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Ministry Status: Routine Monitoring and Engagement

Naloxone

Frequently asked questions

Who can distribute free naloxone kits to the public?

Publicly-funded naloxone for Ontarians is distributed through the:

  • Ontario Naloxone Program (ONP): needle syringe/exchange, hepatitis C programs and participating community-based organizations
  • Ontario Naloxone Program for Pharmacies (ONPP): participating pharmacies
  • Ministry of Community Safety and Correction Services - Take Home Naloxone Program: provincial correctional facilities

Who can get a publicly funded naloxone kit?

ONP:
Ontario’s ONP sites distribute injectable and nasal spray kits to:

  • Clients of participating organizations at risk of opioid overdose
  • Friends and family of clients

ONPP:
Participating* pharmacies distribute injectable and nasal spray naloxone kits to:

  • someone currently using opioids
  • a past opioid user at risk of returning to opioid use
  • a family member or friend of someone who is at risk of an opioid overdose.

A pharmacist may also exercise his/her professional judgement on whether or not to provide naloxone kits for eligible persons.

* Pharmacy participation in the ONPP is voluntary. The decision to participate in the program is up to each pharmacy.

Ministry of Community Safety and Correction Services - Take Home Naloxone Program:
At-risk individuals in provincial correctional facilities are given kits when they are released from custody.

How can my organization become an ONP site?

The following organizations can join the ONP:

  • Aboriginal health access centres
  • AIDS service organizations
  • Community health centres
  • outreach programs
  • withdrawal management programs
  • shelters
  • Hospitals with emergency departments and urgent care centres
  • St. John Ambulance branches
  • Police services
  • Fire services

If interested, your organization should reach out to your local Public Health Units to assess eligibility and discuss the process of joining the ONP.

Who provides training to the person who receives a naloxone kit?

ONP:
Program staff provide training to the eligible person.

ONPP:
For those who receive a naloxone kit for the first time, a pharmacist is expected to provide the necessary professional training to the eligible person.

Replacement kits are available without training provided that the individual had previously received professional training, whether from a pharmacist or through the ONP or Ministry of Community Safety and Correctional Services - Take Home Naloxone Program.

Ministry of Community Safety and Correctional Services - Take Home Naloxone Program:
Individuals in provincial correctional facilities who are deemed to be at-risk for an opioid overdose after leaving the facility will receive training from nurses who work at the correctional facility.

How do Ontarians find out where in their community they can get a free naloxone kit?

The Ontario government maintains a map locator of pharmacies and community programs that distribute free naloxone kits. This map locator can be accessed at Ontario.ca/OpioidOverdose.

How can a pharmacy be added to the map locator?

Pharmacies are encouraged to review the current map locator to ensure they are already listed. The map locator, which is updated on a monthly basis, can be accessed at Ontario.ca/OpioidOverdose.

If your pharmacy participates in the ONPP and would like to be added to the map locator, please send an email request to PublicDrugPrgrms.moh@ontario.ca.

In the event that your pharmacy would like to be removed from the map locator, please send a request and rationale (e.g., change in pharmacy operation, no trained staff, etc.) to PublicDrugPrgrms.moh@ontario.ca.

For either request, please provide the following information:

  • Your name
  • Your pharmacy name and full address, including contact information (e.g., email, phone, fax)

What is included in a publicly funded naloxone kit?

ONP, ONPP, and Ministry of Community Safety and Correctional Services – Take Home Naloxone Program:

Each nasal spray naloxone kit includes:

  • 1 hard case
  • 2 doses of Narcan® Nasal Spray (4 mg/0.1ml)
  • 1 one-way breathing barrier
  • 1 pair of non-latex gloves
  • 1 card that identifies the person trained to give the naloxone
  • 1 insert with instructions (English and French)

Each injectable naloxone kit includes:

  • 1 hard case
  • 2 (0.4 mg/1 ml) vials or ampoules (a small glass container) of naloxone
  • 2 safety-engineered syringes with 25g, 1” needles attached
  • 2 alcohol swabs
  • 2 devices (known as “breakers,” “snappers,” or “openers”) for opening ampoules safely
  • 1 one-way breathing barrier
  • 1 pair of non-latex gloves
  • 1 card that identifies the person who is trained to give the naloxone
  • 1 insert with instructions (English and French)

ONPP (injectable):
Pharmacies are to procure naloxone and the required supplies to assemble the injectable naloxone kit through usual suppliers. The naloxone kit will be assembled by a pharmacist, or a person under the supervision of a pharmacist, and contain the following:

  • 1 hard case
  • 2 (1 ml) ampoules or vials of naloxone hydrochloride (0.4 mg/ml injection)
  • 2 safety engineered syringes with 25 g one inch needles attached
  • 2 alcohol swabs
  • 2 safe ampoule-opening devices (also known as breakers, snappers, or openers), as applicable
  • 1 one-way breathing barrier
  • 1 pair of non-latex gloves
  • 1 card that identifies the person trained to give the naloxone.
  • 1 insert with instructions (English and French)

The ministry is aware that some supplies (e.g., ampoule openers/snappers/breakers) can be ordered from Canadian- based suppliers.

The Ontario Pharmacists Association has also compiled a list of the required kit components, as well as some suppliers for these items, in the event that pharmacists are unable to procure some or all of the elements through their usual suppliers.

* Please note: At the launch of the ONPP, the ministry provided a one-time drop shipment of pre-assembled injectable naloxone kits for select pharmacies that dispensed methadone and/or Suboxone. The one-time drop shipment has ended with no plans for other shipments at this time. As such, all participating pharmacies should be preparing pharmacy-assembled naloxone kits at this time.

Why do publicly funded naloxone programs provide naloxone in different formats?

When the ONP program launched, only injectable naloxone was available in Canada. Since that time, nasal spray naloxone has become available and is provided by the ONP, ONPP, and Ministry of Community Safety and Correctional Services. Injectable naloxone is still distributed by the ONP and the ONPP. Both injectable and nasal spray naloxone are effective at reversing the effects of an opioid overdose.

I prescribe opioids to my patients. Should these patients obtain a naloxone kit?

Many people use opioids safely. It is important that you discuss overdose risks with your patients. If you have concerns about a particular patient overdosing you can direct them to the government’s naloxone web page to find the nearest naloxone distribution site.

Apart from Ontario’s three publicly funded programs, the government is exploring additional community access points for naloxone.  Changes to naloxone access will be posted on the government’s naloxone web page.

Can the staff at my organization be trained on how to respond to an opioid overdose?

Your organization may reach out to your local Public Health Unit to request training on how to respond to an opioid crisis.

I am a first responder (e.g., firefighter, police officer, paramedic). Where can I get a naloxone kit?

All paramedics in Ontario have been equipped with and trained to provide naloxone since early 2016.

All ambulance communications officers who dispatch 9-1-1 calls for ambulance were provided information on naloxone kits in early 2017 in order to assist callers who may have access to a naloxone kit.

All police and fire services, as well as St. John Ambulances branches in Ontario, are eligible to receive naloxone to use when responding to opioid overdoses. Interested services should reach out to your local Public Health Unit to assess eligibility and discuss the process of joining the ONP.

What about other individuals who are interested in getting a naloxone kit on behalf of their organization (e.g. bars, restaurants, schools, etc.)?

The purpose of Ontario’s three publicly funded programs is to serve patients, their families and friends, and those who care for them on an individual basis.

The government continues to explore additional community access points for naloxone. If access to naloxone kits is expanded, details will be posted on the government’s naloxone web page.

Individual organizations that are not eligible to receive publically funded naloxone are able to purchase it directly from the manufacturers.

How can a person who is leaving a hospital (e.g., emergency room) get a naloxone kit?

If a person who is being discharged from a hospital needs a naloxone kit, they can be directed to the most appropriate pharmacy that carries naloxone kits, particularly if the participating hospital outpatient pharmacy is closed.

The ministry encourages individuals to phone ahead to check if their pharmacy is participating in the ONPP and has naloxone kits in stock. They may also ask the pharmacist questions about naloxone kits.

Note that the ONPP only funds community pharmacies, including outpatient pharmacies. The ONPP is not associated with hospitals at this time (i.e., inpatient pharmacies and emergency departments).

Drug costs, including the procurement of naloxone kits, for hospitals would typically be covered under the hospital global budget. It is a hospital-based decision to provide naloxone kits to patients through access points such as the emergency room or inpatient pharmacy.

Is naloxone legal to carry?

Yes, all participating ONP sites are to provide training on how to administer whatever form of naloxone they are distributing.

Can a person be charged with possession of drugs while they’re helping someone who has overdosed?

Bill C-224, the Good Samaritan Drug Overdose Act, provides some legal protection for people who experience or witness an overdose and call 9-1-1 for help. For further details, please refer to the information provided by Health Canada.

Are there any provincial regulations regarding the administration and/or distribution of naloxone in Ontario?

Injectable naloxone (0.4mg/1ml) is a behind-the-counter product available without a prescription in Ontario. 

Pursuant to an Interim Order dated July 6, 2016, the federal Minister of Health has authorized the importation and sale of Narcan® Nasal Spray (4mg/0.1ml) for use in the emergency treatment of known or suspected opioid overdoses.

As a product that contains naloxone hydrochloride, Narcan® Nasal Spray, when indicated for emergency use for opioid overdose outside hospital settings, is exempt from the Prescription Drug List established under the federal Food and Drugs Act.

Naloxone hydrochloride nasal spray has been scheduled by the National Association of Pharmacy Regulatory Authorities (NAPRA) as a Schedule II (non-prescription) drug. 

Are there any contraindications to naloxone use?

Injectable naloxone is considered safe for everyone unless there is a reason to believe a person has a previous allergy (or hypersensitivity) to naloxone.

Health Canada has advised that the use of Narcan® Nasal Spray may not be appropriate for young children and pregnant women.

Can naloxone harm people?

Naloxone only affects people who are using opioids. If a person has been using opioids, naloxone may put them into withdrawal. This can be very uncomfortable for the person, but is not life-threatening.

Where can I, and my patients, get more information?

For more information on naloxone and opioid overdose, including publicly funded naloxone programs, please visit the government’s naloxone web page.

Where can I refer my patients for additional support?

The Drug and Alcohol Helpline provides 24/7 telephone (1-800-565-8603), email and live web chat help for people who need help with an addiction. They provide information about treatment services and support in the community; offer support and strategies to people suffering from an addiction; and provide basic education about drug and alcohol problems.

The Centre for Addiction and Mental Health offers various specialized treatment programs for people suffering from drug, alcohol, gambling or other addiction issues.

For More Information

Call ServiceOntario, Infoline at:
1-866-532-3161 (Toll-free)
In Toronto, (416) 314-5518
TTY 1-800-387-5559.
In Toronto, TTY 416-327-4282
Hours of operation: Monday to Friday, 8:30am - 5:00pm

 

If your pharmacy participates in the ONPP and would like to be added to the list, please send an email request to PublicDrugPrgrms.moh@ontario.ca.

In the event that your pharmacy would like to be removed from the list, please send a request and rationale (e.g., change in pharmacy operation, no trained staff, etc.) to PublicDrugPrgrms.moh@ontario.ca.

For either request, please provide the following information:

  • Your name
  • Your pharmacy name and full address, including contact information (e.g., email, phone, fax)
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