Opioid epidemic: MSFHR funds support research on optimal naloxone dosing

1 February 2017

In April 2016, British Columbia declared a public health emergency and struck a Joint Task Force on Overdose Response. This was driven by rising numbers of fatal and non-fatal opioid overdoses resulting from ultrapotent opioids such as fentanyl and more recently, fentanyl analogues appearing in street opioids.

The task force, led by provincial health officer Dr. Perry Kendall and Clayton Pecknold, director of police services, works closely with health authorities, emergency staff and the BC Coroners Service to improve the sharing of data between organizations to build and strengthen the Opioid Overdose Response Strategy.

In May 2016, Dr. Kendall turned to MSFHR to help address a gap in knowledge about optimal dosing of naloxone, the primary tool used by first-responders and health care professionals to restore normal breathing and consciousness during an overdose. Last fall, in response to Dr. Kendall’s request, MSFHR awarded $98,500 to Dr. Roy Purssell and his colleagues in the UBC Department of Emergency Medicine to conduct phase I of an Emergency Department Opioid Overdose Treatment Study.

Originally, naloxone treatment and dosing was developed and tested primarily in the context of heroin overdose, so relatively little is known about optimal dosing in the context of fentanyl and its analogues. In fact, first responders in BC have reported requiring much higher doses of naloxone than has been customary for the reversal of heroin overdoses. Recognizing the need for further evidence about naloxone treatment in the context of fentanyl and its analogues, Dr. Kendall approached MSFHR with a request to fill this data gap.

Today, Dr. Purssell and his team are working to evaluate the safety and efficacy of different naloxone dosing regimens in the context of fentanyl and its analogues. The outcomes of this year-long research project will help inform the optimal clinical management of overdoses, form part of the province’s broader response to protect those at risk, and potentially save lives.

Dr. Roy Purssell is a professor in the UBC Department of Emergency Medicine and an emergency physician at Vancouver General Hospital. Dr. Purssell is revising longer term components of his research and MSFHR is committing to reviewing and potentially funding these components on an expedited basis once received.