Naloxone – Dispensing, Selling or Providing

Opioid overdose is a very serious, life-threatening condition and a serious public health concern in Canada. Accidental overdoses can occur in both individuals who use opioids as prescribed by their health care provider, and those using opioids for non-medical reasons.

Naloxone is an opioid antagonist that temporarily reverses the effects of opiates such as respiratory depression, sedation, and hypotension. Naloxone is a safe and effective therapy; with proper administration it can save lives in opioid overdose situations. 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.

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.

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 the resources below.

The Ontario 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

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.

Resources for procuring and assembling kits and more information on the ONPP are available from the Ministry of Health and Ontario Pharmacists Association.

Ontario’s Workplace Naloxone Program

Starting June 1, 2023, employers who are required to comply with the Ontario’s Workplace Naloxone Program requirements in the Occupational Health and Safety Act can visit the following participating program providers for more information on how to access free naloxone training and kits:

For more information, contact the Ministry of Labour, Immigration, Training and Skills Development.

External Resources