Public Health warns of rise in opioid poisonings ahead of the holidays

Nova Scotia Health Public Health is warning about an increase in opioid poisoning as we head into the holidays.

Evidence suggests much of the increase may be due to fentanyl – a synthetic opioid 50 times stronger than heroin and 100 times stronger than morphine. Fentanyl may be added to illicit drugs during their production without a customer’s knowledge. This risk of contamination is not limited to opioids and is high for all drug types including stimulants such as cocaine or MDMA and benzodiazepines such as Xanax.

“Many people use substances over the holidays for many different reasons – from a holiday party to coping with the stress of the season,” said Emily Percival-Paterson, harm reduction consultant with Public Health. “No matter your reason for or choice of substance use, the drug supply has changed in Nova Scotia. Opioid poisoning can happen to anyone, no matter what they were intending to use.”

The prevalence of fentanyl has resulted in substantial increases in drug poisoning deaths across the country, including in Nova Scotia. So far in 2023, there have been 56 deaths due to opioid poisoning in Nova Scotia.

“Anyone who uses drugs not given to them by a pharmacy should assume there is a potential for fentanyl contamination,” said Percival-Paterson. “Drugs purchased online, from friends, or from regular dealers could be deadly. It’s important to keep this in mind and aim to reduce their risk of an opioid poisoning.”

Public Health is urging people who use drugs to take steps to reduce the risk of an opioid poisoning:

• Have naloxone available, even if you aren’t intentionally using opioids and especially if you live in rural areas. Although naloxone only works to reverse opioid poisonings, there is no harm in administering it if you are unsure what kind of poisoning you are witnessing. Naloxone is available for free from most community pharmacies and other community locations, including needle distribution and disposal organizations. For more information about where to get a free naloxone kit and how to use it, visit http://www.nsnaloxone.com/.
• Consider screening your drugs for fentanyl using a fentanyl test strip available at either an overdose prevention site, Northern Healthy Connections Society in the Northern Zone, or they can be purchased online and sent to your home.
• Let friends know you have naloxone, where you keep it, and how to use it.
• Don’t use alone. Someone using alone cannot call for help if a poisoning does occur.

Overdose prevention sites support harm reduction by providing equipment and a safe and caring space for people to use drugs. These sites are equipped to respond to and connect people with important health and social services. 

• ReFIX Halifax Overdose Prevention Site (2107 Brunswick St., Halifax) 902-209-9370
• PeerSix Overdose Prevention Site (75 Prince St., Sydney) 902-567-1766

If you are using alone, call the National Overdose Response Service (NORS) phone line at 1-888-688-NORS. It is a 24/7 phone line available for anyone in Canada to call before using drugs and can support you through challenging responses that can sometimes occur when using substances. The operator will stay on the line and call for help should you become unresponsive. For more information visit www.nors.ca.

When using with others, go one person at a time. Watch and wait before the next person uses, even just a few minutes.

Don’t mix drugs. Mixing different types of drugs, like opioids, alcohol, methamphetamine or cocaine increases your risk for poisoning/overdose.

Call 911 in the event of a poisoning. Know your rights under the Good Samaritan Act (http://www.nsnaloxone.com/good-samaritan-act.html).

A drug poisoning involving fentanyl is similar to overdoses of other opioids, but it can come on much faster and stronger than a typical opioid overdose. Overdose signs include:

• won’t wake up or hard to wake up
• slow, irregular breathing
• slow or no pulse
• gurgling, gasping or choking
• pale, ashy, cool skin
• blue or gray lips or fingernails
• vomiting

Nova Scotians can self-refer to Nova Scotia Health’s Mental Health and Addictions program by calling the Intake Service (toll-free) 1-855-922-1122 to be connected to a clinician Monday to Friday, 8:30 a.m. to 4:30 p.m., Tuesdays and Thursdays until 8 p.m.

The Intake Service provides triage, screening, and navigation for programs offered through the Mental Health and Addictions program at Nova Scotia Health (and IWK) including recovery support centres.

Access Wellness Nova Scotia is a free single-session supportive counselling service for individuals, couples, or families. Trained counsellors can help people manage stress, mild to moderate depression or anxiety, relationship issues, general mental health concerns, concerns related to alcohol and drug use, loss and more. Visit AccessWellnessNovaScotia.ca or call 1-833-691-2282 to make an appointment.

The Peer Support Telephone Service is available to all Nova Scotians 18 and up experiencing mild mental health and substance use concerns or who are feeling isolated, alone, anxious, distressed, or need someone to talk to who will listen with empathy and without judgment. The trained peer supporter will provide non-urgent social and emotional support, reassurance, encouragement to callers, and information regarding community services. Call toll-free at 1-800-307-1686.

The Provincial Mental Health and Addictions Crisis Line is available 24/7 for anyone experiencing a mental health crisis or someone concerned about them—call (toll-free) 1-888-429-8167.

Nova Scotia Health’s Mental Health and Addictions program (MHAP) has free e-Mental Health and Addictions tools available to all Nova Scotians at www.MHAhelpns.ca

Visit Mental Health and Addiction’s program website, http://MHAhelpNS.ca, to learn more about our services, resources, and tools.

For more information about Take Home Naloxone, please visit www.nsnaloxone.ca

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