An injectable drug that can reverse an opioid overdose within minutes is now available without a prescription in British Columbia, the province's College of Pharmacists announced Thursday, following Health Canada's decision earlier in the week to loosen restrictions on the medication.
Health Canada initiated an expedited review process into the prescription-only status of naloxone in January amid soaring overdose rates linked to the powerful synthetic opioid fentanyl. The department announced this week that it would amend its Prescription Drug List to allow non-prescription use of the drug in an emergency setting, but individual provinces still had to sign off.
On Thursday, the College of Pharmacists of B.C. announced that it had amended the province's drug schedules to classify naloxone as a Schedule II drug – one that can be sold by a pharmacist without a prescription – making it one of the first jurisdictions in Canada to do so.
Registrar Bob Nakagawa said the college's board had recognized the urgency of the matter and approved a resolution in anticipation of the federal change.
"Everybody seems to be recognizing that we need to make this change," he said. "For the federal government to move as quickly as it did was great. For us, usually we're not able to get things through as quickly, but we all recognized this was an important public safety issue."
Provincial Health Officer Perry Kendall called the move "a great step forward" in addressing Canada's opioid crisis and encouraged opioid users and their loved ones to add naloxone – also known by its brand name Narcan – to their first-aid kits.
Previously, only opioid users who are at risk of overdosing could obtain the drug, and only with a prescription – even though in the event of an overdose, it would be someone else administering it. Now, anyone will be able to purchase the drug after a brief training session with a pharmacist.
"Currently, naloxone is only available in Canada as an injectable solution," said Ashraf Amlani, a harm reduction epidemiologist with the B.C. Centre for Disease Control, "so it's important that pharmacists are around to provide education on how to use a needle to draw up the injectable liquid and inject it into the muscle of the person who has overdosed.
A less intimidating nasal spray version of the drug is available in the United States, though no company has approached Health Canada to have it licensed here yet.
Naloxone administered in the absence of opioids produces no effect; the drug has no abuse potential.
The drug is not currently covered by B.C.'s PharmaCare. The Ministry of Health said Thursday that it is too early to say whether this might change.
Thomas Wong, a pharmacist in Vancouver's Downtown Eastside, said improved access to the drug will help prevent overdose deaths, but underscored the need to look upstream at the root causes of addiction.
"Naloxone being available [without a prescription] is a good thing – it's going to prevent a lot of fatal overdoses – but it doesn't address the larger problem," Mr. Wong said. "An ounce of prevention is worth a pound of cure."
He also added that naloxone, an opioid antagonist, may not help someone who is overdosing on a cocktail of drugs.
Health officials across Canada had called for improved access to naloxone amid the rise of illicit fentanyl, a powerful synthetic opioid that has been linked to a growing number of overdose deaths. Because fentanyl is cheap, relatively easy to obtain and highly potent – it can be up to 100 times more potent than morphine – traffickers have taken to cutting it into other drugs to maximize their profits.
In B.C., fentanyl was detected in 30 per cent of all fatal illicit drug overdoses last year. That is up from 25 per cent in 2014, 15 per cent in 2013 and 5 per cent in 2012.