Alberta is bolstering its response to the fentanyl overdose crisis by making an antidote to the powerful opioid available without a prescription, becoming the second province to do so as public-health researchers call for others to follow suit.
The government announced the decision Wednesday amid the release of new figures showing that 69 deaths in Alberta have been linked to fentanyl so far this year. That's stable compared to the same time last year, but does not show the decline government officials were hoping for, said provincial Health Ministry spokeswoman Laura Ehrkamp.
Health Canada cleared the way in January for provinces to ease access to naloxone, an injectable drug that reverses the symptoms of opioid overdose. British Columbia made it available without prescription in March.
Public-health advocates hailed Alberta's move and said other provinces struggling with fentanyl outbreaks should do the same.
"It's a great idea," said David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto. "It should happen everywhere. It should happen soon."
Fentanyl is up to 100 times more potent than morphine and is often sold on the street cut with heroin or oxycodone, making it even more dangerous. Available as a prescription painkiller, the drug is often sold in patch form but stripped of its gel and smoked by abusers, heightening the risk of overdose.
The rise of fentanyl has hit Western Canada hardest, especially British Columbia and Alberta. But the drug has been migrating east and recently overtook oxycodone as the leading cause of opioid overdose in Ontario.
Dr. Juurlink said that there might, in theory, be a risk that making naloxone more readily available could prompt fentanyl users to be more aggressive in their dosage, but said the possibility was remote and was outweighed by the benefits of the antidote. "There's no argument against the widespread availability of naloxone," he said.
Hakique Virani, a professor of preventive medicine at the University of Alberta, urged other provinces to make the antidote more accessible.
"We're well past time for that to occur," he said. "This is not an Alberta-only or B.C.-only problem. There's no question that every province has to go this way. And the federal government has set the table quite nicely."
But even as Dr. Virani lauded the Alberta government for its move, he said much more remains to be done in the fight against fentanyl, including better opioid-dependence treatment, properly tracking deaths related to the drugs and curbing their overprescription. "The only downside would be if the government decides to hang their hat on this as a complete success," he said. "We need to move faster on those other things."
The Alberta government also announced on Wednesday $3-million in new funding to expand counselling services and methadone treatments for opioid addicts. Dr. Virani said he would monitor how the money was spent before giving a verdict on it.
Along with making naloxone available without a prescription, pharmacies in Alberta will be able to provide the drug to friends and family members of fentanyl users at risk of overdosing, a new policy that begins Friday.
Not all pharmacies in the province carry the antidote but an average of 10 sign up a week, said Ms. Ehrkamp, the Health Ministry spokewoman.
In Alberta, 189 naloxone kits have been dispensed with a prescription. The drug will continue to be free under the new policy.
With files from Justin Giovannetti and The Canadian Press