U of T is ill-equipped to handle fentanyl overdoses

Providing staff and student leaders with naloxone training would better prepare the university for emergencies

U of T is ill-equipped to handle fentanyl overdoses

It’s no secret that the opioid crisis has hit Canada hard — in 2016, over 2,400 Canadians died from opioid-related overdoses.

Just over a year ago, police and community groups warned that the fentanyl crisis would come to Ontario. Last month, The Varsity noted that “between July 27 and August 1, Toronto saw 20 overdoses and six deaths related to fentanyl-laced drugs.”  Fentanyl is considerably more toxic than most opioids — and most users don’t realize just how small a quantity of it can be fatal.

While no fentanyl overdoses have been reported at the University of Toronto thus far, it would be foolish to think this crisis won’t affect U of T students. A 2015 alert from the Canadian Centre on Substance Abuse (CCSA) and the Canadian Community Epidemiology Network on Drug Use noted that fentanyl could be mixed into other recreational drugs such as cocaine and MDMA, or ecstasy. The CCSA reported that as of 2015, about 3.5 per cent of Canadians aged 15-24 had used cocaine in the past year, and as of 2013, over 60 per cent of recreational drug users in Toronto had used MDMA within the past year. Even if students aren’t using opioids, they may be unintentionally exposed to fentanyl through other drugs.

Other Canadian universities are taking steps to ensure the safety of their students. Before the start of the semester, the University of King’s College in Halifax trained about 70 people to administer naloxone, the medication that can reverse the effects of an opioid overdose. Dalhousie University has naloxone kits available at their health and wellness office.

These are important, potentially life-saving interventions that ought to be implemented at more Canadian universities. It’s both surprising and frustrating that at U of T, residence dons at most — if not all — colleges are not trained in naloxone administration. As recently reported by The Varsity, Innis College, Trinity College, New College, and University College have all confirmed that their dons do not carry naloxone. Woodsworth College, St. Michael’s College, and Victoria College did not respond to The Varsity’s requests for comment on this subject.

Naloxone appears to be generally hard to find on campus. It’s not available at the Health and Wellness Centre, and it isn’t carried by Campus Police or U of T Emergency First Responders (UTEFR). The idea of providing naloxone kits was apparently discussed at meetings of the Ontario University & College Health Association, though nothing has come of the suggestion thus far.

An official reason for this has not been made clear. Althea Blackburn-Evans, Director of Media Relations at U of T, said conversations on the subject are ongoing and that potential concerns may include securing the safety of the person administering treatment, as well as health considerations such as allergic reactions. Blackburn-Evans added that she was not privy to all of the conversations on this topic.

A similar situation at the University of Ottawa may offer a clue into another potential motivation. While the university’s student federation initially planned to train 100 people in administering naloxone, it was announced prior to orientation week that leaders would be forbidden from doing so while on duty — lawyers had warned the federation about potential liability issues should the kit not be administered properly and cause an injury.

It’s true that naloxone may trigger allergic reactions or cause heart and lung problems for patients, and these side effects should be taken seriously. However, most other naloxone side effects are simply the symptoms of opioid withdrawal. Considering that administering naloxone is a life-saving medical intervention, it would be foolish to avoid using it in times of desperate need out of fear of incurring potential side effects.

Besides, residence dons are trained in other types of first aid, which can also cause injuries and raise liability concerns. All dons receive CPR training, which can cause injuries even if performed correctly. In this case, the university seems to recognize that the potential to save someone’s life outweighs liability issues.

We should treat naloxone the same way we do CPR. Though the potential risks of administering the treatment should be accounted for, it’s time U of T officials recognize that the potential benefits more than outweigh those risks. While making naloxone kits and administration training widely available may not solve the fentanyl crisis, these measures have the potential to save lives. If even one person’s life can be saved, that ought to be the most important consideration.

In the meantime, it is fortunate that there are resources around Toronto that students can turn to. Free injectable naloxone kits are available without prescription from some participating pharmacies, which can be located on the Government of Ontario’s website. It’s time the university offered similar resources to its students.

Adina Heisler is a third-year student at University College studying Women and Gender Studies and English. She is The Varsity‘s Student Life Columnist.

Residence dons cannot administer opioid antidote

Calls for opioid training on campus follow summer fentanyl crisis

Residence dons cannot administer opioid antidote

Residence dons at many, if not all, colleges on campus do not carry naloxone, the medication used to stop opioid overdoses, despite the spike in deaths and overdoses as a result of opioid drug use in the summer of 2017.

University College, Innis College, Trinity College, and New College confirmed their dons do not carry naloxone. As of publication time, Woodsworth College, St. Michael’s College, and Victoria College did not respond to The Varsity’s request for comment on their practices regarding naloxone.

Melinda Scott, Dean of Students at University College, explained in an email to The Varsity that dons have been instructed to “call 911 and then campus police if they suspect an overdose or other medical emergency” — a policy followed by Innis, Trinity, and New College.

Naloxone is unavailable to the Campus Police, and it is unavailable through the Health and Wellness Centre.

Dons at these four colleges do receive varying levels of first aid and CPR training. At Trinity, dons are given Emergency First Aid training, while Innis, New, and University dons receive Standard First Aid training.

The Emergency First Aid course is a basic one-day course offering lifesaving first aid and cardiopulmonary resuscitation (CPR) skills,” according to the Canadian Red Cross’ website.

By contrast, the Standard First Aid course offers more “comprehensive” training and deals with more types of emergencies, including head and spine injuries, bone, muscle, and joint injuries, sudden medical emergencies, environmental emergencies, and poisons.

Both levels of training meet “legislation requirements for provincial/territorial worker safety and insurance boards,” according to the Red Cross.

David Lowe of the U of T Health and Wellness Centre told The Varsity in August that opioid overdoses, especially from the drug fentanyl, were brought up in regular meetings between the university and the Ontario University & College Health Association.

Amra Das, Executive Director of the University of Toronto Emergency First Responders (UTEFR), previously told The Varsity that UTEFR was not equipped with naloxone, “but in light of growing public health concerns, this is something that we are seriously considering for the upcoming year.”

U of T professor Abhimanyu Sud, who specializes in safe opioid prescription, said that the biggest issue was educating students on the topic.

“We sometimes think that opioid overdoses happen with people who are addicted to opioids, but what’s particular about the moment right now is that we have a lot of opioid contamination of recreational drugs,” Sud said. “And those are potentially some of the more dangerous situations because you’re not expecting it at all. You’re not expecting there to be fentanyl or other opioids in the drug you’re using and you haven’t developed any kind of tolerance to it.”

This summer, the University of Ottawa’s student union had planned to give orientation leaders naloxone kits. However, after consultation with lawyers, they decided against it due to the possibility of being liable if the medication injections caused injury.

According to Sud, “It’s the same kind of ethical issues around administering CPR because you could potentially harm somebody by administering CPR but you’re also potentially saving their life. Naloxone shouldn’t be perceived any differently.”

In the first three months of 2017, there were over 1,300 emergency department visits related to opioids.