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Category: Overdose

  • Overdose Awareness Requires Federal Attention

    Overdose Awareness Requires Federal Attention

    Overdose-Awareness-Day-2013_Facebook-share-Image_CDPC1Today the White House based Office of National Drug Control (ONCDP) released a letter in honour of International Overdose Awareness Day (August 31st). The take home message of the letter emphasizes Obama’s support for overdose initiatives and announces the release of the new toolkit on opioid overdose. As the letter states:

    “This toolkit builds upon our efforts to expand prevention and treatment.  It also promotes the use of naloxone, a life-saving overdose reversal drug which we believe should be in the patrol cars of every law enforcement professional across the nation. Please join us in spreading the word about overdose prevention by sharing a link to this toolkit on your social media platforms.”

    Let’s be clear about one thing: in the slow-moving world of drug policy reform, this is a major step forward. Prior U.S. administrations condemned the use of naloxone to treat opioid overdoses and this one supports it use. In fact, check out the outgoing head of the ONDCP Gil Kerlikowske’s interview with the Washington Post. Kerlikowske mentions the importance of naloxone in this interview and talks about the necessity of evidence-based drug policy reform. This interview comes on the heel’s of yesterday’s announcement that the U.S. Federal government will allow marijuana legalization laws to proceed in Colorado and Washington.

    I don’t want to romanticize the US approach. That government still supports Plan Colombia, an expensive and wasted effort to eradicate coca growing. But change is definitely in the air.

    Unfortunately, the Canadian federal government is nowhere near making similar pronouncements or providing any sort of open support for overdose prevention and treatment initiatives. The CDPC has written to Health Minister Rona Ambrose to emphasize the need for a national overdose strategy that includes harm reduction approaches like take-away naloxone programs. These programs train overdose witnesses to respond effectively to overdose and to prevent them from occurring in the future.

    The math is simple on this one – these programs save lives, so why I ask is Canada now falling behind the US on these initiatives? International Overdose Awareness Day is an opportunity to honour those we’ve lost to overdose but it’s also a time to reflect on how we can do better in Canada.

  • Training Drug Users and Bystanders to Treat Overdose Saves Lives

    Training Drug Users and Bystanders to Treat Overdose Saves Lives

    Drug overdose is a growing public health crisis that now kills more adults per year in the United States than motor vehicle accidents. In cars, seatbelts and airbags save lives. When it comes to opioid overdose a safe and non-abusable medicine called naloxone can restore breathing and avert death. Pragmatic doctors and health officials want anyone who uses opioids like heroin—and anyone likely to be around during an overdose—to have access to this life-saving drug, and know how to use it.

    In Massachusetts, researchers led by Dr. Alexander Walley at the Boston University Medical Center set out to discover the results of a state-supported overdose education and naloxone distribution program on deaths from overdose. We sat down with Dr. Walley to discuss the findings.

    What did your research find?

    This study demonstrates that overdose education and naloxone distribution is an effective public health intervention to address the growing overdose epidemic. We found that communities that received overdose education and naloxone reported significantly fewer deaths than communities that received no training. We also observed that the higher the cumulative rate of program implementation, the greater the reduction in death rates. In other words, the more people at risk or in contact with people at risk for overdose who were given naloxone, and trained to prevent, recognize and respond to an overdose, the lower the overdose death rates.

    Why are overdose education and naloxone delivery programs like these so important?

    Since the beginning of the Massachusetts overdose education and naloxone delivery programs, there have been more than 1,700 overdose rescues using naloxone. While we do not know how many of these people may have died if they had not received naloxone, it is likely that many of them would have. These rescues have inspired many us to maintain hope that all overdose deaths can be prevented.

    People who have recently stopped using opioids—whether because of jail time or treatment—are at increased risk of overdose, and we’ve heard inspiring stories of overdose reversals in these cases. While opioid addiction is a treatable disease, it is a chronic disease where relapse is unfortunately part of the natural history. Preventing overdose allows people to continue their progress towards recovery, and may enable them to seek out other lifesaving services.

    What barriers stand in the way of implementing programs like this in other parts of the United States?

    I’ll start first by listing features of the program in Massachusetts that contributed to its success and would support broader implementation: one is the use of a nasal delivery device for naloxone, allowing naloxone to be administered through the nose, instead of by injection. The other is a standing order issued by the health department that permits non-medical personnel to deliver overdose education and distribute naloxone. Without this order, a doctor would need to be present each time naloxone is given out. To date, there are still large parts of the country with no access to a lifesaving naloxone distribution program; though this program locator tool can help you find out if there is one near you.

    The two main barriers to the expansion of these initiatives are that insurance companies do not cover the nasal delivery device that allows naloxone to be administered through the nose, and prescribers (doctors, nurse practitioners and physicians’ assistants) are not yet adequately educated on prescribing naloxone. We’ve created a website, prescribetoprevent.org, to help facilitate naloxone prescribing.

    What message would you send to officials in countries like Russia and China where the death toll from drug overdoses continues to climb?

    Preventing needless deaths from opioid overdose is a bridge issue – it’s a cause that people from different perspectives on treatment and harm reduction can agree and work together on. It can be a starting point from which we can work together in addressing the harms associated with drug use.

    What happens now?

    We keep implementing and evaluating this program and ones like it. In Massachusetts, overdose education and naloxone have been delivered to heroin users, prescription opioid users, patients in emergency departments, and the people who are most likely to respond to an overdose including: people who are incarcerated, family members, social service providers, police officers, and firefighters. It is important to determine how these programs should be tailored to different populations to maximize their reach, effectiveness and sustainability. That’s what we’re working on now.

    This blog post was originally published on the Open Society Foundations website.
  • SALOME Participants Need An Exit Strategy

    SALOME Participants Need An Exit Strategy

    The SALOME study (Study to Assess Longer-term Opioid Medication Effectiveness), is a clinical trial being conducted in Vancouver, BC. The study compares the effectiveness of six months of injectable diacetylmorphine  (heroin) with six months of injectable hydromorphone (Dilaudid, a licensed medication) and the effects of switching from injectable to oral heroin or Dilaudid.

    SALOME began active recruitment in December, 2011. Participants will be in the study for one year, followed by a 1-month transition period where they will be encouraged to, once again, take part in conventional treatments such as methadone maintenance, drug-free treatments, and detox programs (treatments that have proven to be ineffective for these participants).

    SALOME is a follow-up to the NAOMI study, which tested whether heroin-assisted treatment or methadone is more effective in improving the health of chronic and long-time opiate users. The repeated failure of treatment efforts for participants is in fact part of the criteria for selection of participants in SALOME, as was the case in NAOMI.

    Many of the first participants will be exiting the clinical trial now and over the next two months (February and March).

    Both studies provide an immense value not only to our scientific understanding of heroin dependence, but also to those individuals who have participated in the research. But as with NAOMI, the current study protocol of SALOME puts research participants at an increased risk by failing to have an adequate “exit strategy” in place for when research is complete.

    Each of the research participants has previously failed on methadone maintenance treatment and other conventional treatments before entering the study, yet if the study shows that they are benefiting from diacetylmorphine when the research is concluded, they will not be allowed to be maintained on the drug that is benefitting them. Instead, they will be returned to methadone or other conventional treatment options.

    This practice, as demonstrated in international research and through the accounts of participants in the NAOMI study, produces real harms to members of our community, and we cannot tolerate it being repeated during the SALOME study.

    Canada remains the only country conducting a prescription diacetylmorphine (heroin) trial that has failed to provide diacetylmorphine to the research participants at the end of the trial.

    We feel that research testing new methods of treatment for the harms of addiction is valuable, but must be conducted in ways that effectively address the continuing treatment and support for the individual participants in the research if the intervention proves successful.

    By not putting in place an adequate exit strategy, the study is putting marginalized and vulnerable people at risk.

    We request that Providence Health Care take immediate steps to provide ongoing diacetylmorphine treatment for participants concluding the SALOME study by applying for and supporting Special Access to diacetylmorphine, and begin planning for a pilot program for providing this treatment to the community at large.

    How you can help:

    On behalf of the NAOMI Patients Association (NPA), a community letter directed to Providence Health Care in support of heroin assisted therapy is circulating. The letter is available here.

    For more information please contact Susan Boyd, on behalf of NAOMI Patients Association at naomipatientsassociation@hotmail.com

    To learn more about the NPA click here.

  • Harm Reduction and the Public Good in Victoria, BC

    Harm Reduction and the Public Good in Victoria, BC

    It seems that in Canada, public meetings about harm reduction bring out the best and worst in people. This was certainly the case on Wednesday at a public meeting to discuss the inclusion of improved services in a local health unit on the edge of Victoria’s Fernwood neighbourhood.

    This location is already the site of Victoria’s Sobering Centre and its Medical Detox facility. The meeting was held at the initiation of the Vancouver Island Health Authority (VIHA) to discuss their plan to create two service hubs in Victoria for harm reduction services. As you may recall, Victoria was forced to close its only fixed site needle exchange in 2008 after controversy erupted over public congregation outside its doors. Since then, attempts to move this site to other locations have been met with vociferous public opposition despite an intentional shift away from having just one location to having over 20 options for accessing needles and supplies.

    Going in to the meeting, no one was happy. Clearly some thought the proposed services were too little and some though they were too much. Supporters of people who use drugs wondered about the inclusion of peers in the development and implementation of these services. But some area residents seemed palpably angry about VIHA’s new plan. The Health Authority took pains to argue that their latest proposal only adds new professional services to two locations already providing harm reduction supplies. But no matter how much reassurance representatives gave, some residents still angrily denounced the service.

    Their language was pointed and painfully discriminatory – “those people”, “them” – meaning people who use drugs. Some neighbours worried about the safety of their children and some were afraid that violence, property theft and damage would escalate in their community. Even a Victoria Police’s Staff Sergeant Dave Bown challenged these speakers to rethink that one. These same neighbours were angry with VIHA for communicating their plans in the media despite an agreement to consult with neighbours.

    These days, community input into health care can be an afterthought and even VIHA representatives admitted last night that that they could have done a better job of getting feedback on the plans from residents. So the neighbours are probably angry for a reason. But still, the opposition to harm reduction reminded me that it’s easy to pit children’s safety against the needs of a scary “other”. It’s much harder to get down to work on making the community safe for all, including people who use drugs.

    These kinds of public meetings are taking place all over Canada as residents oppose proposed harm reduction or methadone services in their neighbourhoods. And media coverage often goes hand-in-hand with these events – conveying partial truths and giving angry voices the opportunity to parade out the worst of discriminatory attitudes toward people who use drugs.

    At the same time, I was heartened by some of last night’s speakers who invited their neighbours to help clean up used needles and offered examples of successful programs to educate children about harm reduction. Some neighbours repeatedly spoke about their fear of discarded needles until one resident of Fernwood, Andrea Langlois, stood up and reminded everyone that no one had ever contracted HIV from being poked by a inappropriately discarded syringe off the street. That turned the tide and other neighbours stepped forward to praise the plan and welcome the services. A couple of speakers even wondered if public use of drugs could be addressed with supervised consumption services. These weren’t people used to speaking the language of harm reduction but they seemed to get it – that the public safety and health of the whole community is enhanced by a full range of harm reduction services.

    One of the final speakers from the audience capped off the evening with a request that many of us could heed – stop sowing the seeds of fear and get to work on meeting the needs of all our citizens.

  • Cheap, Easy, and Lifesaving—Naloxone Treatment for Overdose

    Cheap, Easy, and Lifesaving—Naloxone Treatment for Overdose

    How much does it cost to save a life? That question got a clear and striking answer this week in the case of overdose from heroin in the United States. A study published in the Annals of Internal Medicine found that distribution of the overdose antidote naloxone—a safe, non-abusable, and inexpensive medicine—to one in five heroin users in the United States could prevent as many as 43,000 deaths. The cost of distribution would be equivalent to some of the cheapest, most effective, and most accepted medical interventions, like checking blood pressure at a doctor’s office.

    The study used mathematical modeling to assess whether giving out naloxone was “worth it”—that is, to determine how much naloxone distribution would cost per “quality-adjusted” year of life gained. This is the measure used by economists and policymakers to compare health interventions and decide which ones are affordable. The naloxone study also investigated assumptions that patient advocates would rather not acknowledge—like whether it would be cheaper to let illegal drug users die, or to put them in jail. Those are ugly questions, but ones that certainly run through the minds of opponents of health services for drug users worldwide. The answer was that naloxone saves lives with costs far below what health or prison systems pay. For example, screening for cancer with colonoscopy costs over $50,000 per quality adjusted life year gained in the United States, and screening for HIV costs around $40,000.

    Naloxone distribution saves lives for as little as $400.

    The other question, of course, is whose lives are deemed worth saving. Drug overdose now kills more adults a year in the United States than motor vehicle accidents, or deaths from choking or accidental falls. Most of us have seen safety messages related to driving, choking, or minding our step, but naloxone and other measures to prevent overdose remain unknown to many at risk. As noted in an editorial in the same journal, co-authored by officials from the National Institute on Drug Abuse and the FDA, making new and easy-to-use formulations of the medicine can help. However, action can be taken now to make the medicine available to heroin users—actions that will prevent thousands of needless deaths, and spare family and friends who may have to watch helplessly as their loved ones stop breathing.

    – Daniel Wolfe

    Daniel Wolfe is director of the International Harm Reduction Development Program at the Open Society Foundations. This blog post was originally published on the Open Society Foundations website.

  • The Missing Link in Overdose Prevention

    The Missing Link in Overdose Prevention

    Long-established medical practice supports prescribing pre-loaded syringes of epinephrine to people having severe, life-threatening allergic reactions to allergens such as bee stings, nuts and shellfish. Patients, including children, are taught how to use them and carry them with them at all times in order to administer the drug without delay when they have a reaction. It “buys time” to allow the person to get to emergency medical care for monitoring and further treatment if needed. Epinephrine is considered an emergency drug and in most circumstances is administered by trained medical personnel in health care settings. However, the risk of death from a severe allergic reaction, when seconds count, outweighs the risks associated with dispensing the drug for unsupervised use by lay people in the community.

    For about thirty years, the harm reduction approach has been advocated by some in Canada as a means of promoting health and preventing needless injury and death among people who use drugs. It accepts that, whatever one’s beliefs about drug use and the people who use drugs, at any given time some people will use drugs unsafely. It holds that preventing unnecessary morbidity and mortality is best accomplished by a continuum of strategies which include educating drug users about the drugs they use, the risks involved, ways to mediate those risks, and the availability of supports to reduce or cease risky use.

    For example, research from Australia has shown that needle exchange programs prevented 32,000 HIV infections and almost 100,000 Hepatitis C infections in the first decade of the 21st century, saving over AU$1 billion – which represents a five-fold return on investment.  Despite decades of robust evidence supporting the efficacy of harm reduction, in general health care providers have been “slow adopters” of harm reduction strategies.

    In September 2010, the College of Physicians and Surgeons of Ontario (CPSO) described widespread addiction to strong painkillers, known as opiates, as a “public health crisis” in Ontario. Earlier this year, a potent long acting opiate known as OxyContin was removed from the Canadian market and replaced with a new formulation called OxyNeo, which is made with a time release coating which is more difficult to bypass, making it less accessible to people using it without a prescription. This has resulted in fewer people using the drug, but not fewer people addicted to opiates.

    Research from the United States shows that many former Oxycontin users turned to more readily accessible opiates such as fentanyl and heroin after Oxycontin was taken off the market there.Reports from police and addiction workers suggest the same is now happening here in Canada. One of the problems with this is that people have had to change from opiates with a precisely known strength to others with variable potency. The risk of overdose has increased as a result. Recognizing this, Ontario Health Minister Deb Matthews announced in April 2012 that her government was increasing resources to address opiate addiction, including distribution of “emergency overdose kits across the province.”

    Similar to the way in which we provide emergency epinephrine to people with life-threatening allergic reactions, distributing a drug called naloxone, which reverses opiate overdoses, has been saving the lives of people who have overdosed on opiates since 1995 in the UK and Germany. There are 150 such programs in 19 American states but so far only Toronto and Ottawa have naloxone distribution programs up and running in Ontario, eight months after the health minister’s announced support of the strategy.

    Naloxone distribution involves providing opiate users with education on overdose prevention, first aid, CPR, as well as naloxone administration in an overdose situation, which “buys time” to get someone to emergency care. The OHRDP received Ministry of Health funding to create a detailed guidance document, which they have compiled building on the work of the Toronto and Ottawa pioneers. It is replete with supporting documentation, current statistics, training manuals, sample protocols and medical directives (required legally to prescribe and dispense this medication to lay people). The naloxone has been purchased and is ready to be used by trained lay people.

    Few health care providers would argue that the opiate addiction crisis has gone away. Small communities are dealing with issues like heroin which they have never seen before. What is different in small communities is that the people using substances are much more dispersed and invisible (for more information, see “Below the Radar”). While it may be reasonable in large cities to focus overdose prevention in places where there are high concentrations of drug users, small towns need a more widespread system of interventions because the people affected are not to be found in a few highly visible areas.

    For example, Peterborough ranks seventh highest in the province for opioid related deaths.  Peterborough Police Chief Murray Rodd has warned that “already we are seeing an increase in heroin and fentanyl in our city,” which he is concerned will lead to “even more overdoses in the coming months”.  A network of Peterborough agencies is poised to roll out an evidence-based overdose prevention program, which includes naloxone training – the first for an Ontario county which includes many rural communities where 911 response times are longer than is common in large cities.  Supported by the local Medical Officer of Health, the police service and EMS, it will only reach the people it needs to if local health care providers get behind the initiative. One hopes that they will do so without delay, as the project will undoubtedly save lives and provide a model for other small and rural communities.

    One of the reasons we study epidemiology (what is causing injury and death) is to use that information to plan programs which will prevent unnecessary injuries and deaths. Health providers have an obligation to understand evidence based interventions available around opioid addiction and to use them to reduce deaths. Some may ask “is this really needed?” but when overdose death rates are so well documented, the answer is obvious. Saving even one person from a needless overdose death should be considered important. She is someone’s daughter, maybe someone’s mom. While the needs of opiate users may not resonate with health care providers in the same way as the needs of people severely allergic to bee stings, when we have an evidence-proven lifesaving intervention, we are obligated to offer it widely and without delay.

    -Kathy Hardill

    Kathy Hardill is a Primary Care Nurse Practitioner at a clinic which includes patients whose health is made vulnerable through homelessness, poverty and other risk factors. This blog post was originally published on HealthyDebate.ca
  • Supervised Consumption Services and Community Support

    Supervised Consumption Services and Community Support

    Supervised injection sites help save lives and protect communities. This was the conclusion of over 30 research studies on Vancouver’s own supervised injection site (SIS) known as Insite. And Canada’s Supreme Court agreed in September 2011, ordering the federal Minister of Health to grant a Section 56 exemption to the Controlled Drugs and Substance Act to allow Insite to continue to operate.

    To scale up harm reduction and support the development of similar services throughout the province, the BC Ministry of Health has now revised its “Guidance Document for Supervised Injection Services.” Written for health care professionals, it provides advice to health authorities and other organizations considering supervised injection services in their local areas.

    According to provincial policy, anyone who wants to offer this service will need to consider how they will sustain the support of local groups like medical health officers, police departments and other potentially interested groups. The decision of Canada’s Supreme Courts makes brief mention of future applications for a section 56 exemption:

    [153] The CDSA grants the Minister discretion in determining whether to grant exemptions. That discretion must be exercised in accordance with the Charter. This requires the Minister to consider whether denying an exemption would cause deprivations of life and security of the person that are not in accordance with the principles of fundamental justice. The factors considered in making the decision on an exemption must include evidence, if any, on the impact of such a facility on crime rates, the local conditions indicating a need for such a supervised injection site, the regulatory structure in place to support the facility, the resources available to support its maintenance, and expressions of community support or opposition.

    This last sentence has raised concerns about the likely success of future supervised consumption services. Despite overwhelming evidence of their successes, harm reduction services continue to generate public controversy, meaning that some members of a community are likely to object to supervised consumption services. But the existence of opposition does not necessarily mean that potential applicants must halt their efforts. In fact, the Supreme Court’s judgment is not a checklist of requirements for a successful application but rather a description of the factors the Minister must consider when making a decision. Potential applicants must be able to demonstrate that they have gauged public support and can offer evidence that it exists. Applications, as the B.C. provincial government suggests, must include evidence of positive support along with opposition.

    It is important to remember that Insite did not necessarily start out with full community support. Rather, over time, and as the facility continued to operate, the surrounding community felt its positive effects and researchers were able to demonstrate its effectiveness in terms of health and social order. This does not mean that if one group objects then the application will necessarily fail. Potential applicants for an exemption will need to describe what efforts will be made to respond to community concerns and they will need to consider how they plan to educate their community about the positive effects of these services.

  • The Drug War in Your Passport

    The Drug War in Your Passport

    On October 18th, 1929, the Judicial Committee of the Privy Council in England, the highest court in Canada at the time, made a landmark decision that would forever change the role of women in Canadian politics. It repealed a previous ruling by the Supreme Court and made official women’s status as “persons” in Canada, which meant that from that point on, women were eligible to become members of the senate.

    The individual largely responsible for this ruling was the trailblazing women’s rights activist Emily Murphy, who three years prior became the British Empire’s first female magistrate. Along with four other women, who came to be known as “the famous five”, Murphy campaigned for this crucial shift in the meaning of the word “person”.

    Murphy’s legacy is alive and well today, with statues and art depicting her campaign located across the country. And now, according to a recent announcement, she will also be appearing in the pages of the new Canadian passports, alongside Terry Fox.

    But Murphy has another, lesser-known legacy. She is, perhaps more than any one individual, responsible for the criminalization of cannabis in Canada and the beginning of this country’s 90-year war on pot.

    From 1920 to 1922, Murphy wrote a series of articles for Maclean’s magazine, which would later be collected in her book “The Black Candle”. These writings, which amounted to an explicitly racist, anti-immigrant diatribe, were aimed at “educating” the Canadian public as to the dangers of drug use and drug trafficking.

    Informed by her experience as a magistrate in Alberta and a tour of Vancouver’s Chinatown, Murphy surmised that drug addiction was “a scourge so dreadful in its effects that it threatens the very foundations of civilization.”

    In “The Black Candle” she argued that substances such as cannabis, opium and cocaine were being trafficked throughout the country as part of a vast conspiracy aimed at corrupting the “purity” of the white race and the destruction of Anglo-Saxon communities.

    Of cannabis users she wrote:

    “The addict loses all sense of moral responsibility. Addicts to this drug, while under its influence, are immune to pain, and could be severely injured without having any realization of their condition. While in this condition they become raving maniacs and are liable to kill or indulge in any form of violence to other persons, using the most savage methods of cruelty without, as said before, any sense of moral responsibility.”

    Capitalizing on the anti-Chinese sentiment in Vancouver at the time, she successfully elevated and expanded upon the moral panic associated with opium to the national level and helped persuade the Canadian government to enact stricter drug laws.

    In 1921, An Act to Amend the Opium and Narcotic Drug Act increased maximum sentences for trafficking and possession from one year to seven years. And in 1923, informed by Murphy’s argument and “evidence”, the Canadian government became the first western country to ban cannabis.

    It is a strange and tragic irony that Murphy, who used a contrived drug scare to attack immigrants, should after all these years appear in Canada’s new passport; a document that is meant to enshrine and protect the rights of all Canadian citizens, new or old.

  • What is Naloxone?

    What is Naloxone?

    This post was updated on July 7, 2017

    Naloxone is a safe, highly effective chemical compound that reverses the effects of opiates such as heroin. It has been used in clinical settings as an emergency treatment for opiate overdose for 40 years. Naloxone has been approved for use in Canada for over 40 years and is on the World Health Organization List of Essential Medicines. Naloxone has no potential for abuse – in the absence of narcotics it exhibits essentially no pharmacologic activity. Naloxone will work only for drugs in the opiate/opioid family – it is not effective for overdoses of other drugs such as cocaine.

    This treatment can be administered by a by-standard and is available as a non-prescription in Canada. Please note that Naloxone does not replace professional medical treatment and “Emergency medical assistance (calling 911) should always be requested when an opioid overdose is suspected.” Health Canada recommends calling first then immediately administering Naloxone. Multiple doses may be required to reverse an overdose.

    What is a NARCAN kit and is it different than the nasal spray?

    There are now two common types of Naloxone available in Canada: injectable and nasal spray administrations. NARCAN is the brand that is producing the products available in Canada. They produce both the NARCAN Kits which include the injectable naloxone and syringe, and the nasal spray. Depending on where Naloxone is injected, it begins to work in less than 2 minutes or up to 5 minutes. The fastest way to administer naloxone is by injecting it into a vein. The nasal spray effects start in 2 – 3 minutes. (1)

    Both versions are now available as a non-prescription treatment. The injectable version was approved by Health Canada as non-prescription in March 2016 followed by the nasal spray in October 2016.

    How can Naloxone help reduce the number of drugs deaths?

    Naloxone can play a major role in preventing deaths – especially if it can be administered to someone in overdose as early as possible. To maximize the impact of Naloxone on drug deaths, it is necessary to have Naloxone available at the scene of the overdose before specialist help arrives. This means that Naloxone has to be available to members of the community for emergency use. Note that emergency services should always be requested as soon as an overdose is suspected then the Naloxone should be administered immediately.

    Where Can I Access Naloxone?

    Naloxone is available as a non-prescription across Canada and anyone is available to carry it. Pharmacies carry Naloxone and some provinces and non-profits offer Naloxone to take home for free.

    Training sessions are available through many organizations to learn how to administer Naloxone.

    Find Naloxone in Alberta 

    Find Naloxone in British Columbia 

    Find Naloxone in Saskatchewan 

    Find Naloxone in Manitoba 

    Find Naloxone in Ontario 

    Find Naloxone in Quebec and information here 

    Find Naloxone in the Northwest Territories 

    Find Naloxone in the Yukon 

    There are no Naloxone locators available online for the following provinces, however Naloxone is available at pharmacies across Canada. The following information is available:

    Additional information for Nunavut

    New Brunswick – find a pharmacy 

    and Nova Scotia health centre locations 

    Access to Naloxone varies around the world, including take-home doses for people who use illicit drugs in Europe and Australia, and across Canada. Scotland introduced a National Patient Group Directive in August 2010 to ease the development of take-home Naloxone programs. Naloxone is also available over the counter in Turin, Italy. There are over 180 successful take-home Naloxone programs in the U.S., such as Project Lazarus in North Carolina, which has helped to distribute Naloxone to individuals who are at risk due to prescribed opiates (2).

    For more information – visit Health Canada’s Naloxone page