Opioids

Opioids are medications that are prescribed primarily to relieve pain. When used properly, they can help. But misuse can cause dependence, overdose and death.

Opioids that are prescribed as medications include codeine, morphine, oxycodone, and hydromorphone. If you have been prescribed an opioid medicine, it should:

• Only be taken as prescribed;
• Never be used by someone for whom it was not prescribed; and
• Never be taken with alcohol or other medications (except as prescribed).

Keep your medication safe to help prevent problematic use by others by:

• Never sharing your medication with anyone else. This is illegal and may also cause serious harm or death to the other person;
• Keeping track of the amount of pills remaining in a package; and
• Storing opioids in a safe and secure place, out of the reach of children and teenagers.

Unused portions of opioid medicine should always be:

• Kept out of sight and reach of children and pets;
• Stored in a safe place to prevent theft, misuse or accidental exposure. This prevents any possibility of illegal use and protects the environment from contamination; and
• Returned to a pharmacy for safe disposal if it is no longer needed or is expired.

Fentanyl

Fentanyl is an opioid that is 50-100 times more toxic than other opioids (such as heroin, oxycodone and morphine). Doctors may prescribe fentanyl for severe pain and for some medical procedures. Because of the strength of this drug, a health care provider must very carefully monitor the dose to make sure that the person does not overdose.

Legal, prescribed fentanyl is dangerous when it is not used properly.

Illicit or street fentanyl is not received by prescription. It's sometimes sold by dealers as another drug, or mixed into other substances like oxycodone or cocaine. This is when using the drug becomes extremely dangerous; it can slow down a person's breathing, lead to a coma and even death.

For more information:

• Fentanyl - Advisory for Saskatchewan Health Care Providers
• Opioids (Government of Canada website)
• Prescription Medications
• Opioids Video

Preventing Opioid Overdoses

In addition to having a naloxone kit readily available, there are other ways to prevent opioid overdose deaths.

If you have been prescribed an opioid medication, it should:

• only be taken as prescribed; and
• never be taken with alcohol or other medications (except as prescribed).

The best way to stay safe is to not use illegal drugs at all. People who do use illegal drugs should:

• never use alone;
• test your drugs for fentanyl and benzos using a Take Home Drug Checking Strip;
• start with a small amount;
• know that mixing drugs and/or alcohol could lead to an overdose; and
• only use where you can get help right away.

If you are alone while using drugs, call the National Overdose Response Service hotline at 1-888-688-NORS(6677) for a volunteer who will stay on the line with you and call for help if you need it.

Take Home Naloxone

Anyone who uses opioids, whether obtained by prescription or illegally, is at risk of an opioid overdose. Opioids affect the part of the brain that controls breathing, so when too much of an opioid is taken, breathing slows or stops. Naloxone reverses the effects of an opioid overdose temporarily, restoring breathing in a few minutes. It is not a narcotic, is non-addictive and has no effect if opioids are not present. Naloxone is a safe medication, with few side effects.

Saskatchewan residents who are at risk of an opioid overdose and/or might witness an opioid overdose, such as friends and family of people who use opioids, are eligible for free training and a free Take Home Naloxone kit. The training covers overdose prevention, recognition, and response, including how to administer naloxone.

It's important to note that Naloxone treatment itself does not replace the need to seek immediate medical attention. Call 911 immediately if you suspect an overdose.

To find a Take Home Naloxone Program near you call HealthLine 811 or view the Take Home Naloxone Program map.

Naloxone is also available for purchase at pharmacies across Saskatchewan. The Pharmacy Association of Saskatchewan has a list of pharmacies that carry naloxone.

Naloxone is available for free for First Nations and Inuit clients covered by the Non-Insured Health Benefits Program.

The federal Good Samaritan Drug Overdose Act (effective May 4, 2017) provides some legal protection for individuals who seek emergency help during an overdose, or who witness an overdose. It’s vital that even if naloxone is used, seek immediate medical attention by calling 911.

When someone has an opioid dependency, they feel that they need the drug and it can become very hard to quit. When they stop using the drug, it can cause them to feel pain, anxiety or crave more opioids. They might feel shaky, weak, and nauseous; have fever, chills, muscle aches or bone pain; and experience changes to bowel function, sleeplessness, sweating, irritability and vomiting.

There are a variety of treatment options for people with opioid dependence. Opioid Substitution Therapy (OST) provides treatment for individuals with opioid dependence. The Opioid Substitution Therapy guidelines describe the role, services and skills required of addiction counsellors in OST.

For more information, and to get help:

• Call HealthLine 811.
• Download the Mental Health and Addictions Service Directory to find addictions services near you.
• Learn about services available in Saskatchewan to help you deal with alcohol and drug issues.

Harm Reduction Programs are part of a comprehensive public health disease prevention strategy to reduce the spread of HIV, HCV, and other sexually transmitted and blood-borne infections.

Get more information on Harm Reduction Programs and services in your area.

In November 2018, the Government of Saskatchewan signed a bilateral agreement under the Government of Canada's Emergency Treatment Fund.

This agreement provides more than $5 million in funding from the Government of Canada to support initiatives that will:

• Recruit and train more health care professionals qualified to provide opioid-substitution therapy (including nurse practitioners and physicians) and other non-prescribing professionals (such as counsellors, social workers and allied professionals);
• Train health care providers to adjust treatment and care plans based on client needs and root causes of problematic substance use (for example, the impact of trauma on the lives of people with substance use disorders);
• Increase access to treatment for people with opioid or crystal meth dependency by working with the Saskatchewan Health Authority and community-based organizations to expand the use of remote services (such as telehealth) where services are not locally available and support case managers to connect clients to the health and social services they need; and
• Train providers in therapeutic approaches and evidence-based treatment options for patients who use crystal meth (for example, behavioural therapy and motivational interviewing and trauma informed practices).

This matches $7.4 million the Province of Saskatchewan has already invested in expanding access to opioid substitution therapy.

Statistics on opioid related harms in Saskatchewan

The Government of Saskatchewan continues to monitor drug related harms to inform our response activities.

Data on the number of opioid-related deaths in Saskatchewan is available from the Saskatchewan Coroners Service.

National reports on opioid drug use and its impacts, which include data from Saskatchewan, are available from the Government of Canada.