Between life and death: Responding to drug overdoses in Canada
This article appeared in the July 14, 2014 edition of the Waterloo Region Record.
What if you could save a life? Just one life. Would you? For almost all of us the answer to these questions is an enthusiastic yes. Without question, regardless of anything, a life, just one life, is worth saving.
But what if saving that person’s life tested your political standpoints around drug use? Would that life still be worth saving? Across this country people are dying from legal and illegal drug use. Reliable statistics on drug overdoses across Canada are difficult to find, but research by the Ontario coroner shows that on average there is an overdose every day in our nation’s capital and 33 people a year die from overdose in Ottawa. Clearly, people who use drugs along with their family and friends, come face to face with death all the time. But what can be done? How can we save people? One answer lies in the way emergency services respond when they receive drug overdose emergency calls.
If you were to witness a heart attack, you would call 9-1-1 without hesitation. You would not think of the repercussions of making that call – someone is having a heart attack and their life needs to be saved. Now try to imagine how this scenario changes: it is not a heart attack, it is a drug overdose. Our research, published in the most recent issue of the Journal of Critical Social Work , shows that people who witness overdoses think very hard about the repercussions of making that call to 9-1-1. Sometimes these repercussions are too great – people will hesitate or not call at all.
Fear of arrest weighs heavily on this life or death decision. People legitimately fear the police showing up, being criminally charged for drug possession, and for mothers, having their children taken away. All of these consequences anxiously whirl around in the panicked mind of a witness. What happens? Over half of the people surveyed do not make the critical 9-1-1 call. Some may try to help the victim themselves, which sadly can have dangerous consequences. Street remedies can often make the situation worse. The longer someone waits for medical assistance the more likely that a life will be lost.
So what can be done? How can we save people? One idea used in Vancouver is to limit police involvement in routine overdose calls. The theory goes, if you don’t send the police there is no reason to fear calling 9-1-1. Unfortunately, this solution won’t work in many parts of Canada. In many cities and most rural communities the police are often the first responder and those in the best position to save an overdose victim’s life. A more feasible, Canada-wide option is Good Samaritan Drug Overdose Laws. These laws protect overdose victims and someone who calls 9-1-1 from arrest for being under the influence, simple drug possession, and possessing drug paraphernalia. They do not protect people from serious offenses such as trafficking. Good Samaritan Drug Overdose Laws exist in several American states. Preliminary evaluation of Good Samaritan Drug Overdose Laws out of the United States show that 88% of opiate users are aware of the law and are more likely to call 9-1-1.
Making naloxone, also known as Narcan, available in every province without a prescription is also an essential piece of this puzzle. Naloxone can be easily administered and it temporarily counteracts the effects of drug overdose, providing precious time to get the person to the hospital. The Ontario Health Ministry recently introduced naloxone for public distribution and emergency responders watch in amazement as the compound saves lives.
Ultimately if we truly believe that every life is precious, then the answer is policy change. We need to reduce the barriers to calling 9-1-1 during routine drug overdoses by providing limited legal immunity through Good Samaritan Drug Overdoes Laws and we need to work on distributing naloxone across Canada, barrier-free. That life, that one life, would be saved.
If you ever are unfortunate enough to witness a drug overdose the correct course of action is to call 9-1-1, perform CPR if the victim has stopped breathing and administer naloxone if you have access to it.
Author: Kayla Follett is a Master of Social Work graduate, with the Newfoundland and Labrador Sexual Assault Crisis Centre. Her research on this topic was conducted during an internship with the Waterloo Region Crime Prevention Council, and was published in the July 2014 issue of the Journal of Critical Social Work (co-authored by Anthony Piscitelli, Michael Parkinson and Felix Munger).