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PMID:32134609
Abstract

Canada is in the midst of an opioid crisis. The number of deaths due to opioids has increased from 3,023 in 2016 to 4,588 in 2018. In 2018, this equated to the life of one Canadian being lost every 2 hours as a result of opioid use. The increase in opioid-related deaths has been attributed to a number of different causes. The increased contamination of street drugs due to fentanyl is one reason, with estimates of the percent of opioid deaths due to fentanyl or fentanyl analogues having increased from 50% in 2016 to 79% in 2019. Prescription opioids have also contributed to the crisis. The volume of opioids sold to Canadian hospitals and pharmacies has increased by more than 3000% since the early 1980’s, with over 20 million prescriptions dispensed for opioids in 2016 alone. Addressing the opioid crisis has been complicated by the fact that the use of opioids is illegal in Canada, unless prescribed by a physician. Therefore, many opioid users buy opiates illegally on the street, and these opiates have unknown strength and may be contaminated with other drugs such as fentanyl. In addition, those who face addictions are frequently greeted with stigma, rather than an understanding of their addiction and mental health problems. To help address these issues, a Good Samaritan Drug Overdose Act was enacted so that those who call for help when an overdose occurs are protected from drug possession charges. The distribution of naloxone kits in the community is one strategy being implemented internationally to reduce the number of opioid-related deaths. Naloxone is a powerful anti-opioid drug, which temporarily blocks the effect of the opioid on the body. Furthermore, it is not harmful for those who have not been exposed to opioids. In Canada, take-home naloxone kits are available at most pharmacies without a prescription and are free in some provinces. The naloxone kits include naloxone nasal spray or naloxone intramuscular injection. Both take less than five minutes to take effect. For these reasons, the distribution of naloxone kits in the community has been a powerful tool to save the lives of those who have experienced an overdose due to opioid use, and there has been increased efforts to expand the availability of naloxone in the community setting. This purpose of this report was to explore the experience of administering naloxone in the home and community setting and to explore whether this experience differs between those who may typically administer naloxone, including paramedics and peers or people who use drugs (PWUD). Understanding the administration of naloxone from the perspective of the person administering it is useful for a number of different reasons. It can highlight the challenges and advantages of using naloxone from the perspective of the user, and can shed light on the emotional consequences of dealing with the opioid crisis.

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