Overdose calls in Moncton decreasing, but poisonings still happening

More than a month after a sharp spike began in drug poisonings in Moncton, public safety and medical responders say things are letting up a bit, but partly because of new treatment protocols.

Overdose calls in Moncton decreasing, but poisonings still happening Medical, shelter staff change tack to deal with powerful tranquilizer Workers in public safety and health care who have been dealing with a spike in overdoses in Moncton say the number of emergency calls has come down a bit, but the issue hasn’t gone away. In June, first responders were responding to as many 50 calls a day, with public health officials warning about the presence of medetomidine — a potent veterinary tranquilizer frequently mixed with fentanyl — in street drugs.

“It has calmed down,” said Dr. Erin Rogers, a family physician who works for the Horizon Health Network at the Salvus Clinic. The number of calls per day is hovering at 10 to 12, said Conrad Landry, the Moncton fire chief, still a lot more than the normal rate of no more than a few. “We're hoping that it goes down ... obviously for these citizens, these vulnerable people that are being affected by it, and the mental health of firefighters,” he said.

“It's been a difficult time,” Rogers agreed. The drop in call volume doesn't mean drug poisonings from medetomidine aren't happening. It’s more that staff at local shelters are now better able to manage it, and EMS does not need to be called up every time.

The response to the crisis has been an evolution, Rogers said. When it began, groups of five or eight unconscious people at a time were being found together, she recounted. Staff and volunteers providing services to the homeless community were using their stock of opiate reversal drug kits, but it was ineffective and they were overwhelmed.

“We were seeing in the beginning lots and lots and lots of naloxone being used in efforts to wake people up and it just wasn't working,” she said. “So people getting up to nine doses of naloxone. “That's not a great use of naloxone.”

Because of the strength of the tranquilizer that’s in the drugs, it’s not realistic to try to wake up people who have taken it, Rogers said. Plus, naloxone totally reverses the effects of the opiate, she said, so the person who is dependent on opiates would wake up in a very unpleasant state. “That can itself put people at further risk because they then now need to fix those symptoms,” she said.

Medical resources were deployed to treat those who had been poisoned and to provide some training. Salvus pivoted its mobile outreach team of “generally two nurses” to the Bridge to Home Resource Hub, a shelter and resource centre operated by the John Howard Society, where most of the mass poisonings were being noticed, said Rogers. “We started with a tent where we could bring people in to monitor them,” she said.

“We were seeing people unconscious after using for five, six hours. “And for folks who do not have a roof over their head in order to be safe during that time, you can imagine it's really challenging.” The treatment protocol became to monitor breathing and only call for paramedics if it got too slow, said Rogers.

“We’re looking for breaths every seven seconds. ... Then they're generally going to be maintaining their oxygenation. ...

letting them essentially recover over a period of time.” The Salvus Clinic’s small staff was at the same time trying to spend some time at other local shelters, where poisonings were also taking place, and appealed to health authorities for support, which did come through, she said. “It's been really heartwarming, actually, to see how many people have come together to support,” Rogers said.

“It's really been a large and coordinated effort from Horizon, Vitalite, Addictions and Mental Health, Public Health.” Those efforts are now winding down, said Rogers. “Shelter staff are now hopefully more comfortable managing this,” she said.

The toxic drug supply is not going to get any cleaner, warned Rogers. “This is just one of many contaminants that will continue to be introduced.” The doctor sees a silver lining to this challenging situation: “the folks who are trying to provide alternative solutions are now connected,” she said, “in a way that we weren't connected before.”

She hopes they’ll be able to use those connections to lower barriers to addiction supports. With files from Information Morning