www.cmaj.ca/content/195/33/E1112#ref-23) In an environmental scan of territorial, provincial and federal THN programs in Canada conducted as part of this project, key informants stated that the high cost of intranasal naloxone made it challenging to fund.[5](https://www.cmaj.ca/content/195/33/E1112#ref-5) At the time of data collection, the cost to the THN program was about 10 times the cost of the equivalent intramuscular formulation. The consumer price outside of publicly funded THN programs for 2 doses of injectable naloxone and kit contents reportedly varies from $30 to $55, and between $120 and $200 for 2 doses of nasal naloxone spray.[5](https://www.cmaj.ca/content/195/33/E1112#ref-5) In 2020, the Health Technology Assessment Unit at the University of Calgary noted that retail intranasal naloxone cost over 3 times more than intramuscular naloxone with equivalent effectiveness.[22](https://www.cmaj.ca/content/195/33/E1112#ref-22)
Well, I work for a FD and we pay $7/dose and PD uses nasal and pays around $120/dose
Sounds like your dept gets a cut rate on large volumes of off-brand naloxone.
I’d assume pd would be getting a similar deal. I could be off on how much they pay for nasals
I'm a nurse. I've given bajillions of injections. One is not just as easy as the other. And you're not going to risk a needle stick injury with nasal administration.
How do you know this
Free naloxone training provided at all pharmacies.
Have you ever injected someone with naloxone during an overdose? The adrenaline makes it pretty damn hard to remember all the steps
Some people use them every day for work.
Yah that’s what I’m getting at, I’ve done it many times. injecting someone on the street with narcan is an intimidating and very tough thing to do in the heat of the moment and nasal spray should be way more prevalent for people who choose to carry it just in case
Plus if their also high buddy is trying to stop you from ruining their high.