Is Overdose Antidote ‘Enabler’ Of Opioid Use


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jason-luan

Alberta’s associate minister of mental health says he’s worried that kids are deliberately taking larger doses of opioids.

Jason Luan says he thinks youth may do so, knowing that naloxone can be used to reverse an overdose.

That distribution of naloxone kits, he says, might be enabling greater drug use — a suggestion strongly opposed by a top Calgary medical professional.

Luan made the comments after meeting with Albertans directly impacted by addictions in Calgary on Friday for a round-table discussion. He told reporters afterward that he learned naloxone has been used as a sort of safety net to push the limits of opioid dosing.

“You know the naloxone kit that we send as an emergency recovery for people with overdose? Actually, the kids take that, knowing they have the kit, because now you’re safe,” Luan said.

“They want to push it to their limit, how far they can go to overdose, because they’re safe, because the kit is there,” he said. “So it begs the question of, you know, lots of times we’re trying to make it easier, wanting to help but it’s a fine line. If you cross that line, you become an enabler.”

Two parents in particular, his chief of staff later noted, believed their children had done this. Luan’s spokesperson said on Saturday that the provincial government remains committed to naxolone “100 per cent” and will continue to fully fund its distribution.

After Friday’s round-table, Luan told reporters this was the first time he had heard about naloxone being used “in the wrong way.” He said it affected his thinking about the overdose-reversing agent.

“For me as a policy maker, as a minister, my thinking is, ‘wow, this is interesting,'” Luan said. “We’ve got to find the balance. We can’t just be one way of thinking, believing we are doing something good, when in fact that can be utilized in the wrong way.”

ER physician disagrees

But Dr. Eddy Lang, an ER physician and head of emergency medicine at the University of Calgary’s medical school, said he hasn’t seen evidence that naloxone is being misused in the way Luan describes.

“I wouldn’t agree necessarily with the idea that giving naloxone is enables someone to pursue their addiction,” Lang said.

“While that’s a possibility and maybe that does occur, it’s a really small proportion — a drop in the bucket of how naloxone is being used in the community…

“What usually happens is that someone who has an opioid use disorder, who is addicted to illegal or legal opioids, if they’re using outside of a safe-consumption site, they will often get into trouble.”

“If for whatever reason one of them goes overboard and then becomes unresponsive and then starts breathing very slowly, the naloxone is a life-saving opportunity to bring that patient around from what occurred,” the physician said.

“But I’ve never gotten the sense from the patients coming to the emergency department that they had the naloxone at the ready, trying to push the limits on what they were using.”

Lang said naloxone routinely saves lives and needs to be readily available.

“You cannot limit its distribution for that reason, because the results would be catastrophic,” he said.

“I don’t think that we’re enabling or contributing to the problem by offering a life-saving intervention that can be used in a moment of crisis.”

In emergency rooms, Lang said doctors are training overdose patients to use naloxone and sending them home with the overdose-reversing drug.

Luan told reporters naloxone is just one tool of many needed to combat the opioid crisis.

This content was originally published here.


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