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Naloxone

Frequently asked questions

This webpage provides information on Ontario’s naloxone programs for health care professionals.


Where can I get information on Ontario’s publicly funded naloxone programs?

For general information on Ontario’s naloxone programs, including details on naloxone and naloxone kits, and a map locator tool on where to get them, please visit: www.ontario.ca/page/get-naloxone-kits-free.

How can my organization become an Ontario Naloxone Program (ONP) site?

The following organizations are eligible to participate in the ONP:

  • Needle Exchange/Syringe Programs
  • Hepatitis C Programs
  • Public Health Units
  • Aboriginal Health Access Centres
  • AIDS service organizations
  • community health centres
  • outreach programs
  • Withdrawal Management Programs
  • Shelters
  • Hospitals with emergency departments and urgent care centres

Additionally, police and fire services, as well as St. John Ambulances Branches, are eligible to receive naloxone through the Ontario Naloxone Program (ONP) for use when responding to opioid overdoses.

If interested, your organization should reach out to your local Public Health Unit (PHU) to assess eligibility and discuss the process of participating in the ONP.

Please note that the ONP serves community-based organizations that are not pharmacies or linked to pharmacists. Pharmacies/pharmacists interested in participating in distributing naloxone kits should refer to the information on the Ontario Naloxone Program for Pharmacies (ONPP).

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

Ontario Naloxone Program (ONP):
Program staff provide training to the eligible person.

Ontario Naloxone Program for Pharmacies (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 ONPP or Ministry of the Solicitor General - Take Home Naloxone Program.

Ministry of the Solicitor General -Take Home Naloxone (MSG-THN) Program:
Individuals in provincial correctional facilities, who are identified as being at-risk and who have interest, will receive training from health care staff at the correctional facility.

How can a participating pharmacy be added to the map locator tool?

Pharmacies are encouraged to review the current map locator tool to check if they are listed. The map locator tool, which is updated regularly, can be accessed at www.ontario.ca/page/where-get-free-naloxone-kit.

If your pharmacy participates in the Ontario Naloxone Program for Pharmacies (ONPP) and would like to be added to the map locator tool, 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 tool, please send an email 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?

Each nasal spray naloxone kit includes:

  • 1 hard case (for example, a zippered hard black case with red “naloxone” cross)
  • 2 doses of naloxone hydrochloride intra-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 (for example, a zippered hard black case with red “naloxone” cross)
  • 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)

What other information about distributing naloxone kits do participating pharmacies need to know?

Through the Ontario Naloxone Program for Pharmacies (ONPP), participating pharmacies can distribute publicly-funded injectable naloxone kits or intra-nasal naloxone spray kits. Additional details are as follows:

Pharmacies are to procure naloxone and the required supplies to assemble the injectable naloxone kit and/or pre-assembled kits through their usual suppliers. The naloxone kit will be assembled by a pharmacist, or a person under the supervision of a pharmacist.

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. See details on the kit contents.

The list can be accessed at opatoday.com/naloxone.

What can be done with naloxone kits that are expired or unused?

Naloxone kits that are expired or unused can be brought to any pharmacy for safe disposal in Ontario.

Individuals, including patients, are encouraged to talk to their pharmacist about disposal of unused or expired medications, that may include unused or expired naloxone kits. Most Ontario pharmacies are able to accept such medications, as well as sharps (e.g., needles/syringes).

How many naloxone kits can be distributed through the ONPP at one time?

Through the Ontario Naloxone Program for Pharmacies (ONPP), eligible individuals may receive up to two (2) naloxone kits at a time on an individual basis.

Note: For the ONPP, it is up to the pharmacist’s professional judgement on providing naloxone kits.

Do individuals need to show their Ontario health card at a participating pharmacy to receive a naloxone kit?

As of March 2018, an Ontario health card is no longer required to receive free naloxone kits from a participating pharmacy. More specifically, pharmacists may provide naloxone kits to Ontarians who meet the eligibility criteria and who do not have an Ontario health card or to those who do not wish to provide identification.

The intent is for pharmacists to ask for a health card when distributing naloxone kits. Should the individual not have a health card or does not wish to present it, pharmacists can still provide a naloxone kit based on their professional judgement.

Under the ONP, Ontarians can also receive a naloxone kit without a health card from community-based organizations.

To find out where to get free naloxone kits (includes both ONP and ONPP), please refer to the following map locator at: www.ontario.ca/page/where-get-free-naloxone-kit.

Why do Ontario’s naloxone programs provide naloxone in different formats?

Both injectable and nasal spray naloxone are effective at reversing the effects of an opioid overdose, and the provision of both through the Ontario Naloxone Program (ONP) and Ontario Naloxone Program for Pharmacies (ONPP) provide Ontarians with options based on their preference.

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

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

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. The PHU will also provide training to organizations eligible to participate in the ONP.

Please note that the Ontario Naloxone Program (ONP) serves community-based organizations that are not pharmacies or linked to pharmacists. Pharmacies/pharmacists interested in participating in distributing naloxone kits should refer to the information on the Ontario Naloxone Program for Pharmacies (ONPP).

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, are eligible to receive naloxone through the Ontario Naloxone Program (ONP) for use when responding to opioid overdoses. Interested parties should reach out to their local Public Health Unit to assess eligibility and discuss the process of participating in the ONP.

Please note that the Ontario Naloxone Program (ONP) serves community-based organizations that are not pharmacies or linked to pharmacists. Pharmacies/pharmacists interested in participating in distributing naloxone kits should refer to the information on the Ontario Naloxone Program for Pharmacies (ONPP).

What about other organizations/businesses that are interested in getting a naloxone kit (e.g. bars, restaurants, schools, etc.)?

The purpose of Ontario’s naloxone 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 webpage.

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

Can a hospital (e.g., emergency room) participate in Ontario’s naloxone programs?

Hospitals with an emergency department and/or urgent care centre are eligible to participate in the Ontario Naloxone Program (ONP).

Please note that, at this time, inpatient hospital pharmacies do not distribute publicly-funded naloxone kits and are not part of the Ontario Naloxone Program for Pharmacies (ONPP).

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

The Good Samaritan Drug Overdose Act, provides some legal protection for people seeking emergency help during an overdose. For further details, please refer to the information provided at: www.canada.ca/en/health-canada/services/substance-use/problematic-prescription-drug-use/opioids/about-good-samaritan-drug-overdose-act.html#a2.

In addition, Ontario’s Good Samaritan Act, 2001 provides some legal protection to individuals from civil liability in certain cases, such as if a person administers naloxone to a person experiencing an overdose in certain situations.

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

Injectable naloxone (0.4mg/1ml) and nasal spray naloxone (4mg/0.1ml) are behind-the-counter products available without a prescription in Ontario, when indicated for emergency use for opioid overdose. The dispensing of naloxone in an Ontario pharmacy is subject to the Drug and Pharmacies Regulation Act and the policies of the Ontario College of Pharmacists.

Are there any situations where naloxone should not be used?

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

Please refer to the product monograph of individual naloxone products for further information.

Can naloxone harm people?

Naloxone only affects people who are using opioids, or people who have an allergy (or hypersensitivity) to naloxone. If a person has been using opioids, naloxone may put them into withdrawal.

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 substance use disorder. They provide information about treatment services and support in the community; offer support and strategies to people suffering from a substance use disorder; and provide basic education about substance use disorderdisorders.

The Centre for Addiction and Mental Health offers various specialized treatment programs for people suffering from substance use disorders, gambling and/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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