Opioid Crisis & Safe Consumption Sites Flashcards
Facts about Opiods?
- Opioids: prescribed pain relief medications such as codeine, fentanyl, morphine, oxycodone.
hydromorphone and medical heroin. - Opioids can also be produced or obtained illegally (there are prescribed opiods that can find its way outside of healthcare system)
- Opioids may be naturally occurring (made from liquid harvested from the
unripe seed pods of the opium poppy flower,
semi-synthetic (modifying the chemical structure of naturally occurring
opioids, and synthetic (manufactured chemicals, - Opioids are taken in many way: tablets, skin patches, and injections
- Use (particularly long-term use) can lead to increased tolerance, physical
dependence, substance use disorder (i.e., addiction), and overdose, and
other health issues)
What are the 2 primary reasons the opioid crisis occurred?
1) high rates of opioid prescribing (more opioids enter the market)
2) emergence of strong synthetic opioids (fentanyl) in the illegal drug supply
- fentanyl is a cheap way to make street drugs more powerful
What are possibly policy responses to the opioid crisis?
- Safe injection sites
- Education on opioids
(Dangers, treatments) - Preventative measures
- Providing sterile equipment
- Monitor prescription and use of opioids
- restricting who can prescribe opioids (specific clinics)
- Provide help (ie. hotline)
- Provide support to individuals to help stop taking opioids
- Provide services to ensure opioid use is as safe as possible (ie. needle exchange programs)
- Provide resources to the public to prevent opioid-related (free overdose kits)
overdoses - Reduce/change opioid prescribing practices
- Change pharmaceutical marketing practices
- Reduce the illegal production, supply, and trafficking of opioids
Categorizing these Policy Responses
1)Eliminate/abolish/prohibit unhealthy or harmful practices or
behaviours
- ‘Prevalence reduction’, often via criminalization (ie. find alternatives to opioids that have same effect)
2) Harm reduction: a set of strategies to reduce the negative consequences associated with unhealthy or harmful practices
or behaviours
- Face the facts that people will use opioids, but use interventions to make practice safer and reduce deaths
Target Individuals takign Opioids
- Wellness Together Canada (help line)
- National Overdose Response Service (NORS hotline)
- Drug rehab services
- Narcotics anonymous
- Overdose Intervention App
- Harm reduction supplies (e.g., sterile needles)
- Supervised consumption sites and servicex
Target the public
- Raise awareness about opioids, overdoses, and other policies
directed at reducing opioid-related harms - Opioid response training
- Free naloxone kits and training
Target health practitioners
- MYPRACTICE: Allows healthcare practitioners to identify patients who were prescribed opioids and track their use and history overtime
How the federal government wants to address the opioid crisis?
Prevention strategies - opioid prescribing guidelines, handouts for
patients
Treatment strategies - promoting evidence-based approaches to treatment
Enforcement strategies,- reduce controlled substances being diverted from legal activities (ie.pharmacies)
- drugs can be stolen from pharmacies and enter the ‘street’ market
Harm reduction strategies - safe consumption sites
Evidence strategies - systematically collect information about opioids and their harms (make evidence)
Funding strategies - provide grants to community-led organizations to respond to drug issues
Consultation strategies - to gather input from impacted communities
Good Samaritan Drug Overdose Act (2017)
- federal law that came into force in that provides some legal protection for people who experience or witness an overdose and call 911/local emergency number for help
Can protect individuals from:
* Charges for possession of a controlled substance
* Breach of conditions in probation orders, parole, etc. (ie. if you are on parole and can not possess narcotics, if you overdose, you might be hesitant to call 911, but they want make sure that you feel comfortable to do so)
- Applies to anyone seeking emergency support during an overdose, including the person experiencing an overdose
- law that supports those taking drugs so they can do it safely
- create exemption in the Controlled Drugs and Substances Act to operate a supervised consumption site (if we want ppl to come to site to use opioids, we would get possession charges if there was no exemptions in the law)
- Legal prohibition with a medical interest which can exempt us from particular penalties (not common in law)
What are Safe Consumption Sites?
- Safe consumption sites are designated sites where people can use their own drugs under the safety and support of trained personnel
(aka safe injection sites, supervised injection sites, overdose prevention sites) - offer evidence-based harm reduction services, such as drug checking, and provide access to important health and social services, including substance use treatment
- Not only do they save lives, they decrease drug use and crime providing resources to facilitate easier drug use
Objectives of Consumption Sites
- Help prevent overdose deaths (via drug checking and emergency
medical care, and because people are not rushing or using alone) - Provide health care (e.g., wound care)
- Facilitate entry into and inform about addiction treatment programs and other health
and social services (e.g., housing, employment assistance, and food
banks) - Reduce the spread of bloodborne infections (e.g., HIV, hepatitis C),
by providing access to clean drug use equipment and safe disposal,
as well as testing/screening - Reduce the strain on emergency medical services
- may also reduce public drug use and discarded
drug equipment
In order to have a safe consumption site in Ontario…….
….you are mandated to have services that meet specific conditions
Urgent Public health need sites
- Similar to supervised consumption sites, but established on a temporary basis to respond to urgent needs in a specific region or community (aka overdose prevention sites)
- Class exemptions (under the Controlled Drugs and Substances Act) authorize the Minister of Health in each province and territory to establish urgent public heath need sites as required
-It is the Minister of Health’s discretion if they wish to implement the
class exemption or not
- if your Minister of Health is not establishing any urgent
public health need sites in your province/territory, you may apply to set one up in your community
What is the Advocacy Coalition Framework?
- Theory that says policy changes because of groups who form to advocate in favour of certain change
