NOTE: The following is an op-ed piece from Nova Scotia Chief Medical Officer of Health Dr. Robert Strang
The recent national summit into the opioid crisis in Canada emphasized two distinct, but related, issues unfolding here in our province and across the country.
We have an increase of opioid overdoses and overdose deaths related to the arrival in Canada of illicit fentanyl in street drug supplies. But we also have a problem with the significant increase in prescriptions of opioids for pain treatment.
Part of our response to this serious public health problem is accepting that people struggling with drug addictions and abuse must be treated with dignity and respect – the same as any other person dealing with a health issue.
These are our young people, our neighbours and our most vulnerable, and they live beside us in our communities.
The prescription of opioids within the health care system over the past 20 years has created large numbers of people who are dependent on opioids, many of whom shifted to prescription and/or illicit fentanyl when changes were made to the formulation of Oxycontin.
The current situation highlights the complexity of the issues we are dealing with and the need to move carefully to change opioid prescribing and pain management practices to avoid having more people accessing illicit opioids.
Nova Scotia has begun developing a coordinated response. A joint statement of action to address the opioid crisis was agreed upon at the national summit, and Nova Scotia is a key part of that plan. At the summit, Health Minister Leo Glavine committed to advancing our existing opioid misuse and overdose response, while supporting a national response.
Nova Scotia doesn’t have the number of overdoses and overdose deaths being experienced in British Columbia and Alberta, but we have had 49 overdose deaths so far this year.
Those are 49 families and communities forever changed.
It is also a tremendous strain on an already taxed health-care system. Opioid overdoses are overwhelming emergency services and departments, and needlessly taking lives. This is most acute in the western provinces, but it is moving east.
The response requires international police and border security efforts to cut off the supply of illicit fentanyl from China. It requires widespread implementation of safer consumption sites, ready access to naloxone, better access to evidence-based opioid addiction treatment, and enhanced monitoring to track progress across the country.
Our response also requires fundamental changes in how pain, mental health and addiction issues are handled in the health-care system, and how primary care is structured to allow treatment of the whole individual by collaborative teams and practices.
A key component is going back to basics with a greater focus on creating healthy and supportive families and communities as the backbone of improving our collective health.
Fundamental changes in these areas will lead to substantive improvements in our health-care system and are part of the overall transformation currently underway.