Naloxone or Narcan (brand name), and Fentanyl

[Scooter]

Here are some articles worth reading:

http://www.theglobeandmail.com/news/bri ... e29389795/

http://www.theglobeandmail.com/news/inv ... e29570025/

http://www.cbc.ca/news/world/fentanyl-d ... -1.3181725

http://www.huffingtonpost.ca/2016/09/01 ... 27312.html

[Scooter]

Here's an especially in-depth article that just appeared in the Globe this morning. Carfentanil is receiving more publicity, finally.

http://www.theglobeandmail.com/news/bri ... e33462579/

Cheque Day in the Downtown Eastside

ANDREA WOO, SUNNY DHILLON, WENDY STUECK, MIKE HAGER, MARK HUME, IAN BAILEY, AND LUIZ LOPES
VANCOUVER
THE GLOBE AND MAIL
LAST UPDATED: SATURDAY, DEC. 31, 2016 9:46AM EST

The prevalence of fentanyl and carfentanil means drug users in the Downtown Eastside are always at risk, but never more so than when social assistance cheques arrive every month. The Globe spent roughly 24 hours in the troubled neighbourhood for a first-hand look at the overdose crisis.

Deirdre is leaning against an alley wall, prepping a needle full of crystal methamphetamine that could be contaminated with fentanyl. She and a friend have paused to cheer as an employee of a nearby needle exchange rushes over to revive an overdosing man.

“Breathe bro, breeeeathe!” another bystander shouts as he gently slaps the man’s blue face while the employee preps oxygen and a syringe of naloxone that can reverse the deadly effects of opioids.

A small team of firefighters and paramedics take over. The first responders believe the man – Justin – is the one they revived in the same spot a day earlier.

Deirdre, who asked that her real name not be used, and her friend prepare their rigs and inject them into their arms, the scene in front of them no deterrent to the risk that could put them on the pavement in need of a similar lifesaving intervention.

It is 11:29 a.m. on a frigid Wednesday morning– the second-last Wednesday of December, when millions of dollars of social-assistance payments flood into the Downtown Eastside, or DTES. For recipients who regularly use drugs, this day – known in the neighbourhood as “Cheque Day,” “Welfare Wednesday” or “Mardi Gras” – dramatically increases their risk of a fatal overdose.

Though much of Canada has felt the effects of the fentanyl-driven overdose crisis, British Columbia has been hardest hit, experiencing more fatal overdoses this year than in three decades of record-keeping. The death toll is expected to climb to more than 800. Two weeks ago, eight overdose deaths were recorded in the Downtown Eastside in a single day.

In the troubled neighbourhood, more than 6,300 people draw social assistance and more than half the 18,000 residents are thought to be drug users.

In the streets and back alleys, people slump against walls, their bodies suddenly limp as an overdose of synthetic opioids crashes their system, and their skin turns blue from a lack of oxygen. There are cries of people calling for help, shouting for the naloxone antidote kits that can reverse the effects of opioids. The names of loved ones lost are tagged on brick walls, in long lists. In the background, there is the constant wail and yelp of sirens.
On the final Cheque Day of 2016, seven reporters and two photographers with the Globe’s B.C. bureau spent the day and night walking through the Downtown Eastside, witnessing the impact of the fentanyl crisis on most facets of life in the neighbourhood where the overdose epidemic has become troublingly normal.

The reporters saw first responders revive overdose victims who could have died otherwise, they saw outreach workers connect addicts with life-saving services, and they gained unprecedented and exclusive access to a mobile emergency room set up in the heart of the Downtown Eastside to quickly respond to the public-health crisis.

It would be a busy night.

“You clear a call, you get another one,” paramedic Brian Twaites said during his shift. “You clear a call, you get another one.”

This was just the start of the article. There's a whole lot more, really in-depth coverage, if you click on the link at the top.

[fluffer]

Wife is emergency nurse. 2 years ago we were seriously contemplating a move to van city for her to work at the hospital near the East side. She dodged a bullet.

[narcan_man]

I saw a discussion about this on facebook and did not want to contribute under my own name there. I am an OFA3.

Here are some issues relating to Narcan:

• How legal is it to use a kit? My OFA3 instructor told me that we are not allowed to dispense drugs. The discussion we had in class was related to over-the-counter drugs like aspirin, not to a response to an overdose. Example: we are not allowed to administer an epi-pen, although we can assist someone to self-administer with their own pen. To be clear, if someone was dying of an overdose and I suspected it was fentanyl and I had a narcan kit, there's no question that I'd try to save them, regardless of whether or not it is legal.

• Maybe administering drugs is different if the person is unresponsive? If a conscious person refuses first aid, you cannot treat them. If that person becomes unconscious, the Good Samaritan Act protects you and you are expected to administer first aid to the level of your competency.

• If we ignore the common sense issue of "I'd use the kit anyway for an overdose victim," Canadian law varies. Under common law, which applies to most of Canada, there is no "duty to assist," so a bystander is not obligated to try to help a person in distress if they don't feel comfortable or competent. This is different in Quebec (civil law) by virtue of their Charter of Rights. However, in common law (which is applicable in BC) an employer has a "special relationship" and should have a responsibility to rescue employees, under an implied contract theory, which I think would mitigate the prohibition of a company from dispensing drugs (although it might not let me off the hook, as a first aid attendant). Is all of this correctly stated?

• Can I, as an OFA3, "decline" a role as an official OFA3 for the company (if someone else is paid or designated to fill that role), and if so, what happens to my moral and legal responsibility when things go wrong?

• What happens if a company is uncomfortable having company-sponsored kits on site, under the rationale that it's an implied acknowledgement that employees are using illegal and controlled substances in the workplace, therefore increasing the company's liability? If a company stocks kits, and someone dies, will their parents sue the company and point out, "this company had kits on site, they knew it was a risk and they should have controlled it." How does a company prevent employees from taking illegal drugs while off-duty, and eliminate the risk that a drug seen as normally being fairly harmless (mdma, acid, mushrooms) hasn't been laced with fentanyl?

• How would you deal with a triage situation? What happens if someone brings a bunch of bad pills (mdma) into camp, everyone eats them at dinner on the night off, and then suddenly an hour later the camp is dealing with six or eight simultaneous OD's?

• Can kits that test for the presence of fentanyl mitigate this situation somehow? Or will that, once again, be considered to be taboo because of the assumption that the presence of a kit is a tacit admission of dangerous drug use being implicitly tolerated in the workplace? Never mind the fact that fentanyl is extremely dangerous because of its toxicity, and a batch of dangerous pills would possibly have an uneven distribution so that a test for fentanyl would be positive on some pills in the batch, and negative on other.

• Are there any issues to be aware of if non-first-aider employees bring kits into the workplace of their own initiative? Can this be encouraged?

• Will this situation encourage many planters to switch from drugs to alcohol, which brings about a different set of problems? Alcohol taken in excess can be equally dangerous.

[Treeppy]

Those are very good points narcan_man... and not necessarily easy to answer.

I can only talk from the situation in BC, but regarding the legal aspect, it seems that anybody which has received naloxone training (which is given to you when you get your kit) is allowed to administer naxolone.
Here is a paper from the BC Centre for Disease Control: http://towardtheheart.com/assets/naloxo ... 16_229.pdf
It states that "On Oct. 13, 2016, regulations under the Health Professions Act and the Emergency Health Services Act were amended to enable all healthcare professionals, first responders (e.g. police, firefighters), social workers and citizens to administer naloxone outside of a hospital setting."
This is also stated in this article from the College of Pharmacists of BC http://www.bcpharmacists.org/naloxone

I also found this interesting, though rather short, article about bar and restaurant owners having somewhat similar concerns about liability http://sunpeaksnews.com/bars-opiate-ove ... 4716796875

As for the company liability, that sure would be easier to deal with if WorkSafe BC had made a clear statement on the subject. That being said, people that may have difficulty to access emergency medical services (i.e. living in remote areas) have been identified as a population that could benefit from naloxone kits (as seen in those links from the Provincial Harm Reduction Program http://towardtheheart.com/naloxone/heal ... essionals/ ).

I think that it would be a good idea for companies that have camps far from medical services to have naloxone kits, but for the rest I think education (official and non-official, such as through this forum or facebook group discussions) are probably the best answer. For example, I wouldn't expect a company to have test kits, but if I were to use any kind of drugs at some point in the season, I would most likely buy my own test kits, and I am fairly confident I would not be the only one, seeing the replies to those discussions in the past few days. I find it very encouraging that we are having these talks, and I also saw in one of these that Jordan Tesluk was willing to bring up the subject at the soon-approaching WSCA conference, which might hopefully bring us a few answers as to where the industry is wanting to stand on this matter.

Anyway, this is were I stand right now, I am gonna keep digging the subject, but I am very curious to hear and read other's opinions, especially on the liability issues.

[jdtesluk]

I've already raised this matter to a few people within the industry. I will certainly see if there is an opportunity to raise it during a forum. With sensitive topics such as this, it is important to approach it in the right way. You want there to be uptake, and not reactionary judgments or tunnel-vision on liability. The sole focus is on life-saving. I think the people here (and on Facebook) have done an excellent job of rounding out some of the specific considerations around this issue, and I took a lot of notes. Silviculture is lucky... It has a lot of very thoughtful people involved, including both workers and contractors. If any natural resource industry is mentally and morally equipped to tackle this issue in a conscientious manner, it is silviculture.
Great links Treepy and NM!

[Scooter]

Someone just sent me this link:

http://www.hc-sc.gc.ca/dhp-mps/consulta ... 24-eng.php

Looks like Health Canada is treating this with some urgency. That's great, although I'm not sure if 48 hours of public consultation is quite enough? Much better than taking months though. That will hopefully save a lot of lives.

[ohsnap]

This info is from March 2016, so it's outdated, but it gives a wider province by province idea of the steps planned for the take home kits being used by the public. Obviously these steps are already in motion, but I'm unclear about the regulations each province currently has in place.


http://www.ccsa.ca/Resource%20Library/C ... 016-en.pdf

[jdtesluk]

Some good commentary from my colleagues at UBC

http://www.cbc.ca/news/canada/british-c ... -1.3956308

[newforest]

I've lost some friends to overdose, before Fentanyl was common on the street. One was surrounded by another dozen friends of mine while it happened. They were all as lit up as he was, pretty much, and after a long night of drinking and just a little bit of opiates on his part, unknown to everyone else, it seemed like he had just simply passed out, somewhat routinely as the sun was soon to come up.

OD recovery kits and a person trained to use them would be great. So would pre-use testing of street drugs, though this can miss Fentanyl or the analog version, as it is a big, potent grain that doesn't mix well, and is used as a 'cut' in very small amounts with resulting unequal distribution. Thus the people enjoying themselves need to understand a lot of this, and what to watch for. The person with the training can hardly be expected to just sit around and babysit the entire time.

Cuz come midnight:30 and the question "are you feeling it?" can easily be answered by "let's do another one" without normal checks-n-balances on how much of everything has already been consumed, or how many other people might still be around the rest of the evening.

[Scooter]

More info about Carfentanil, now showing up in British Columbia:

http://cfjctoday.com/article/557951/bc- ... arfentanil

Also, I'm now aware of at least three cases in the past six months that have involved OD's with tree planters. Hopefully we'll see things moving very quickly on this, as it came up at the WSCA conference this week.

[Scooter]

More news:

http://www.cbc.ca/news/canada/british-c ... -1.3999187

[Scooter]

Carfentanil in the Kootenays:

http://www.cbc.ca/news/canada/british-c ... -1.4005886

[Scooter]

From today's WFCA (Western Forestry Contractors' Association) "Rumour Mill Roundup" newsletter:

Forestry Contractors Should Plan for Fentanyl Scourge

It would be unwise for forestry contractors to think their workers are exempt from the lethal hazard posed by fentanyl overdoses. At least one forestry firm has reported a work-related opioid death this year. Forestry workers may be particularly vulnerable in an incident given the remote work locations of some camps, available first aid, and the isolation possible between individuals in tents or hotel rooms. Fentanyl affects the part of the brain in charge of respiration. Victims simply stop breathing. CPR can sustain a patient if their condition is recognized in time. Injections of naloxone are effective provided someone knows the symptoms and how to administer the drug. Just who can do this, under what circumstances, along with the legalities it might attract are under review now by proactive WFCA companies. We will be sharing those practices once we have fully explored the legal, health, and safety landscape of this crisis. In the meantime we recommend employers familiarize themselves by visiting fentanyl information websites like: www.towardtheheart.com and http://www2.gov.bc.ca/gov/content/overd ... ed-to-know

[Scooter]

Full Article: http://brinkmanreforestation.ca/news/al ... ved-friend

Alex Robertson, An Account of Our Beloved Friend's Passing: An Unthinkable Threat to Planter Well-being

By Erik Brinkman
Intro: An Unthinkable Threat to Planter Well-being, by Dirk Brinkman


As each 2016 month’s opioid death count mounted—it reached 922 unexpected deaths in BC by year’s end—and as coroner statistics revealed fentanyl laced drug victims were the casual party crowd-- 4/5th young males and all in the planter demographic--and as doctors appealed to everyone to respond quickly and watch each other because Naloxone is easy to administer and can revive victims --if the interception is prompt-- my 2017 New Year’s Life First message became “take care of each other”.

On Thursday morning Feb 2nd, when Erik phoned with the news of Alex, I had just completed a breakfast conversation with the representatives of the BC Safe Silviculture Program Advisory Committee, delineating how the opioid crisis is going to reach its fingers randomly into the whole reforestation industry in 2017. They had just agreed to make it a priority when Erik phoned to say Alex Robertson was in St Paul’s hospital in a coma, brain dead.

Joyce and I had seen Alex Saturday night at Erik’s house. He had just returned from his seasonal international travels and was preparing to present his upgrades to his Trees App for the Project Managers. But he had not shown up. Instead of going to the WFCA conference, Erik had stayed behind to follow the feeling in the pit of his stomach that something was wrong.

Alex’s death underlines what it means to be responsible for each other’s safety. To face the fentanyl invasion into the stimulants circulating on our streets and amoung predominantly young people, we have to change. We have to commit to prevention, training, and be especially ever vigilant as we are isolated in our remote wilderness work camps. We honour Alex best by celebrating his Trees App, by sharing his story, and by committing to never permit any more of our friends to die of the opiate crisis, especially not while doing the life affirming work of Tree Planting.

Dirk


An Account of Our Beloved Friend's Passing

By now many of you know that our good friend and sage colleague, Alex Robertson, recently passed away. As a community we are here supporting each other through the immense grief and shock ­­-- shock that BC’s opioid crisis could take someone from our midst who we never would have thought vulnerable. I am writing this account to honour his memory by shedding some light on the details of the week surrounding his passing as best I can. Perhaps his passing can be a learning event for us to help mitigate a tragedy like this from happening again.

Alex was a tree planter, foreman, first aid attendant, silviculture innovator, and everyone’s friend. He started planting with Brinkman in Ontario in 2007 at the age of 18. Several seasons later he migrated out west, planting in Alberta in 2011 where I met him in Andy Cameron’s camp. The following season Alex joined my crew in BC, was quickly promoted to driver, and then in 2013 to foreman and first aid attendant. His humble leadership instincts and no-drama reliability made him an ideal friend, lieutenant, and obvious future project manager material.

For Alex it was about purpose, not position, so he always brought something more. After three seasons of filling out stock sheets and learning how much paperwork is involved in running a planting crew, he decided on his own initiative to take an iOS development course in the off season. At the 2016 Western Project Manager’s (WPM) meeting he surprised the company managers with his presentation of an original app he called “Trees”. He digitized the stock tracking process for planter numbers, densities, plots, and block data in the field, and even enabled it to catch over-counts in real time. We were so impressed that Brinkman agreed to purchase the app, and hired Alex to develop it further.

After successfully testing the app in the field with my crew in 2016, a colleague and I continued working with Alex to upgrade it over the winter until it was ready to present on the 2nd day of the 2017 WPM meetings Jan 29th and 30th, for a wide roll out across Canada this season. Alex arrived in Vancouver on Thursday January 26th, with plans to stay for a week at a friend’s place in East Vancouver to present his polished app to the team, catch up with friends, sell his car and then head to Thailand for a few months before the spring plant.

We had a productive meeting at the head office on Jan 27th to review progress and have a trial run. The next day he drove his two-tone VW Rabbit to my house in East Van for a work session to put the final touches on the app presentation. We ate Thai food, toured my woodshop, and caught up. Dirk and Joyce dropped in and we all shared a laugh. Around 7PM Alex left my place to meet up with a friend for dinner on Main St, and then later he met another friend on Commercial Drive until roughly 10:30 PM Saturday night, Jan 28th. Before saying their goodbyes, Alex said he would walk home and that he was excited to present his work at the meetings.

Alex made it back to the place where he was staying sometime Saturday night/Sunday morning to sleep and left around noon to go work on his laptop. Early Sunday morning on her way to work a housemate saw his door freshly closed and his shoes outside his door. Another housemate spoke to him as he was heading out. He said he was heading to downtown Vancouver by bus to work in a café.

On Sunday morning Jan 29th when Alex did not show up for the 1st day of the WPM meetings, I messaged him to see where he was. After receiving no response, I figured he was working hard at perfecting his Trees app for the presentation. On Monday, day 2, we were sure he would arrive in time for the scheduled 5PM presentation of the project he had worked on for the past two years. But when the time came for his presentation and I had to fill in for him, I realized something must be wrong. Alex has always been in the top tier of reliable people I've worked with. So on Tuesday I reached out to friends to find him. I noticed he had left his laptop charger and his car was still parked outside my house since his visit Saturday. No one had seen him for several days, so Wednesday morning I called the VPD to report him missing and they put out an All Points Bulletin.

Just after midnight on Wednesday Feb 1st the VPD called to inform me that Alex was in a coma in the ICU at St. Paul's Hospital. I went straight there at around 1AM and met with the Constable who assisted me to get in to see him. Alex was on full life-support and non-responsive. The nurse informed me that Alex’s family had been contacted the day before, and his sisters had arrived earlier that day from out east and his parents were arranging travel from abroad to get to Vancouver.

According to the doctor’s report, at 1PM Sunday afternoon Jan 29th, a café barista saw him go into the bathroom and when he didn’t come out they went in and found him on the floor with no signs of life. A patron administered CPR without success until EMS arrived. He was rushed to emergency and resuscitated with the help of machines. They found fentanyl (but no other controlled substances) in his system, which they attributed to him losing consciousness. He also had head trauma which they speculated was from the fall when he passed out.

We don’t know where he got the drug, but we do know that he was not a regular user. Alex was an accidental victim of the opiate fentanyl, and like so many loved ones of the victims blindsided by what is being called “the worst drug-safety crisis in history” we are in a state of utter shock at how this could have befallen our dear friend Alex.

Many of Alex’s friends and his immediate family spent time with him at the hospital, to sit with him and say their goodbyes. News of Alex’s condition was shared with his friend network on February 2nd via his FB profile, with the following message:

Hey Everyone. This is Alex's family. I know that many of you are trying to reach Alex. He's been in an accident. We regret to inform you that Alex has been in a coma for the last 4 days and won't be coming out of it. It's a terrible loss and we aren't really sure how to handle it, but we thought that you all should know. We will keep you posted with any further developments. Thanks again and I'm sorry for your loss. Lots of love. Xoxo

Alex passed away at 6:44 PM on February 5th, one week after he was found, and his organs were donated to grateful recipients.

Alex's Western Afterglow memorial was held the following day at his grandfather Jim Irvine’s Legion Hall in West Vancouver. It was well attended by many friends and family and loved ones who sang songs, read poems, played slideshows and shared stories and love and appreciation for the amazing person that was Donald Charles Alexander Robertson. Alex's Eastern Afterglow will be held on April 15th, at the Midland Bay Sailing Club, Marina park avenue, Midland Ontario, from 4pm on.

[Cactus]

We're having a conversation on the very serious issue of fentanyl and the countering of it with naloxone - which is great - but what is actually being done by silviculture companies as we speak?

Are there any companies that plan on providing naloxone kits for their camps (or that already have)? If so, what kind of complementary measures are they taking? (for example, who will they ensure will be trained to legally administer naloxone or how will they dispose of the kit(s))

I am trying to get naloxone kits into my own camp and I know of some peers that are engaged in obtaining a few, in case management doesn't. However, I have no idea what is my company's current stance on naloxone so it is possible that they have already taken matters into their own hands. In any case, is this more of an upper management issue or are supervisors allowed/expected to provide for their own camps?

Thanks a lot,
Cactus

[jdtesluk]

This topic was taken up at the WSCA conference in January. There are some committed individuals working at this time to produce some good guidelines on the issue of naxolone. They are hoping to have some information to share in the coming weeks. It would be nice to have this right now, but the issue is complicated, and there is a need to be accurate.

Generally, this is a topic that should be taken on by management. By all means, if management is inaccessible, speak to your supervisor to find out if they have a plan. Without fault to any company, it may be too much to expect each or any company to have policies in place....this is a fresh issue, and a lot of folks are waiting for some help in finding the right direction. Policy evolution on matters like this tends to spread at a frustratingly slow pace. You can help by raising the issue to your higher-ups.

Even if a company does not have a naxolone plan, they can contribute to awareness by discussing the dangers of fentanyl and carfentanyl with their workers. I suggest planters are no more likely than any other worker population to fall victim to bad drugs. Generalized references to the "industry culture" often tend to be stuck in stereotypes of the past, and out of touch with the actual worker population we see today. In this I mean, planters are no better or no worse about drug use than say oil and gas workers, loggers, miners, or farm workers. I challenge anyone to provide hard data to the contrary. Certainly there are specific crews that party more than others. However, our real vulnerability is not our people.....it's our circumstances....... Isolation. Camp life. Tent life. Demanding shift work ending with trips to unfamiliar towns with unfamiliar faces........ These things amplify the hazard faced by any individual that dabbles with drugs, particularly drugs as lethal as fentanyl etc. Planting is different in that a person having a medical emergency is more likely to be isolated from their peers. There is no dorm, no shared work space, no eyes watching when a person passes out in a tent or in a patch of bushes. When that person passes out, they are that much farther from help, and there may be less equipment and fewer people there to assist them. A person buying drugs on their day off is less likely to know their seller, and less able to ascertain the safety of the product.

These circumstances would be threats to any worker. Planters need to look out for themselves and each other. Management can help by being part of the education process. YES AND FOREMOST, it is best to not have drugs in camp or at work. That much is beyond argument. But you can only help people by educating them of the dangers they face, and the trappings of their surroundings. For example, people should know how the drug works (shutting down your respiration), and know that CPR is the key to keeping a person alive, and that CPR is necessary even in conjunction with naxolone.

People should stay tuned, as some better guidance should be coming soon for companies to integrate naxolone into their plans. In the meantime, everyone here can help by seeking knowledge, stimulating discussion in their company, and looking out for their peers.

[Scooter]

Great post. There's only one thing that I'd like to clarify, as yet another hidden issue that might be overlooked. It was this sentence that made me think of it:

A person buying drugs on their day off is less likely to know their seller, and less able to ascertain the safety of the product.

I worry that there's a danger of situations like this: "Oh, we didn't get these drugs from someone in town; that's too dangerous. Tim got them shipped in from a buddy back home, so we know they're safe."

The danger of course, is that nobody really knows where Tim got them from. While I might place some trust in a statement like the above if they were referring to pot, which many Canadians grow at home, I think that it would be naive at best and incredibly dangerous for someone to make any assumptions about "safe sources' when talking about any drug other than pot or alcohol.

[Cactus]

Even if a company does not have a naxolone plan, they can contribute to awareness by discussing the dangers of fentanyl and carfentanyl with their workers. I suggest planters are no more likely than any other worker population to fall victim to bad drugs.

Thanks for your post!! It has definitely made things a little more clear to me. My greatest fear was that management would turn a blind eye on the issue, like it's not their problem, because the drugs aren't supposed to be there in the first place. But we all know they sneek their way in no matter how ''zero tolerance'' the company's policies are. Of course liability becomes a potential issue with or without naloxone but I don't know exactly how that works. In any case, there should be a talk about fentanyl at camp meetings this year.

Cheers,
Cactus

[Scooter]

From this week's WFCA Rumour Mill Roundup newsletter:

Primer on the BC Opioid Crisis and What to do Available to Employers

As we have gone to some efforts to make clear in recent media interviews regarding the WFCA warning its members about fentanyl, the forestry sector does not have a rampant problem with drug abuse in the work place. What we have is a workforce that, like the rest of society, has an exposure to the risks of recreational drug use and dependency. That combined with seasonal crews, remote worksites, limited first aid capacity and the fact that our workers don’t go to their own homes at night creates a larger risk for employers to try and manage. As part of our ongoing awareness campaign, which is being led in part by employers now developing their own internal protocols and practices, we are sharing this overview from an overdose expert used as introductory training for one company’s supervisors and managers.

Link:
https://wfca.ca/2017/03/preventing-over ... ds-032817/

[jdtesluk]

Just a note, that link includes a power point slide show with a TONNE of helpful information. Contractors should be encouraged to review this information with their crews.

[Scooter]

Tom Petty's autopsy just released. Drug overdose, a mix of various painkillers, but fentanyl was present.

[jdtesluk]

Good point Scooter. It shows that fentanyl and carfentanyl are not just street-junkie materials....the killer drugs are everywhere, and they don't discriminate. That might be a helpful piece of context when communicating to workers...if that is part of the conversation.

[Scooter]

This is concerning, for any planters who assume that a Naloxone kit will be adequate protection in the case of an accidental overdose in camp.

Link: https://www.cbc.ca/news/canada/british- ... -1.4930761

Apparently, once a kit has been exposed to temperatures of below +5 Celsius, or above +25 Celsius, it becomes less effective. In these cases, a patient may require more doses in order for the naloxone to keep the patient alive (until they get to a health care provider for proper medical treatment). The health care advocate quoted in the article suggests that if a kit is ever stored outside of those temperature extremes, it should be replaced with a fresh kit.

There is no question that any kit being stored in a planting camp will repeatedly be exposed to temperatures outside of that range.

[Scooter]

Every day there's another:

https://www.cbc.ca/radio/thesundayediti ... -1.4928510