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UBC Hospital’s Urgent Care Centre now stocks take-home naloxone kits.

UBC’s naloxone kits sit mostly unclaimed as students are reluctant to be seen as ‘high risk’ drug users

The urgent-care centre began stocking naloxone kits in late October

By Sophie Gray , in City , on January 22, 2017

The University of British Columbia Hospital’s urgentcare centre now stocks the take-home naloxone kits being widely used in Vancouver’s Downtown Eastside to reverse drug overdoses.

But some student leaders wonder whether those efforts will be in vain because of government policies that subtly discourage students from asking for them.

The urgent-care centre began stocking naloxone kits in late October in response to the ongoing crisis in B.C. with fentanyl overdoses.

There is concern around overdoses at the school, as UBC Hospital experienced an increase last year. Eight overdose incidents were recorded, up from the six that occurred in 2015, prompting further prevention methods like more available naloxone kits.

But so far only six kits have been handed out.

Students fear stigma of declaring themselves drug users

The low number of kits handed out is likely because students must declare themselves opioid drug users at the campus health clinic, according to provincial laws. This means students must face the stigma that comes with being a drug user, says one student representative

Obtaining a kit requires a person to be at a high risk of an opioid overdose, which is where some students are concerned.

Having to identify yourself as an IV drug user’ is enough of a deterrent so that 85 to 90 per cent of students will go without,” said Brian Spencer, a student and president of the Interfraternity Council at UBC. He believes that the B.C. government rule could prevent students from asking.

He said students are reluctant to classify themselves as high-risk opioid users because there is a stigma attached to this.

As well, students who do use recreational drugs don’t use opioids and so wouldn’t identify themselves that way. But non-opioid drugs like cocaine or MDMA can also be contaminated with fentanyl.

It is not enough for a student to go to the health clinic and say they occasionally use party drugs, or that a friend uses substances frequently and they want to have a naloxone kit to be safe. They are not considered to be enough of a risk.

For students who do say opioids are their drug of choice, asking to be classified as “high risk” is straightforward. Anyone who plans to use opioids falls into the highrisk category and will be given a kit. The process involves going to the health clinic and speaking to a nurse.

Nurses say they have no choice but to follow provincial rules

Nurses say they have no choice but to follow the provincial regulations for dispensing naloxone kits.

 One of the nurses who talks with potentially high-risk students is Kate Kinloch, head of the nurse on campus program. She said that, “because [UBC health services] gets [naloxone kits] free from the government, we have to follow the mandate of the government and their protocol,” which limits who receives the kits and how they access them.

Record overdose numbers

Drugrelated overdose deaths in the province reached 914 in 2016, a 77-per-cent increase over 2015.

B.C. paramedics received a $5 million boost in funding to help fight the crisis in November, in the wake of a record-breaking week of overdoserelated 911 calls. UBC’s increase in overdoses has health-care professionals concerned about the epidemic further affecting the university.

Dr. Marna Nelson, interim director of student health at UBC’s Student Health Services, said she would not comment on whether the the B.C. government’s policies should change.

Instead, she said health services are “trying to be proactive so we don’t have someone in a residence have an extreme issue or a frat party or any other situation on campus.” Both she and Kinloch are pushing for the kits to be more widely available throughout the campus. They hope to educate as many people as they can on safe drug use and how to use naloxone kits in case they witness an overdose.

A harm-reduction strategy is in place at the school and throughout the province.

Both Kinloch and Nelson are in favour of educating students on safe drug use as part of a proactive harm-reduction strategy. They accept that, although abstinence is the best strategy, it is not realistic, and other possible options to promote safe drug use for recreational users of all drug types have potential benefits.

Naloxone kits contain supplies for three injections.
Naloxone kits contain supplies for three injections.

Some of those options include drug-testing strips, which provide an alternative for recreational student drug users to avoid the necessity of labelling themselves as high-risk. At Insite locations on the Downtown Eastside, urine-testing strips were altered to check street drugs for the presence of fentanyl before consumption. Other drug-testing services have been used at music festivals around North America and Europe.

The B.C. Ministry of Health is conducting research to provide drug-checking services to the general public, but how these would work on a permanent basis is unclear. Spencer believes that such services should be as readily available as condoms are at the health clinic to proactively help students stay safe.

Nelson agrees that options like these are important to explore, but believes that it is the provincial government’s responsibility to do so, as health-care professionals dealing with the overdose crisis are limited by the province’s regulations. Due to these regulations, nurses and doctors cannot help students access drug-testing services even though statistics show that university-age students use drugs of all kinds.

Young people experiment more with drugs than other groups

Young people between the ages of 15 and 25 use illicit drugs three to five times more often than those over 25, according to Health Canada numbers. “Kids will experiment,” Spencer says, “and though it’s not ideal to use illegal drugs, and in no way does the Interfraternaty Council condone that type of behaviour. It just seems that having all the necessary knowledge and safety precautions is the most intelligent way to proceed.”

Drug-testing services are not currently available at UBC, but Kinloch and Nelson urge any students who might use drugs to purchase a naloxone kit from a pharmacy. They believe anyone who qualifies as high risk should have a kit, and all students should attend open information sessions to educate themselves.