my naloxone kit
I carry a naloxone kit in my backpack.
I don’t use opioids.
I don’t intend to use opioids.
But that’s not the point.
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In the summer of 2019 I was on the 7 heading home from Downtown to the Kitsilano apartment I shared with my wife. It was a perfectly normal day on transit. Hot. Stagnant air. Sweaty people. Stop and go from stop to stop on Granville Street. The whine of the electric bus. The clack-clack of the trolley bar on the overhead cables. People were zoning out.
One guy was different.
I had noticed him getting on earlier. Not exactly sure what it was, but something suggested there was a problem. This guy looked like a pretty normal construction worker on his way home. Work boots with leather missing over the steel toes. Dusty clothes. Dirty face. Pretty normal stuff.
But something was off.
He took a seat near the front. This was just after the bus turns on to Granville and there was still space left. By the end of Granville it’s standing room only folks. This guy immediately started to nod off.
I’m not sure if you’ve experienced this but there is a difference between people who fall asleep because they are hot, bored, and tired, and people who are passing out. People the former camp will fight it. Head bouncing up and down. Shifting in their seat. Looking around. Yawning. People in the second camp … just pass out. This guy was passed out, fast.
Okay, so the guy had a couple of drinks after work. Taking the bus home rather than driving. Not the first time I’d seen it on the bus. Commendable. Right?
By the time we got to Davie Street things had changed. The guy was not responding and had half fallen out of his chair. I had stopped watching him by this point because I was all the way in the back and there were many people standing in the isle. A lady grabbed the driver’s attention. The driver stopped the bus and tried to get the guy to respond without success. Verbal and physical queues were having no impact. The driver called the ambulance on the radio and asked everyone to get off the bus. I was one of the last people to step off.
The last thing I saw from within the bus was the lady and bus driver trying without success to wake the man. He was laid out on the floor of a bus with two strangers looking down at him watching him die. There was nothing I could do.
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Around this time the Canadian and BC governments started handing out Naloxone kits. Naloxone is an injectable opioid antagonist. It binds to opioids that have blocked receptors in the brain and knocks them free. And it works fast - scary fast. And the side effects are minimal so it’s safe to inject even if you don’t have full confirmation that the patient is overdosing on opioid.
Given my experience I just couldn’t sit by. I took the online course. Then stopped at the London Drugs downtown. A quick couple of questions and I’m off with my kit.
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That kit has sat unused in my backpack for years. Right beside my small first aid kit. Neither take much room. And I’d rather have it and never use it.
It’s become apparent to me that the opioid crisis is not a crisis of status or money or opportunity. It’s an equal opportunity problem. People are getting hooked for many reasons. Once hooked in, it’s a hard one to shake. So my thinking is simple. Anyone, at any time could have an issue. If I can help just by carrying the kit and being close at hand, it costs me nothing.
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A couple of months ago I was very tired after the drive in and coming down the elevator of the Bay Parkade, decided to get some Tim’s for breakfast. This is not something I do.
As I passed the driveway past the parkade and neared the old RadioShack building, I noticed a small group of people. It quickly became clear that one person was giving another CPR.
Two Vancouver Downtown Ambassadors were giving aid to a guy who had obviously been sleeping rough. The second Ambassador was watching. This looked like a classic overdose to me. As I approached, I asked if they had administered Naloxone. His reply stunned me. They were barred from administering Naloxone. But don’t worry they had called for an ambulance. WTF! You can give CPR/Mouth-to-mouth but not Naloxone. In downtown Vancouver? Blocks away from the center of the opioid epidemic in Canada?
I dropped my bag and rummaged around for my kit. I had just gotten my gloves on when one of the quick response trucks pulled up. First responders piled out. Much better equipped than I. I slipped my kit back together into my bag and kept on with my day.
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I carry a naloxone kit in my backpack.
I don’t use opioids.
I don’t intend to use opioids.
But that’s not the point.