Naloxone – Dispensing, Selling or Providing

Opioid overdose is a serious public health concern in Canada. Accidental overdoses can occur from use of opioids that have been prescribed by a health care provider and from illicit opioids.

Signs of opioid-induced respiratory depression (OIRD) include CNS depression, sedation, hypotension and respiratory depression that may lead to death due to respiratory failure. As an opioid antagonist, naloxone can save lives by temporarily counteracting these effects.

In the absence of an opioid, naloxone exhibits no effects and the only contraindication to its use is a known hypersensitivity. Naloxone does not increase the likelihood of risk-taking behaviours, is non-addictive, and cannot be abused.

jump to Jump To:

Print Page
Background

Following a public consultation, in 2016, Health Canada amended the Prescription Drug List to make naloxone a non-prescription drug when indicated for emergency use for opioid overdose, which subsequently allowed for it to be moved to Schedule II of the NAPRA National Drug Schedules. Pharmacists should ensure they act in accordance with NAPRA Supplemental Standards of Practice for Schedule II and Schedule III Drugs when dispensing naloxone.

There are two publicly funded take-home naloxone programs in Ontario.

Ontario Naloxone Program for COMMUNITY Pharmacies (ONPP)

The Ministry of Health established the Ontario Naloxone Program for Pharmacies (ONPP) to increase public access to this life-saving medication at no charge through community pharmacies. It is critical that the pharmacist is properly trained to effectively educate and prepare the patient or their agent for dealing with an opioid overdose, prior to providing naloxone. In addition to understanding naloxone therapy and being taught how to administer it they should also be educated on such topics as:

  • Harm reduction strategies when using opioids
  • How to identify and respond to an opioid overdose
  • Importance of immediately calling 9-1-1 and staying with the person until emergency first responders arrive
  • When and how and why to administer naloxone
  • Importance of performing rescue breathing
  • Any other information the pharmacist deems relevant

Pharmacy professionals are responsible for ensuring they possess sufficient knowledge, skills, and abilities to competently provide naloxone in a safe and effective manner. Please consult the College’s Continuing Education for Pharmacists and Pharmacy Technicians page and the resources below.

Pharmacists must also provide educational information and the steps for dealing with an opioid overdose in writing to the patient and/or agent. These written materials are not a replacement for pharmacist interaction and are only to be used as a supplemental.

Ontario Naloxone Program (ONP) FOR HOSPITALS and other organizations

The Ministry of Health established the Ontario Naloxone Program (ONP) to increase public access to naloxone kits at no charge through various organizations, centres and programs such as:

  • Public Health Units
  • Aboriginal Health Access Centres
  • Community Health Centres
  • Outreach programs and shelters
  • Hospital emergency departments, urgent care centres and inpatient units

Police, fire services and St. John Ambulances Branches can obtain naloxone for use when responding to opioid overdoses.

Applying for the ONP is coordinated via local public health units. Organizations not eligible to receive publicly funded naloxone are able to purchase it directly from the manufacturers.

Ontario’s Workplace Naloxone Program

Under the Occupational Health and Safety Act (OHSA), certain workplaces are required to have naloxone available in case a worker experiences an opioid overdose. These and other businesses are not eligible for the publicly funded take home naloxone programs.

For more information, visit Naloxone in the workplace. Inquiries related to OHSA requirements should be directed to the Ministry of Labour, Immigration, Training and Skills Development (MLITSD) by email: WebHSpolicy@ontario.ca.

External Resources