Some boroughs decline naloxone
Although naloxone is freely available and the health ministry supports its use in cases of opoiod overdose, some boroughs are discouraging workers from carrying it, or at least are not training them in how to administer it – even those with first aid training.
Ian 08:33 on 2024-07-10 Permalink
I wonder if it’s an insurance worry, as it’s dispensing medication.
Kate 08:41 on 2024-07-10 Permalink
That crossed my mind too. So many of the choices made by authority can be explained if you take concerns about liability into account.
CE 09:08 on 2024-07-10 Permalink
I did a first aid training a couple months ago and naloxone/narcan administration was part of the training. Even if you don’t carry it, any pharmacy will give it to you in case of an emergency (which is of no use to anyone if it’s after business hours).
jeather 09:14 on 2024-07-10 Permalink
I thought we had a good samaritan act here — in fact I thought we had an affirmative duty to help, but weren’t liable unless we were intentionally causing harm/being reckless. I suppose that would make a worker with naloxone liable if they didn’t use it.
steph 09:32 on 2024-07-10 Permalink
jeather is correct https://www.canada.ca/en/health-canada/services/opioids/about-good-samaritan-drug-overdose-act.html
You don’t need to listen to your employer to be a good citizen.
Joey 10:13 on 2024-07-10 Permalink
What a disgrace. @Ian if it were an insurance worry, other boroughs wouldn’t permit it. This just seems cruel.
jeather 10:16 on 2024-07-10 Permalink
That’s a slightly different one, about not being arrested for having drugs, I was thinking about the more standard one, where you can’t get sued for breaking someone’s ribs while providing CPR, but also in Quebec if you know CPR, you’re required to help in an emergency that needs it.
Blork 11:13 on 2024-07-10 Permalink
“if it were an insurance worry, other boroughs wouldn’t permit it.” I wouldn’t make that assumption. The insurance worry (if it is that) is likely an attempt to balance benefits and risks. One borough might tip the balance one way while another borough tips it the other way. Boroughs are governed by people, and different people interpret these risks differently.
Joey 13:02 on 2024-07-10 Permalink
@Blork the notion of an “insurance worry” was just speculation, not rooted in the reporting, but I still don’t see how a lifeguard in the Plateau (trained in administering Naloxone) could be less of an insurance risk than a lifeguard in Rosemont with similar training. Moreover, I’m fairly certain anyone who has the proper training (which is minimal) can administer Naloxone, in part because the extraordinary benefits greatly outweigh the virtually non-existent risks (which are, chiefly, that the Nalxone may wear off quickly, that it might cause a cardia event and that it might cause withdrawal symptoms – each of these is dramatically better than dying of an overdose). Even further, it’s not as if the paramedics won’t eventually administer Naloxone; they most certainly will – unless the overdose victim has died because of a failure to act.
Anyway, the city and the province are already pressuring the boroughs to change course. I suspect they will within hours…
And, BTW, from Health Canada (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/prescription-drug-list/questions-answers-naloxone.html#). I can’t imagine that there would be an “insurance worry” here:
4. Why did Health Canada change naloxone’s prescription status?
With the dramatic increase in opioid use and opioid related deaths, in June 2015, the provinces and territories (P/Ts) requested that Health Canada make naloxone available without a prescription for use in emergency situations.
In March 2016, Health Canada changed the prescription status to increase public access to naloxone. Instead of requiring a prescription for each individual in need of naloxone, pharmacies are now able to proactively give out naloxone to those who might experience or witness an opioid overdose. Additionally, switching naloxone to non-prescription enabled emergency responders to administer naloxone without having to wait for a prescription to be ordered for each individual in need.
Kate 13:31 on 2024-07-10 Permalink
Joey, is there perhaps a legal distinction between a layperson administering naloxone on their own account, versus having it given by someone working for public services, possibly with official first aid training?
Blork 13:39 on 2024-07-10 Permalink
Joey, the only thing I’m disputing is the notion that because one borough deems something an insurance risk, then ALL boroughs will necessarily arrive at the same conclusion. Different boroughs. Different decision makers.
Joey 14:14 on 2024-07-10 Permalink
@Kate I don’t think so: https://www.quebec.ca/en/health/advice-and-prevention/alcohol-drugs-gambling/rescuing-a-person-from-a-possible-opioid-overdose
The whole point of the provincial Naloxone campaign is that people who are at high risk of overdose or who are at high risk of witnessing an overdose should have Naloxone on them to intervene and save a life. You or I could be easily trained (follow that link, the steps are very easy) to administer it, there is literally zero reason why, say, a lifeguard shouldn’t be expected to carry it in their first aid kid and administer as needed. The alternative, and this is not an understatement, in many cases is certain death.
jeather 14:18 on 2024-07-10 Permalink
It isn’t clear to me — are the employees not allowed to get naloxone as any citizen would and keep it with them while working, or is it just that the borough doesn’t supply it and doesn’t train?
Kate 16:35 on 2024-07-10 Permalink
The lede on the La Presse piece says “Plusieurs arrondissements de Montréal découragent leurs employés, même ceux formés en secourisme, d’administrer de la naloxone” which is pretty clear.
jeather 16:41 on 2024-07-10 Permalink
And the first paragraph says: À l’arrondissement de Rosemont–La Petite-Patrie, les employés – autant les cols bleus que les cols blancs – ne peuvent pas administrer de la naloxone s’ils suspectent une surdose d’opioïdes.
Which suggests something really different, which is why I asked.
Kate 19:07 on 2024-07-10 Permalink
If I see anything that clarifies this point I will post it.
…CTV says specifically that “several boroughs have banned their employees from administering the lifesaving opioid antidote naloxone.”
jeather 11:47 on 2024-07-11 Permalink
Thanks Kate. Not providing it is a choice, but banning anyone from carrying it is a bigger choice. (And might be illegal, based on that good samaritan law, where you have to intercede if you can?)