naloxone training – The Concordian

Concordia’s student community looks increasingly supportive of having an open conversation about drug use

In Canada, in the first half of 2021 alone, an average of 19 people died from opioid-related overdoses every day, with a daily hospitalization of 16 people according to the federal special advisory committee on opioid overdoses.

For the Concordia chapter of the Canadian Students for Sensible Drug Policy (CSSDP) and other harm reduction organizations, these numbers could be greatly attenuated through education, support for substance users, broad access to naloxone as well as safe supplies and safer injection sites.

The CSSDP hosted a naloxone training on Jan. 26 at Le Frigo Vert at the downtown campus. Students and people in the broader Concordia community were invited to learn how to administer naloxone (also known as Narcan) to counter the effects of opioid overdose.

Harm reduction refers to the set of strategies aimed at limiting health or social risks related to a specific issue.

CSSPD member Assaf Azerrad explained that advocating for a harm reduction approach in the context of drugs meant taking the stance that drug use should not be encompassed in the criminal justice system, but instead should be understood as a public health and human rights issue.

In Oct. 2021, the CSSDP developed an anonymous 15-question survey about the perception and consumption of substances by the Concordia student body. The survey was aimed at gaining a deeper insight into how to deliver substance use education to students. A document sent to The Concordian from the CSSPD highlights that, among the 350 respondents, 60.3 per cent said they considered drug education on campus to be extremely important.

According to CSSDP member Alice Gendron, the data demonstrated a change in students’ perception of drug use and a greater openness to discussing the topic.

“The thing that is changing is maybe how open people are with talking about their substance use,” said Gendron. “There seems to be a progression in how open people are and that’s really something we focus on a lot as an organization because the more people are isolated in their consumption, that’s when issues can arise.”

Concordia student and substance analyst at CACTUS Philippe Lavoie said that opening this conversation is a way for people to start consuming more sensibly and in safer environments. CACTUS is a Montreal-based organization centered around harm reduction and prevention of sexually transmitted and blood borne infections.

“Especially with the rise of opioid overdose, I think people are thinking we should talk about this situation,” said Lavoie. “I think youth are feeling more empowered, and groups like CSSDP really help people feel safe to talk about it and exchange ideas.”

CSSPD member João Barbosa emphasized that naloxone kits are available for free at any pharmacy for everyone in Quebec.

“The most important thing is to learn how to use it because people might be afraid to administer it,” said Barbosa. “We want to help people to learn to recognize an overdose, and how to act in such a situation.”

The CSSPD also offers a substance analysis service to test substances for potential contamination with opioids such as Fentanyl. For Lavoie, this is an important harm reduction tool as the amount of street drugs that are laced with Fentanyl or Benzodiazepine rises.

“It’s part of consuming sensibly to know what you consume,” said Lavoie. “The fact of knowing what’s in it, you can better assess the risks. Knowing the different cutting agents allow us to give better harm reduction tips as well.”

Individuals that are interested in free, anonymous drug testing are encouraged to go to the CACTUS checkpoint at 1300 rue Sanguinet or to the CSSPD on Fridays from 12 a.m. to 4 p.m. at Le Frigo Vert.

Harm reduction organizations in Montreal include CACTUS, which offers supervised injection sites throughout the island, Groupe de Recherche et d’Intervention Psychosociale , a mobile drug-checking service, Dopamine in Hochelaga-Maisonneuve as well as Spectre de rue.

On campus, the Recovery and Wellness Community Centre offers resources for Concordia students who have experienced addiction and/or are in recovery.

A previous version of this article stated that the CSSPD partnered with CACTUS for the training. This was incorrect.

Saving lives and breaking down stigmas with public education

“I’m here today because there isn’t a very effective public education program,” said Richard Davy, a first-year social work student at McGill, after wrapping up the first in a series of naloxone training sessions he’s holding in November. To Davy’s delight, his first presentation on Nov. 7, which amassed an assorted crowd of students, community members and TV news crews, was a success. “People aren’t aware of this, even though we’ve known about naloxone for what seems like forever,” he added.

Naloxone, also known by its brand name Narcan, is the substance used to reverse an opioid overdose. Once administered, either nasally or through muscular injection, the naloxone blocks opioid receptors in the brain and temporarily alleviates some of the life-threatening effects of opioids. In cases of accidental overdose, it is often family, friends or bystanders who are tasked to recognize and treat an overdose, so the naloxone kits are designed to be easy-to-use for non-medical professionals.

Naloxone is also fairly easy to access; in 2017, the Quebec government began offering free naloxone kits in Quebec pharmacies to anyone 14 or older. The decision was made in reaction to the rising opioid-related hospitalization rates across Canada over the past decade. According to former Quebec Health Minister Gaétan Barrette, this was also part of a comprehensive strategy to address the public health emergency in the province that was declared after a spike in fentanyl overdoses in the summer of 2017.

Despite removing significant barriers to harm-reduction tools, the provincial government’s comprehensive strategy seems to be missing a key piece: public education. There remains a widespread lack of practical education that could equip community members with the skills and confidence required to capitalize on these resources. A 2017 opioid awareness survey by Statistics Canada found that only seven per cent of Canadians know how to both obtain and administer naloxone. Less than 30 per cent of respondents agreed that they would be able to recognize the signs of an opioid overdose.

Richard Davy, a first year social work student at McGill, held a series of naloxone training sessions throughout November. Photo by Mackenzie Lad.

Grassroots community organizations have long been doing the harm-reduction work the provincial government has only recently began to adopt in principle and practice. In 2013, Méta d’Âme, a Montreal-based “self-help organization ‘by and for’ people who depend on opioids,” created Prévenir et Réduire les Overdoses Former et Accéder à la Naloxone (PROFAN), a project focused on reducing opioid-related deaths through harm-reduction tactics, mainly the use of and access to naloxone.

PROFAN is among many longstanding independent initiatives offering informal overdose 101 education and, despite consistent action on a community level, there has yet to be a government-subsidized education program that offers the same hands-on experience.

“[Naloxone training] should be part of our repertoire of first aid. We should have an epipen in our first aid kit; we should have a naloxone kit in our first aid kit,” said Davy. “And again, that begins with education. That begins with the government getting behind it, with schools getting behind it, so we can start to raise awareness.”

Those aged 15 to 24 are within the demographic with the fastest growing rate of hospitalization for opioid poisoning according to the Canadian Institute for Health Information (CIHI). Yet youth and young adults are not formally presented with this information in an educational setting, nor are they given any collective incentive to seek it out. “If youth are going to [use substances/drugs], and they are, we need to at least give them harm-reduction tools,” said Davy. Seeing both the need for and lack of practical education at his university, Davy stepped in.

The training session not only includes step-by-step instructions of how to detect signs of an opioid overdose and how to respond using naloxone, Davy deliberately contextualized the issue to present a more comprehensive, human view of drug use and addiction. “As social workers, we’re really encouraged to look at things through a holistic lens, including the more invisible stigmas and oppressions, and I think it makes it much easier to have that deep sense of compassion for people,” said Davy. “I see the pain. I have my own history of trauma, and I connect with that when I see it in other people.”

“The absence of public education encourages more stigma and discrimination, which discourages treatment and access to treatment,” said Yamin Weiss, a fellow McGill social work student invited by Davy to share his lived experience with drug addiction and recovery. “Public opinion is huge to people internalizing a problem of addiction. A lot of people don’t seek help because they’re so stigmatized.”

Each participant left Davy’s training session with a fully-stocked naloxone kit and a new set of practical skills. Photo by Mackenzie Lad.

Naloxone may be the antidote to opioid overdose, but, according to Weiss, it will take much more to solve the underlying structural issues. “Drug addiction and recovery is something for the public to be concerned about and to care about,” said Weiss. “And public acceptance can only happen through public awareness, which is why we have Naloxone training like today.”

In its federal opioid awareness campaign, the Canadian government has broadly recognized social and structural stigma as being a pervasive force impacting the quality of and access to care for people with problematic drug use. Under the bolded “How You Can Help” heading of the government website, it is suggested that we, as Canadians, “can learn about substance use disorder and educate ourselves about the medical condition.” An auspicious idea, yet rendered ineffective without corresponding educational opportunities provided on a broad scale.

Each participant left Davy’s training session with a fully-stocked naloxone kit, a new set of practical skills, and a more nuanced view of an issue that may have seemed insurmountable from the outset. “One of my intentions with this today was to take away a little bit of the fear. Take away some of that fear and now we’re progressing” said Davy.

Davy will hold a Naloxone 101 workshop at Concordia (CSU Offices H-711) on Thursday, Nov. 22. Admission is free, but due to overwhelming demand, participants are encouraged to register beforehand via Facebook to secure a spot.

Photos & video by Mackenzie Lad