Opioids
This page is intended for healthcare professionals and stakeholders. For public information, please visit Understanding Opioids.
Ontario continues to respond to the opioid crisis by working closely with health system partners and frontline workers. As well, Ontario is collaborating with people with experience with substance use, opioid use disorder and chronic pain to strengthen the health system's response.
The following resources provide information on some aspects of the province's response to opioid use and overdose. They may be a useful starting point for stakeholders seeking further information on some of the available programs and supports.
- Programs
- Harm reduction services
- Key tools for practice and research
- Quality standards
- Notices, articles and reports
- Patient education
Programs
Ontario Naloxone Program (ONP) - ONP provides naloxone through community-based agencies, including:
- Public Health Units (PHUs) and community partners leading Needle Exchange/Syringe Programs;
- Ministry-funded Hepatitis C programs; and
- Eligible community agencies, including:
- Community Health Centres, including Aboriginal Health Access Centres
- AIDS service organizations
- shelters
- outreach programs
- withdrawal management programs
- Overdose Prevention Sites
- Supervised Injection/Consumption Services
- hospitals with emergency departments and urgent care centres
Ontario Naloxone Program for Pharmacies - Participating Ontario pharmacies provide injectable and intra-nasal spray naloxone kits to eligible recipients. Eligible recipients include a person who is currently using opioids or is a past opioid user who is at risk of returning to opioid use, or a family member, friend or other person in a position to assist a person at risk of overdose from opioids. Pharmacists can provide naloxone kits to Ontarians who do not have an Ontario health card or to those who do not wish to provide identification.
Provincial Correctional Facilities Take Home Naloxone Program - Inmates in provincial adult correctional facilities who are at risk of an opioid overdose are trained on how to use nasal spray naloxone and given kits when they are released from custody.
Needle exchange program - Free sterile harm-reduction supplies are available through 35 needle exchange/syringe programs, which include over 370 distribution points across Ontario.
Fentanyl Patch for Patch Program - To address the misuse and diversion of prescription fentanyl, the law requires pharmacies to collect used fentanyl patches from a patient before dispensing new patches to the patient.
Ontario College of Pharmacists Patch for Patch Fentanyl Return Fact Sheet
Harm reduction services
In October 2018, Ontario's Deputy Premier and Minister of Health and Long-Term Care announced a new program to help people who are struggling with addiction receive health care and other supports. Consumption and Treatment Services (CTS) will provide integrated, wrap-around services that connect clients who use drugs to primary care, treatment, and other health and social services. The new program will also include requirements to address community concerns, and ensure ongoing community engagement and liaison where CTS are established.
Consumption and Treatment Services will replace the provincially funded Supervised Consumption Services and Overdose Prevention Site models that exist in Ontario. The federal government (Health Canada) remains responsible for granting exemptions to Section 56.1 of the Controlled Drugs and Substances Act (CDSA) to operate Supervised Consumption Services (SCS). Ontario is augmenting Health Canada's SCS program to include requirements for treatment and support services. In order to receive provincial funding for CTS, applicants must demonstrate their proposed service meets federal requirements, as well as additional requirements under Ontario's CTS program. Existing SCS and OPS must apply to become a Consumption and Treatment Service and receive provincial funding.
Consumption and Treatment Services will be located in communities in greatest need based on ministry-defined criteria. They will be established in Community Health Centres, Aboriginal Health Access Centres or similar incorporated health care or community-based organizations that offer integrated, wrap-around services. Mandatory services include:
- Supervised consumption (injection, intranasal, oral) and overdose prevention services
- Onsite or defined pathways* to addictions treatment services
- Onsite or defined pathways to wrap-around services including: primary care, mental health, housing and/or other social supports
- Harm reduction services:
- Education
- Distribution and disposal of harm reduction supplies
- Provision of naloxone and oxygen
- Removal of inappropriately discarded harm reduction supplies (e.g. potentially contaminated needles and other drug use equipment) surrounding the CTS area
Consumption and Treatment Services (CTS) Program: Application Guide
Consumption and Treatment Services (CTS) Program: Application Form
The Consumption and Treatment Services: Application Guide provides guidance on the provincial CTS program requirements and the application process. The Consumption and Treatment Services: Application Form should be used to apply for provincial funding.
*Defined pathways are mechanisms to ensure clients access the intended service(s), which can be measured. They may vary by site and/or community. The services should be within proximity to the CTS (walking or transit distance).
Key tools for practice and research
Digital Health Drug Repository allows providers to see patients' medication information at the point of care; includes publicly funded drugs and pharmacy services, and all monitored drugs (narcotics and controlled substances) regardless of payor.
Public Health Ontario Interactive Opioid Tool allows users to explore the most recent opioid-related morbidity and mortality data including emergency department visits, hospitalizations and deaths.
Health Quality Ontario MyPractice is a report that enables family physicians to confidentially see their individual opioid prescribing patterns in relation to peers across the province.
2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain
Ontario Pain Management Resources: A Partnership to Help Clinicians Support their Patients
New Prescribing Authority for Nurse Practitioners - Ontario nurse practitioners can prescribe controlled substances if they have completed approved courses in controlled substances education.
Quality Standards
Health Quality Ontario: Opioid Prescribing for Acute Pain
Health Quality Ontario: Opioid Prescribing for Chronic Pain
Health Quality Ontario: Opioid Use Disorder (Opioid Addiction)
Notices, articles and reports
Executive Officer Notices for pharmacists
Health Quality Ontario: Opioid Prescribing in Ontario - 9 Million Prescriptions
Health Quality Ontario: Starting on Opioids in Ontario
Canadian Institute for Health Information Pan-Canadian Trends in Opioid Prescribing, 2012-2016
Canadian Institute for Health Information Opioid-Related Harms in Canada
Measuring the Burden of Opioid-Related Mortality in Ontario, Canada
The Ontario Drug Policy Research Network (ODPRN) Latest Trends in Opioid-Related Deaths
Statistics Canada: Results on Survey on Opioid Awareness, November 2017
About the Good Samaritan Drug Overdose Act
Patient Education
Pharmacies: Opioid Collateral and Re-ordering - Ontario has developed brochures and posters to help educate patients about prescription opioid use. These materials have been created with the support of Dr. David Williams, Chief Medical Officer of Health and Provincial Overdose Coordinator, as well as the Ontario Pharmacists Association, Neighbourhood Pharmacy Association of Canada and other clinicians.
School Mental Health ASSIST Information Sheets - In collaboration with the Provincial System Support Program at the Centre for Addiction and Mental Health, with input from Jack.org, School Mental Health ASSIST has developed a series of information sheets on prescription opioid misuse, including a focus on fentanyl. There are three versions of the info sheet, one for educators, one for parents/caregivers and one for youth.
Disclaimer
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The Government of Ontario does not assume and is not responsible for any liability whatsoever for the linking of any of these linked websites, the operation or content (including the right to display such information) of any of the linked websites, nor for any of the information, interpretation, comments or opinions expressed in any of the linked websites. Any comments or inquiries regarding the linked websites are to be directed to the particular organization for whom the particular website is being operated.
Public Information
