Ontario Naloxone Program (ONP) Distributing Agencies and First Responders

Contact(s)

Naloxone is a safe medication that temporarily reverses the effects of an opioid overdose. Opioids include drugs like heroin, morphine, methadone, codeine, oxycodone and fentanyl (including analogues such as carfentanil). It is important to remember that other drugs can contain opioids or a person may take more than one drug at a time.

During an opioid overdose, a person’s breathing becomes shallow, slows down or stops. If the person has used any drugs and is showing signs or symptoms of an opioid overdose, call 911 and give naloxone. Giving naloxone can reverse the effects of an opioid overdose and help save a life.

Naloxone usually starts working within a few minutes. The effects of naloxone, however, only last for 30 to 45 minutes. If the opioid is still in the body after the naloxone wears off, the overdose can return so be sure to monitor the individual until EMS arrives.

The following menus contain information specific to agencies that distribute naloxone, and first responders that use/administer naloxone in the Nipissing and/or Parry Sound districts under the Ontario Naloxone Program (ONP). If you require additional information or have questions about naloxone, please contact Katharine O’Connell, Community Health Promoter at 1-800-563-2808 ext. 5322 or via email at harm.reduction@healthunit.ca.

Naloxone Ordering

 

How do I order more naloxone for my agency or organization?

Qualifying agencies or organizations that have signed a naloxone agreement with the Health Unit can order naloxone kits by completing an online order form. Once an order is placed, you will receive a confirmation message. Someone from the Health Unit will connect with you once your order is ready for pick up.
How often can I order naloxone kits and/or refills?

Qualifying agencies can order naloxone kits and/or refills as often as they need. Please allow 2-3 business days for orders to be processed.

The Health Unit keeps records of how many naloxone kits and refills are distributed and/or used/administered by each agency. Your agency may be required to provide records of distribution or use/administration if naloxone kits and refills have been unaccounted for.

How many naloxone kits and/or refills can I order at a time for my agency?

Qualifying agencies that distribute naloxone typically order between 5-30 kits and/or refills at a time. If more than 30 kits or refills are required at one time, the Health Unit will need to check stock levels before the order can be processed.

First responders who are using or administering naloxone to respond to emergencies typically request a smaller number of kits or refills per order. This varies based on the number of staff and trucks each agency has.

Can I order injectable naloxone as well as nasal spray naloxone from the Health Unit?

The Health Unit can provide qualifying agencies with either nasal spray naloxone and/or injectable naloxone kits. Nasal spray naloxone refills are also available. In the majority of cases, agencies request nasal spray naloxone for distribution and/or use/administration.

Where do I pick up my naloxone order once it has been processed?

Naloxone orders that are being picked up at our North Bay office (345 Oak Street West) can be retrieved from our shipping and receiving department located at the far side of our building.

If you are picking up your naloxone order at our Parry Sound office (70 Joseph Street), please go to front reception.

Naloxone Distribution, Use and Training

 
I am an agency that can distribute naloxone under the ONP. Who can I distribute naloxone to?

Qualifying agencies signed onto the ONP can distribute naloxone to the following individuals

  • Clients of participating organizations at risk of opioid overdose
  • Family members or friends of someone at risk of an opioid overdose
How many naloxone kits can I give each client?

Feel free to distribute the number of naloxone kits or refills requested by a client. The ONP requests that Public Health Units and qualifying agencies use their discretion when distributing multiple naloxone kits or refills, but also work to prevent both clients stockpiling and acting as distributors. That being said, your agency may have an internal policy or procedure outlining how many naloxone kits or refills you can distribute per client per visit. Please consult with your workplace to see if there are any existing policies or procedures in place around naloxone distribution.

How do I train someone to use/administer naloxone?
Training someone to use/administer naloxone is easy. Simply complete the train-the-trainer program offered by the Health Unit and use the CarrynaloxONe Training PowerPoint and materials provided to your agency to train new clients to use/administer naloxone. Training individuals takes about 20 minutes but can be condensed, if needed. Repeat clients do not need to be re-trained to use/administer naloxone.
Are there changes to using/administering naloxone during COVID-19?

The ONP has confirmed that the administration of intranasal naloxone is not an aerosol generating medical procedure (AGMP). Performing CPR (chest compressions) alone does not generate aerosols. Clients should be advised to provide CPR (chest compressions) when responding to an overdose, NOT rescue breaths.

Public Health Ontario (PHO) has provided additional recommendations regarding the use of naloxone during COVID-19. If you are a health care worker please consult IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19 for recommendations on personal protective equipment when administering naloxone during the pandemic. The general public are advised to wear disposable gloves (found in naloxone kit). Individuals responding to an overdose can also:

  • Place a mask or cloth over the individual’s face who is overdosing to minimize potential COVID-19 exposure in case the individual coughs after being given naloxone
  • Tilt the head of the person who is overdosing to the side to minimize potential COVID-19 exposure in case the individual coughs after being given naloxone
  • Step back after giving naloxone to provide physical distance to minimize potential COVID-19 exposure in case the individual coughs after being given naloxone
  • Avoid touching your face when responding to an opioid overdose
  • Clean hands with soap and water or an alcohol-based hand sanitizer after responding to an opioid overdose
Are there changes to training people to use naloxone during COVID-19?

Whenever possible, ONP sites should provide virtual naloxone training to clients. If resource and logistical pressures on ONP sites do not allow for this, naloxone kits may be provided to clients without training during the current COVID-19 pandemic.

The Health Unit has created and distributed a naloxone training postcard to ONP sites to give to clients when training cannot take place. If you require additional training postcards please contact Katharine O’Connell, Community Health Promoter at 1-800-563-2808 ext. 5322 or via email at harm.reduction@healthunit.ca 

What materials do I use to train clients picking up naloxone?
The following carrynaloxONe materials have been created to train someone to use/administer naloxone:

You may also wish to request a naloxone nasal spray kit from the Health Unit for training purposes. This kit includes the components found in a nasal spray naloxone kit as well as an empty nasal spray plunger. To request a kit, email Katharine O’Connell, Community Health Promoter at 1-800-563-2808 ext. 5322 or via email at harm.reduction@healthunit.ca.

Please note that injectable naloxone training kits are not available at this time.

For additional opioid and naloxone related resources, please visit our Naloxone page.

I would like to have my staff and/or new staff re-trained to distribute or use/administer naloxone. Who do I contact to assist with this?
Please contact Katharine O’Connell, Community Health Promoter at 705-474-1400 ext. 5322 or via email at harm.reduction@healthunit.ca if you would like staff to be trained to distribute or use/administer naloxone.
My agency would like to be trained to use/administer naloxone on-site in case of an emergency. Can I train my staff and give a naloxone kit to each staff member?

If you work for a qualifying naloxone distributing agency and have received the train-the-trainer naloxone training from the Health Unit then you can train your own staff to use/administer naloxone. The Health Unit, however, is happy to support you and/or facilitate the training if you prefer. 

Please note that if you are a naloxone distributing agency you will not be able to provide your staff with naloxone issued by the Health Unit as the ONP only allows naloxone to be distributed to clients at risk of an opioid overdose and/or family members or friends of someone at risk of an opioid overdose. If you are a naloxone distributing agency and wish to have naloxone on-hand for staff to use/administer in case of an emergency you can:

*Participating pharmacies that distribute naloxone under the Ontario Naloxone Program for Pharmacies (ONPP) can provide training and 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 to eligible persons


First responders signed onto the ONP are permitted to carry naloxone and use/administer it in emergency situations.

Local businesses and agencies have contacted our agency about being trained to use/administer naloxone in case of an emergency. Can I train them and provide their business with naloxone?

These requests are best directed to the Health Unit. Please contact Katharine O’Connell, Community Health Promoter at 705-474-1400 ext. 5322 or via email at harm.reduction@healthunit.ca.

The Health Unit can provide training to local businesses and/or agencies but will not be able to provide these establishments with naloxone as per the ONP guidelines. If a local agency or business wishes to have naloxone on-hand for staff to use/administer in case of emergency they can:

*Participating pharmacies that distribute naloxone under the Ontario Naloxone Program for Pharmacies (ONPP) can provide training and 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 to eligible persons
If a client under the age of 16 requests a naloxone kit, can I train them and provide them with a naloxone kit?

Naloxone kits and/or refills (both nasal spray and injectable) can be provided to anyone who requests them so long as they are someone who uses opioids and/or are a family member or friend of someone at risk of opioid overdose. The Ministry of Health does not have an age restriction on who naloxone can be distributed to.

What other agencies in my area distribute naloxone?

Use the locator map to identify what local organizations and pharmacies in your area currently distribute naloxone. You can also call 1-866-532-3161 Mon to Fri 8:30 a.m. to 5 p.m. to ask about naloxone distributors in your area.

Please note that not all ONP distributing agencies in the Nipissing and Parry Sound districts have been included on the locator map as some agencies only distribute naloxone to clients. For a full list of ONP distributing agencies in our Health Unit region please contact Katharine O’Connell, Community Health Promoter at 1-800-563-2808 ext. 5322 or via email at harm.reduction@healthunit.ca.

My agency would like to find out if they are eligible to distribute naloxone or use/administer naloxone (as a first responder) under the Ontario Naloxone Program (ONP). Who do I contact to find out if my agency is eligible?

The following organizations can join the ONP:

  • Aboriginal health access centres
  • AIDS service organizations
  • Community health centres
  • Outreach programs
  • Withdrawal management programs
  • Shelters
  • Community-based organizations that meet expanded access criteria
  • Hospitals with emergency departments and urgent care centres
  • St. John Ambulance branches
  • Police services
  • Fire services

If your agency is interested in joining the ONP to distribute naloxone or use/administer naloxone (first responders only), please contact Katharine O’Connell, Community Health Promoter at 1-800-563-2808 5322 or via email at harm.reduction@healthunit.ca.

 Naloxone Reporting

 
What type of information is collected when distributing or using/administering naloxone? Why is this information collected?

For agencies that distribute naloxone, basic demographic information such as age, gender, community and type of individual (person who uses opioids or family member/friend) are collected to identify local trends in distribution. Some agencies may also collect name, date of birth as well as a phone number or email address as part of their internal policies or procedures. This information may be used to contact individuals in the event there is a product recall. Individuals are also asked if they have witnessed, responded to or experienced an overdose since their last visit as well as information related to the overdose (e.g., number of naloxone doses used/administered, if 911 was called). This information along with the number new individuals trained, and number of kits and/or refills distributed is provided quarterly to the Ministry of Health to identify trends and patterns in distribution, usage and response.

First responders are asked to provide basic information such as number of times naloxone was used/administered and number of naloxone doses used/administered. This information is provided to the Ministry of Health on a quarterly basis.

If an overdose is reported, please ensure that all information is collected to ensure accuracy of your quarterly report. In addition, please complete the online overdose reporting form (link provided with each weekly Nipissing Parry Sound Overdose Incident Report). This online form allows the Health Unit to collect additional information about overdoses that will help inform work and issue drug alerts in a timely manner, when needed. If your agency wishes to be added to the weekly Nipissing Parry Sound Overdose Incident Report email list, please contact Katharine O'Connell, Community Health Promoter, at 1-800-563-2808 ext. 5322 or via email at harm.reduction@healthunit.ca.

How often do I provide a naloxone report to the Health Unit?
Naloxone reports are submitted quarterly. Reporting periods are:
  • Q1: April 1st to June 30th
  • Q2: July 1st to September 30th
  • Q3: October 1st to December 31st
  • Q4: January 1st to March 31st

The Health Unit will reach out to each agency requesting your quarterly report. It is important that reports are completed and submitted on time to ensure accuracy of Ministry of Health reporting.

How do I report naloxone distribution and use/administration if I am an ONP distributing agency?

If you are distributing naloxone as an Emergency Medical Service (EMS) the updated Excel reporting form can be found here. A printable version of the report can also be downloaded here. The printable version (i.e. paper copy) may be useful when working outside of an office setting (i.e., distributing naloxone via truck or on an emergency call). All printable reports should be inputted into a single Excel reporting form (i.e., found above) before submitting to the Health Unit for each quarter. Instructions on how to complete reporting for EMSs distributing naloxone can be viewed here.

All other agencies distributing naloxone are asked to use the Excel reporting form located here.

Each quarter, naloxone distributing agencies will be asked to submit their report to harm.reduction@healthunit.ca. A Health Unit staff member will send out an email at the end of each quarter requesting your report from the previous quarter.

How do I report naloxone use/administration if I am a first responder? 
First responders can submit their quarterly reports here. First responders may report naloxone use/administration as it is used or on a quarterly basis.

 Other Information

 
What is the difference between the Ontario Naloxone Program (ONP) and Ontario Naloxone Program for Pharmacies (ONPP)?

The Ontario Naloxone Program (ONP) and Ontario Naloxone Program for Pharmacies (ONPP) are two of the programs in which publicly funded naloxone can be provided to Ontarians free of charge.

For information on each of these programs including eligibility, visit http://www.health.gov.on.ca/en/pro/programs/drugs/naloxone/naloxone_faq.aspx.

Our naloxone kits and/or refills have expired. How do I dispose of them properly?
For expired nasal spray naloxone, scratch out the expiry date on the naloxone package with a permanent marker and bring the expired medication to a pharmacy that offers medication drop-off or disposal. Should this not be possible, please refer to the following fact sheet regarding alternative methods of disposal.

We ask that expired injectable naloxone be brought to a pharmacy that offers medication drop-off for disposal. This will ensure that the glass ampoule and/or syringe are discarded safely.

Where should naloxone be stored?

Naloxone should be stored at room temperature. Nasal spray naloxone should be stored at 15oC -25oC while injectable naloxone should be stored between 15oC -30oC). Do not store naloxone in your vehicle as it may overheat or freeze. Injectable naloxone and nasal spray naloxone (white plunger) exposed to extreme heat or cold should be replaced.

Nasal spray naloxone that comes in a newly issued red plunger can be thawed by allowing it to sit at room temperature for 15 minutes, and may still be used/administered if it has been thawed after being previously frozen. If nasal spray naloxone is frozen and is needed to respond to an overdose, do not wait for the product to thaw. Seek emergency help right away.

It is suggested that naloxone be kept in a safe, secure location at your agency (e.g., locked cabinet). Naloxone should not be stored in direct light. 

Is there liability when using naloxone in the workplace?

The liability associated with using or administering naloxone is low as individuals are protected under the Good Samaritan Act, 2001. If using/administering naloxone is part of your job, it is best to check with your agency about policies and procedures for using/administering naloxone. It is suggested that employers wishing to add additional first aid measures, such as naloxone use/administration, into the workplace seek legal counsel, and check with local jurisdictions responsible for health and safety so they are aware of any liability issues.

Is it recommended that my agency has a workplace policy for distributing and/or using/administering naloxone in the workplace?

Yes, it is recommended that agencies develop a workplace policy for distributing naloxone as well as for using/administering naloxone.

Workplace policies for distributing naloxone should include information related (but not limited) to:

  • Staff permitted to train and distribute naloxone to eligible clients
  • Procedures and staff training required to distribute naloxone to eligible clients (e.g., overview of opioids, how to use/administer naloxone, expired naloxone, records of staff training, frequency of training)
  • Location and/or links to naloxone training materials and resources as well as key content covered in materials
  • Contents of an injectable and/or nasal spray naloxone kit
  • Naloxone distribution (e.g., client training materials, type of naloxone that can be distributed, checking expiry dates, who is eligible to receive naloxone under the ONP and where to direct individuals if they are not eligible under the ONP)
  • Storage of naloxone
  • Naloxone inventory and ordering (i.e., naloxone kits and refills)
  • Naloxone reporting (i.e., forms, requirements, reporting periods)
  • Other relevant information such as disposal of expired naloxone; changes to training, distribution or administration of naloxone during COVID-19; self-care; definitions etc.

Workplace policies for using/administering naloxone could include information related (but not limited) to:

  • Staff permitted to administer naloxone
  • Procedures and staff training required to administer naloxone in the workplace (e.g., overview of opioids, how to use/administer naloxone, expired naloxone, records of staff training, frequency of training)
  • Personal protective equipment required to administer naloxone safely (i.e., during COVID-19)
  • Location and/or links to naloxone training materials and resources as well as key content covered in materials
  • Initiation of any workplace codes, where applicable (i.e., code blue – cardiac arrest)
  • Procedure to responding to an opioid overdose (i.e., shake and shout, call 9-1-1, administer naloxone, chest compressions and rescue breaths, recovery position, monitoring the individual, number of doses)
  • Location and storage of naloxone
  • Naloxone reporting (i.e., where to report naloxone use, information to be reported, records retention)
  • Other relevant information such as disposal of expired naloxone; changes to training or administration of naloxone during COVID-19; self-care; definitions etc.

For copies of workplace or school sample naloxone policies, please contact Katharine O’Connell, Community Health Promoter at 1-800-563-2808 ext. 5322 or via email at katharine.oconnell@healthunit.ca

What types of protocols, policies and/or procedures currently exist around distributing and/or using/administering naloxone on the job?

We will be adding sample policies and/or procedures shortly. Please look back later.

Where can I find information on local naloxone distribution and opioid related statistics for the Nipissing and Parry Sound Districts? 

Local opioid-related and naloxone distribution statistics can be found on the Health Unit’s Nipissing Parry Sound Opioid Related Dashboard.

Please visit the dashboard by clicking here.

North Bay

345 Oak Street West
705-474-1400

Parry Sound

70 Joseph Street Unit #302
705-746-5801

Burk's Falls

17 Copeland Street (by appointment only)
1-800-563-2808