New N.S. ER protocol gives patients opioid dependency treatment but not take-home naloxone

Click to play video: 'Questions raised over Naloxone kits unavailability in Halifax hospitals' Questions raised over Naloxone kits unavailability in Halifax hospitals
WATCH: A Halifax physician raises concern over why emergency department staff in the city aren't able to provide patients with take-home naloxone kits. – Jul 2, 2019

A new protocol provides emergency department physicians with the ability to connect people with opioid dependency to treatment before they’re sent home.

“If patients are in opioid withdrawal or are interested in treatment at all for opioid use disorder, there’s a protocol for emergency physicians to start buprenorphine/naloxone, the trade-name Suboxone, as treatment right then and there,” said Dr. Tommy Brothers, a Halifax-based physician. “Then our community partners can see them even the next day in their clinics.”

While Dr. Brothers praises the new Nova Scotia Emergency Substance Use Treatment Program for its ability to connect emergency department patients with the treatment they need, he questions why emergency department staff across the province aren’t also able to provide their patients with take-home naloxone kits.

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“(Naloxone) is another life-saving medication that reverses opioid overdoses and this medication is available for free through the province through the provincial take-home naloxone program at community pharmacies, and now it’s even available for hospital inpatients, but in the emergency department we haven’t been able to stock it and supply it,” said Dr. Brothers, a member of the HaliFIX Overdose Prevention Society.

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Currently, the take-home kits are available to emergency department patients only in the western zone of the province, but according to the program co-ordinator, a strategy is in place to eventually include EDs across the province.

“That’s, like, nine emergency departments from Annapolis Valley all the way to Yarmouth that are in that process,” Amanda Hudson-Frigault said. “However, we also want to have a look at expanding that in the future to other emergency departments in other zones as well.”

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Hudson-Frigault says the authority isn’t trying to steer people away from accessing naloxone kits through emergency departments, but rather to train and inform people about the hundreds of access points where the kits can be obtained for free.

“We want to make sure that that’s done really well and really mindfully to make sure that individuals in the community know about all the points of access that there is because we understand that emergency departments are also very busy locations,” she said.

Dr. Brothers feels there is already training in place for emergency department staff to safely provide the kits to patients in need.

“This Nova Scotia Health Authority policy and program already exists, where these kits are already purchased and there’s already a policy in place where any facility can register as a take-home site,” he said.

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Hudson-Frigault says there are hundreds of access points for people to obtain the kits.

“We have over 300 access points across the province. We’re also supporting staff to be able to share that message as well.”

Opioid overdoses claim the lives of about 60 people every year in Nova Scotia, according to the provincial government. There have been 70 reported overdose reversals using the take-home naloxone kits, according to the Nova Scotia Health Authority.

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