Post-secondary students, many who have moved away from home for the first time, have the potential to face all kinds of hazards and dangers.
While young adults have been known to experiment with drugs and alcohol while attending school, recent research reveals they are now at greater risk of hospitalization due to opioid overdoses. This means Canadian post-secondary institutions are now tasked with the balancing-act of educating students, while also doing their best to keep them safe from life-threatening drugs.
According to a 2016 report co-authored by the Canadian Institute for Health Information and the Canadian Centre on Substance Abuse, 13 people were hospitalized due to an opioid overdose on an average day in Canada in 2014-15.
The report also found that between 2007-08 and 2014-15, the number of hospitalizations due to opioid poisoning increased by more than 30 per cent. These statistics led the authors of the report to conclude that the number of hospitalizations was evidence of not just an epidemic, but a major “public health crisis.”
The study determined it was youth aged 15 to 24 that had the largest increase in hospitalizations due to opioid poisonings, accounting for a 62 per cent increase in hospitalizations during the study period.
Opioid overdoses aren’t just occurring in Canada. It’s an issue affecting countries all over the world. According to data provided by the World Health Organization in 2014, an estimated 69,000 people died from opioid overdose annually.
While opioids can come in different forms, many of the overdoses plaguing Canadian emergency rooms are a result of notorious street drugs such as cocaine, heroin, and fentanyl.
It can come from anywhere
Miriam Brisbin, an accounts supervisor with Advocates for Opioid Recovery, a U.S.-based advocacy group, said that opioid addiction can come from anywhere.
“Many young people’s addictions begin with something as simple as a high-school sports injury or wisdom tooth removal when the doctor provides opiates as part of the recovery regimen,” she said.
Using opiates as a form of medication is a long-running practice, with drugs such as OxyContin and Vicodin often being prescribed to help patients manage their pain.
Problems can arise, Brisbin explained, when this medicine is prescribed in dosages that are too high.
“When the doctor provides opiates as part of the recovery regime—often times prescribing up to two-weeks worth of medication when best practices are three to five days worth—soon enough an addiction is born,” she said.
Opioid overdoses continue to pose major challenges for Canadian healthcare professionals. According to a Statistics Canada report, they killed more than 2,400 people in Canada in 2016.
However, Dr. Abhimanyu Sud, a lecturer in the department of family and community medicine at the University of Toronto, said those figures may be misleading.
“The important takeaway from that [report] is that it is actually an underestimate because not all the opioid deaths are captured,” he said.
The antidote
But, there is an antidote for opioid overdoses.
Naloxone is a drug, which, when administered intravenously or through the nose, can undo a narcotic overdose if it’s given quickly enough. The life-saving drug is distributed in kits that are available for free in many Canadian provinces.
Although all 13 provinces and territories in Canada have some form of naloxone distribution program, the availability of the drug varies across the country.
According to a report by the Canadian Pharmacists Association, Alberta is a Canadian leader in making naloxone kits as widely available as possible. The provincial government there has made naloxone kits free and available for anonymous pickup in pharmacies across the province.
Meanwhile, in Ontario, people can present a valid provincial health card at most pharmacies to receive a free naloxone kit. Community based-programs such as needle exchange programs and hepatitis C programs also stock the kits.
In September, Quebec announced it would start making naloxone freely available in pharmacies across the province.
With statistics showing that post-secondary aged students are at greater risk of overdosing, universities and colleges across the country are doing what they can to prepare in the event of a drug-induced emergency.
Naloxone on campus
At Carleton University, officers with the Department of University Safety (DUS) and staff with the university’s Health and Counselling Services are trained with the kits and have them available when needed.
DUS Sgt. Richard Sabourin said officers are given nasal naloxone kits in order to better protect them.
“It avoids introducing a sharp [needle] to the scene, which an officer could potentially get stuck with, which is why we use the nasal kits,” he said.
Sabourin added that he was unaware of any suspected overdoses on campus, although he added that there was one incident last year where opioids were considered as the possible cause.
Kevin Friese, assistant dean of students for health and wellness services at the University of Alberta (U of A), said the university is prepared should a member of the school community overdose.
“Our protective services [officers] have been provided with those naloxone kits in case an opioid overdose occurs,” Friese said. “We’ve considered giving them to RAs [resident assistants], but are considerate at the time about the safety risk to RAs. They could potentially get stuck with a needle in an unstable situation.”
To date, Friese said health services on the U of A campus have also distributed two dozen naloxone kits to individuals who wish to pick one up.
Meanwhile, Carleton, is also boosting student awareness around opioids and how to deal with suspected overdoses.
“We’ve done a lot of awareness with students coming in, of being able to identify symptoms and what to do if you suspect someone is having an overdose,” said Maureen Murdock, the director of Health and Counselling Services at Carleton. “And we’ve distributed a lot of material from [Ottawa] Public Health to share with the student leaders during orientation week.”
Murdock said Carleton has naloxone available in the health clinic on campus, and that campus safety officers are trained to use and carry naloxone kits.
But, she said while the health clinic is equipped to deal with an overdose should one occur, that it is unlikely clinic staff would come across an overdose. She added that there are protocols for campus safety officers to follow when administering naloxone.
“They would be taken to hospital. That’s part of the protocol, because naloxone the way it works, it’s only for a short period of time,” she said. “Then it’s possible that the opioids in the system can last longer than the naloxone, so they need to be taken to the hospital for further medical treatment.”
Raising awareness
Back at the U of A, Friese said naloxone kits aren’t the only new development in dealing with the opioid crisis. The U of A’s approach to raising awareness of opioid addiction has changed too.
“We’ve always followed a social norming approach when it’s come to awareness of drugs and alcohol,” he said. “We’ve always tried to make people aware of what drug use is like socially, because there’s a big difference between actual use and perceived use.”
According to Friese, if students think that it’s “normal” to be doing drugs, they are more likely to do them. He saic the U of A’s former approach to social norming was trying to dispel that commonly believed myth.
“A lot more people think drug use is a lot higher than it actually is,” he said. “There was a survey where only nine percent of students had smoked marijuana in the past month. But when students were asked what percentage they thought had smoked, it was something like 90 per cent.”
More recently though, he said the university has switched to a harm reduction model, which aims to help victims rather than discourage non-users.
“It acknowledges that [no matter] how much health promotion and education you provide, there’s always going to be some individuals who are going to use,” Friese said. “It’s not about guilting people or making a judgement call against a victim, it’s very much about people knowing what their options are.”
Photo by Meagan Casalino