An introduction to Canada's opioid crisis, 2018
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The opioid crisis in Canada is an increasing threat to all Canadians; according to the CMAJ in March 2018 "Opioid use disorder is one of the most challenging forms of addiction facing the Canadian health care system, and a major contributor to the marked rises in opioid-related morbidity and death that Canada has been seeing in recent years. The evolving landscape of nonmedical opioid use has become increasingly dominated by prescription opioids diverted from the medical system and, more recently, by highly potent, illicitly manufactured synthetic opioids (e.g., fentanyl and its analogues, including carfentanil)...". The growing number of overdoses and deaths caused by opioids (see 2016 statistics), and now the rise of fentanyl (and its analog Carfentanil or carfentanyl), is an increasing public health emergency across the country. The phrase used most to describe (and thus search for) the topic in Canada is opioid crisis. Though this phrase also locates some American resources, the phrase most commonly used in the United States is opioid epidemic. The crisis is a complex health and social issue that needs an evaluated response from all health workers, including librarians in hospitals and public libraries, as well as members of the general public. Though much of the discussion around opioids is generally associated with recreational street drugs, it is also important to note that opioids continue to be legitimately prescribed to individuals who suffer from chronic pain.
The epidemic is not confined to Canada's major urban centres such as Vancouver, Toronto, Montreal, Calgary, Edmonton, Winnipeg, Saskatchewan, Hamilton, Ottawa and cities on the east coast. Opioid use disorder is a public health emergency nationwide. The main issue is withdrawal management coupled with the loss of tolerance (and high rates of relapse). Stepped care approaches are required involving opioid agonist treatment with buprenorphine–naloxone as a first-line treatment, progressing toward methadone as second-line if required; then, if needed and appropriate, toward slow-release oral morphine with the support of a specialist. Further, evidence-based harm-reduction approaches such as naloxone programs and novel treatments not yet widely available in Canada and must be urgently provided. Rural areas of Canada are also affected. The national response to the opioid crisis in Canada is being lead by several branches of government and medical organizations, which aim to be comprehensive, collaborative, compassionate and evidence-based in their resolutions.
Pre-searching & browsing
Much of the discussion points to changing prescription practices and pain treatment habits, the need to create stronger policies and regulations, and to educate patients and their families about limiting their risk of opioid addiction; as well as care for loved ones struggling with substance abuse and addictions.
What librarians are doing
Librarians around the world can assume unique roles in dealing with the opioid crisis within their communities. This is particularly true of public libraries in the United States and Canada as their services and spaces are often the most openly accessible to individuals who are struggling with opioid addiction, and are located in urban centres near the epicentre of the epidemic. In some cases (mostly in the United States but increasingly in Canada and elsewhere), librarians may assume the role of first responders in the crisis, and in assisting those experiencing an overdose. It is therefore important for librarians to be aware of current initiatives taking place at libraries within their regions, and training opportunities that can provide them with the skills necessary to help those in need.
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