I am often asked what my thoughts are on the “fentanyl epidemic” and what impact it will have on Nova Scotia so here it is:
Fentanyl is of great concern due to its potency and accessibility vs other prescription opioids. The healthcare system created a huge market of opioid dependant people which organize crime is now going to capitalize on.
It’s an OPIOID epidemic not simply a fentanyl epidemic and has been going on for over a decade. Many people who use fentanyl have already been exposed to opioids but are looking for a cheaper more potent opioid that is easily accessible or some may think they are taking a completely different drug. It certainly is the king of opioids in terms of morphine equivalents.
Nova Scotia like other provinces was far too hesitant to acknowledge the opioid issue and act in a timely manner. The real sense of urgency only came into play when organized crime entered the picture with their own opioid products. It was easy for government and enforcement to condemn illicit fentanyl as its manufactured by organized crime not prescribed by our doctors.
In the city of Edmonton this year more people died from RX opioids than Fentanyl but you would never know that based on the news coverage and government task forces who call this simply a fentanyl crisis.
In Alberta from January to September 2016 there were 338 opioid overdoses 193 of these deaths (57%) were related to fentanyl and 145 (43%) were related to an opioid other than fentanyl. 49% of the people who died from an opioid overdose other than fentanyl filled an opioid prescription within 30 days of their death and 17% were under medical care for pain.
Until we prevent new exposures through more responsible prescribing and have timely access to services for those already addicted we will continue to create more opioid dependant people than we can treat and organized crime will be ready to feed that market with fentanyl or any other opioid they can get their hands on.
The most popular opioid on the streets and in medicine cabinets in Nova Scotia right now is hydromorphone and it accounted for 30% of opioid overdose deaths between 2007-2012 but most people have never heard of it. I’m sure the new stats are even higher. It’s also the second deadliest drug in Ontario this year. It will never get the same attention and sensationalism though as it comes from your family doctor.
Nova Scotia needs to take a strong public health approach and stop wasting everyone’s time with working group after working group and review after review. We need access to treatment, harm reduction, and a change in prescribing practices with a more accountable prescription monitoring system. We need to acknowledge that opioids are not always safe as prescribed.
There are too many people with special interests steering the boat in the wrong directions or simply treading water.