Overdose antidote naloxone now available in Canada without a prescription

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      Health Canada has reclassified a so-called overdose antidote to make the drug available without a prescription.

      According to a March 22 notice, naloxone, also known by its trademark name Narcan, will now be available over-the-counter.

      The drug is used to counter the effects of opioids such as heroin and fentanyl. It’s administered in a liquid form via an intramuscular injection.

      Last January, Health Canada launched a public-consultation phase around the question of making naloxone more easily available. That call for responses only closed on March 19, but the feedback the regulator received was overwhelmingly one-sided.

      “Over 130 responses on the proposal of removing prescription status for naloxone when used outside hospital settings were received and all were in favour,” reads today’s notice.

      It acknowledged many comments emphasized the importance of training people how to properly administer naloxone. Some expressed concerns that pharmacists, though technically able to provide that training, might not always have time to do so.

      On January 6, the Straight reported that frontline care providers working in the Downtown Eastside wanted naloxone made available in a nasal form that might be easier for some people to use.

      Today’s Health Canada notice discussed that suggestion but reiterated a nasal form of naloxone would be considered a new drug, and therefore should be proposed for review by a sponsor such as a pharmaceutical manufacturer.

      “The most common comment was the need for a more user-friendly dosage form, since the use of a syringe by a person trained but not familiar with administering the drug under emergency situations is awkward, risky and may reduce its effectiveness,” the notice reads. “Many commented that the nasal formulation would be a better alternative, which Health Canada would agree with if one were approved and available at this time. It should be noted that approval of alternative dosage forms of naloxone must be initiated by a sponsor of such a formulation, such that Health Canada can assess its safety, effectiveness and quality.”

      TOWARD THE HEART

      Calls for greater availability of naloxone have come in response to a synthetic opioid called fentanyl turning up in more drug overdoses in B.C. According to the provincial coroners service, during the first eight months of 2015, fentanyl was detected in 91 overdose deaths in B.C., or more than a third of the total. That’s up from 90 during the whole of 2014, 49 in 2013, and 13 in 2012.

      To date, naloxone has been used to reverse 326 potentially fatal overdoses in B.C., according to a provincial harm-reduction program called Toward the Heart, though the actual number is likely much higher, as it is believed the drug's administration is vastly underreported.

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