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Naloxone Distribution

PI: Jane Buxton (BC Center for Disease Control)

Leadership Group: Katherine Rittenbach (University of Alberta, AB); Carole Morisette (Direction de la santé publique de Montréa, QC); Pamela Leece (Public Health Ontario, ON)

As Canada finds itself amidst an evolving opioid public health crisis, including escalating mortality from overdose, the provision of ‘naloxone’ has been recognized as a key emergency measure and targeted tool to reverse opioid overdose and prevent mortality. Naloxone availability and distribution has evolved in different jurisdictions across Canada, in rather diversified ways; for example, federal and provincial legislation/regulations have been modified to expand naloxone distribution, and different naloxone distribution models and practices (e.g., injection/nasal; multiple availability sources; provision through first responders, peers, take-home programs) have been proposed or implemented in different jurisdictions, including provinces and/or municipalities. 

Phase 1: Environmental Scan of Naloxone Parameters across Canada

Key parameters of current naloxone legislation/regulations, modes/products, availability, distribution practice across Canadian jurisdictions are not systematically documented. A previous cross-sectional effort was conducted some years ago but was limited to the state of ‘take-home naloxone’ and is now outdated. Objectives of this project include:
  • Use key informant interviews and a systematic review to answer key questions in naloxone safety, distribution and use to inform national best practices
  • Support outcomes research (including data analysis, literature review, writing/copy-editing, dissemination) for projects related to naloxone distribution
  • Disseminate and distribute final scan to key stakeholders and policymakers to inform research and policy/practice

Between Janurary and May, 2019, CRISM conducted an environmental scan of naloxone practices towards the goal of consolodating all available information regarding current practices and programs which distribute naloxone. A systematic review was conducted, including grey literature, in conjunction with key informant interviews in order to better understand access and distribution of naloxone across Canada. In June, 2019, the report was released. The report highlighted thatover 590,000 publicly-funded naloxone kits have been distributed across more than 8,700 distribution sites in Canada. Over 61,000 kits were used to reverse an overdose. All provinces and territories across Canada currently operate publicly-funded take-home naloxone programs. Although access to naloxone has increased, barriers to access remain. Please see links below for the finished report.

Phase 2: National Best Practice Guideline for Naloxone Provision

The second phase of this project is currently being undertaken. Utilizing the information gathered during Phase 1, CRISM will assemble a National Best Practice Guideline for naloxone provision in Canada.