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Opioids are medications that relieve pain. When used properly, they can help. But when misused, they can cause addiction, overdose and death.

About opioids

What are opioids?

Opioids are substances that can be used to treat pain and may be misused recreationally. They include fentanyl, heroin, morphine, oxycodone, codeine, hydromorphone. Opioids can be addictive, and if taken at high doses, can cause coma or death. Special types of opioids, including methadone and suboxone, may also be used to treat opioid addiction.

What is fentanyl?

Fentanyl is an opioid medication legally prescribed to treat severe or chronic pain. Fentanyl is 100 times more toxic than morphine and 40 times more toxic than heroin.

Fentanyl can be found on the street in many forms including patch, powder, pill and liquid forms. Other street drugs can be laced with fentanyl making them more potent and increasing the risk of overdose.

Fentanyl use and overdose has been on the rise in Ontario over the last several years.

How does fentanyl become misused?

Fentanyl can be acquired through prescription forgeries, overprescribing, pharmacy robberies, break and enters or when legitimate prescriptions fall into the wrong hands. Synthetic fentanyl can also be trafficked and sold on the street.

What are the signs and symptoms of an opioid overdose?

Recognize the signs and symptoms of an overdose, including:

  • Difficulty walking, talking and staying awake
  • Blue lips or nails
  • Very small pupils
  • Cold and clammy skin
  • Dizziness and confusion
  • Extreme drowsiness
  • Choking, gurgling or snoring sounds
  • Slow, weak or no breathing
  • Inability to wake up, even when shaken or shouted at

If you think someone is overdosing, call 911 right away. For more information about opioid overdose, visit Health Canada

Why is opioid misuse a growing problem?

Opioid misuse and overdose is an important public health and safety issue nationally and provincially. In 2016, Ontario’s Minister of Health and Long-Term Care announced a strategy to address opioid misuse and addictions.

The Ontario Drug Policy Research Network (ODPRN) reported that opioid overdose is the third leading cause of accidental death in Ontario, totalling 638 deaths in 2013. In York Region there were:

  • 34,733 individuals using opioids in 2015
  • 125 emergency room visits due to opioid use in 2014
  • 26 opioid related deaths in 2013 (ODPRN, 2016)

Research indicates these numbers have been increasing over the last 10 years. To address this growing concern, Health Canada approved non-prescription over-the-counter access to naloxone in 2016. The Ontario Ministry of Health and Long-Term Care provides access to naloxone without charge through settings such as pharmacies. Naloxone is the medication that counteracts the effects of an opioid overdose.

Treating an opioid overdose with naloxone

What is naloxone?

Naloxone is a non-opioid medication that counteracts the effects of opioid overdose. Naloxone is available in injection and nasal spray . Administering naloxone to someone experiencing an opioid overdose gives the person enough time to seek emergency care. Always call 911 if someone is overdosing on opioids, regardless of whether naloxone has been administered or not.

Where can I access naloxone?

Individuals who use opioids, or are at risk of overdosing and concerned family and friends are encouraged to pick up a free naloxone kit from a participating community pharmacy. You will need to provide a valid OHIP card.

Naloxone is also kept on-hand by paramedic services and hospital emergency departments in case of opioid overdose.

Where can I get help for substance misuse?

To get help for an addiction, please consult your health care provider, Addiction Services York Region or access other community supports in York Region.

What is York Region doing?

The Opioid Safety and Education Forum

York Region Public Health established an opioid education working group in early 2016, together with community partners including York Regional Police, Addiction Services York Region, community pharmacists and physicians. The purpose of this working group was to address the issue of opioid use and misuse in York Region through community education.

The working group held a York Region Opioid Safety Education Forum in November 2016 to educate physicians, pharmacists, dentists and other health care providers about opioid misuse, the introduction of over-the-counter naloxone, and the Fentanyl Patch 4 Patch program. The forum promoted open communication about opioid use in the Region, removal of stigma and provided information about community supports to manage opioid use. This was a first step in the response to opioid use in York Region.

The Opioid Education and Response Workgroup

The Opioid Education and Response Workgroup has evolved from the inter-professional working group that came together in 2016 to plan and deliver the Opioid Safety Education Forum. It now includes York Region Paramedic Services, fire services and others. This working group will meet regularly to create an opioid response plan, monitor naloxone use in York Region and provide education to health care providers and the community. The goal is to obtain more up-to-date information about opioid use in York Region and identify options to address this issue.

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