Overdoses and Opioids: A Scheduled Drug Analysis Service in Quebec City

the CIUSSS continues to develop its tools damage control in the field.

According to public health, this approach essentially consists of: reducing the stigma of drug users and the negative effects of their consumption on their health, while promoting safe practices

Following the same logic, Quebec City last year organized a first controlled consumption service for users of drugs by means of injection or inhalation.

Substance analysis is now the next step.

we are really theresays dr. Anne-Frédérique Lambert-Slythe, medical specialist in public health and preventive medicine at the CIUSSS of the National Capital. The project had been in the works for a year and a half, she says, but was delayed by the pandemic. We’re getting this back on track.

In particular, the spectrometer makes it possible to detect the presence of fentanyl in a substance in just a few minutes and should be part of the instruments used in Quebec.

Photo: Radio Canada / Christian Milette

Winter 2023

According to the current schedule, a call for projects would be launched in August next year by the CIUSSS of the National Capital. The commissioning of the dust analysis service is expected sometime in the winter of 2023.

As with supervised consumption, the management of which has been entrusted to the SABSA Solidarity Cooperative, the aim is to establish a partnership with the community. They really know the needs of the customers.urges Dr. Lambert-Slythe.

Once the partner is found, a waiver request should be sent to Health Canada, as drugs will necessarily go through the future analysis site, the location of which has also yet to be determined.

These exemptions from the Controlled Drugs and Substances Act are in particular granted when: potential risk or harm to the health and safety of Canadians† Tools to tackle the opioid crisis qualify in this category.

An injection room where syringes and waste containers are set up on a sterile aluminum table.

The management of L’Interzone, the first controlled consumption center in Quebec City, has been entrusted to the Coopérative de solidarité SABSA.

Photo: Radio Canada

Improve security

The future analytics site will, it is hoped, CIUSSS, to quickly collect valuable information about the content of a substance that a person wants to consume. This detection can be done with different devices in a few minutes.

Stakeholders can then provide advice with the aim of: improve [sa] security during consumption, says Dr. Lambert-Slythe.

For example, depending on the substances detected, a person may be suggested to consume smaller amounts of the drug they have in their hands, or to avoid certain mixtures that are more likely to cause side effects. We will be able to say that it may not be a good idea to take three sedatives at the same time.says the specialist.

The purpose of such a service is to detect poor-quality medicines, mixed with dangerous products such as fentanyl, for example.

A quote from dr. Anne-Frédérique Lambert-Slythe, medical specialist in public health

A person can receive simpler basic advice such as not to consume alone, be referred to other psychosocial resources such as the supervised consumption service, or receive a kit of naloxone, an opioid antidote. The center may also prove to be a gateway for people excluded from the health system.

Detecting lower-quality products would, according to Dr. Lambert-Slythe can finally help public health give warnings to the public when contaminated drugs find their way onto the black market, or to warn consumers about the unusual effects of certain substances.

the CIUSSS de la Capitale-Nationale is currently evaluating the technologies available for the future dust analysis site. It is a program that is difficult to implementemphasizes Anne-Frédérique Lambert-Slythe, adding that it need scientific knowledge and qualified people to operate some of these tools.

A combination resources are determined at the launch of the call for projects. A device called the spectrometer will likely be part of the arsenal, according to Dr. Lambert-Slythe.

We see two tests that are positive, placed on a wooden table.

There are test strips on the market that can detect the presence of fentanyl.

Photo: Tweeter Sarah Blyth

Rise in overdoses

This desire to establish a substance analysis center comes at a time when the Capitale-Nationale region is experiencing a significant increase in overdoses on its territory. The increase mainly relates to cases of non-fatal overdoses reported to the Regional GGD.

From 153 non-fatal overdoses in 2020, their number rose to 409 in 2021.

The two years are difficult to compare, depending on the CIUSSSas continued efforts have been made to promote reporting by the various partners, namely the police, paramedics, hospitals and the community sector.

But despite these numbers inflated by a greater turnout of reports, the observation on the ground is that overdoses are more numerous, Anne-Frédérique Lambert-Slythe said. In fact, she believes the reported non-fatal overdoses are justifiable the tip of the iceberg

Moreover, according to her, the trend will continue in 2022 with more than a hundred reports already. We see that we have more and more substances that are contaminated and this is reflected in our overdose figures.

The substance most often used in cases of non-fatal overdoses in the Capitale-Nationale is GHB, which is currently very popular in the region, especially among young people. In 2021 there will be an increase in the number of reports of GHB and an increase in the severity of these overdose casesreports the CIUSSS

The number of fatal overdoses fell from 37 in 2020 to 30 in 2021. Of that number, a quarter of drug-related deaths in 2021-2022 were due to opioids.

There would have been polyconsumption [de plusieurs substances simultanément] in a large proportion of fatal overdose reportsspecifies the public health report of the Capitale-Nationale.

For the year 2022, 17 deaths from drug overuse have already been recorded as of May 13.

Despite the lower representation of opioids in nonfatal overdoses, the CIUSSS also specifies that this place is becoming increasingly important.

Number of non-fatal opioid overdoses growing every year since 2017† There would also exist increased diversity of opioids on the market.

consumer research

Before launching the call for projects for the analysis of substances, public health first wants to know what the specific needs are in the region. the CIUSSS de la Capitale-Nationale is currently conducting consumer surveys in its territory to determine, among other things, the appropriate technologies for Quebec.

The habits of consumption and attendance at community organizations, the nature of the drugs used, the type of intervener preferred, the preferred location for its implementation are all elements considered in the study.

Respondents have until 3 June to report. The answers will allow public health to steer the characteristics of the project it wants to implement.

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