New approach aims to divert overdose patients in Sudbury away from the ER

Suboxone is a combination of naxalone and buprenorphine, a drug that decreases the severity of opioid withdrawal symptoms. (File)

Paramedics in Greater Sudbury say the number of people refusing to go to hospital after an opioid overdose doubled between 2019 and 2023, in part because of the increased use of naxalone.

While essential in treating overdoses, naxalone creates severe opioid withdrawal in overdose patients, who are left craving more drugs after they refuse to be taken to hospital.

"One of the consequences of liberal use of naloxone in the community is that paramedics frequently encounter patients with acute naloxone-precipitated opioid withdrawal," says a report headed to the city's community services committee Oct. 15.

"This is a very uncomfortable condition."

In 2023, almost 31 per cent of people treated for an overdose using naxalone refused admission to hospital, leaving them extremely vulnerable.

"Many will resort to the street supply immediately after naloxone reversal to treat their symptoms," the report said.

To address this problem, paramedics will begin treating certain patients with Suboxone, which is a combination of naxalone and buprenorphine, a drug that decreases the severity of opioid withdrawal symptoms.

And instead of diverting these patients to the emergency department, they will be encouraged to go to Health Sciences North Withdrawal Management Services for treatment of their addiction.

The idea is that rather than refusing to go to hospital because naxalone has left them with a severe craving for more opioids, patients receiving the newer drug will be more open to getting help.

More likely to seek help

"Suboxone is a medication used primarily to treat opioid dependence and addiction by reducing cravings and withdrawal symptoms while minimizing the potential for abuse and overdose," the report said.

"Patients feel better, are more comfortable, are more likely to seek follow-up care and are more amenable to discussions about their condition and available treatment options."

If successful, the approach will reduce the number of people repeatedly overdosing, leading to more visits to the treatment program and fewer visits to emergency.

Paramedics will begin administering Suboxone at the end of October.

"Program success will be measured by the number of patients who qualify and accept Suboxone treatment and for those patients who accept long-term treatment, remain in long-term treatment," the report said.

Read the full report here.