PREPARED BY:
Chronic Disease and Injury Prevention
DATE:
2024-05-16
SUBJECT:
Implementation of the Ontario Naloxone Program 2023
BACKGROUND/PURPOSE
Naloxone is a fast-acting medication that can temporarily reverse the effects of an opioid overdose. The Windsor-Essex County Health Unit (WECHU) operates the local Ontario Naloxone Program (ONP) which provides naloxone kits to eligible community organizations that work directly with populations at risk of opioid overdose through harm reduction programming, outreach and/or social determinants of health.
In 2023, there were 26 community partners actively involved with the ONP, 7 of which were newly on-boarded. Through these partners, there were:
- 1,487 naloxone kits distributed
- 171 single nasal sprays distributed
- 1,106 individuals trained to administer naloxone
- 43 overdoses where naloxone was administered (emergency services only)
The WECHU’s ONP team actively recruits new agencies for participation in the ONP, including the two local police services, emergency medical services, fire departments, addictions treatment facilities, outreach programs, and several others. A WECHU public health nurse consults with new partners, provides training, enters into a service agreement with new partners, and manages storage, inventory, delivery, and reporting components of this program.
In addition to operating the ONP locally, WECHU staff also engaged in several interventions to enhance community access to naloxone, which are highlighted below.
DISCUSSION
Supporting Pharmacy Naloxone Distribution
Through participating pharmacies, the Ontario Naloxone Program for Pharmacies (ONPP) distributes injectable and nasal spray naloxone kits to:
- Individuals at risk of opioid overdose
- Family and friends of a person who uses substances
- People in a position to care for individuals who uses substances
In 2023, there were 99 eligible pharmacies in the ONPP across Windsor-Essex County that distributed:
- 2,801 injectable naloxone kits
- 23,036 intra-nasal naloxone kits
These pharmacies were engaged in a survey to identify gaps and/or barriers in naloxone distribution practices and to determine strategies to support distribution.
- 42 pharmacies participated in the survey, 41 of which distributed naloxone.
- Lack of public awareness about naloxone availability and stigma around naloxone/substance use were the top reported barriers to client access of naloxone kits.
- 80% of pharmacies reported that their naloxone distribution could benefit from support including access to naloxone educational posters and handouts (75%) and client training resources (50%).
The findings will be used in 2024 to create tailored outreach packages to participating pharmacies to support the promotion of naloxone distribution.
Fentanyl Test Strip Pilot
A three-month pilot of fentanyl test strips (FTS) distribution was conducted with three shelter partners and SafePoint. The purpose of the pilot was to examine the usefulness of FTS as a harm reduction strategy. Over the three-month pilot period:
- 292 FTS were distributed to 53 unique clients, 4 of which were returning clients.
- As a result of receiving the FTS package, 43 total behaviour changes were reported by clients following use of FTS:
- 18 instances of clients having naloxone available when using substances.
- 12 instances where clients used substances with someone else present.
- 5 instances of clients using slower.
- 4 instances of clients doing a test shot/hit before using substances.
- 4 instances of clients seeking substance use treatment and/or counselling.
Moving forward, additional ONP partners will be engaged to distribute fentanyl test strips, as well as xylazine and benzodiazepine test strips.
Community Training Event
In November, the Kingsville Community Centre and Town of Kingsville hosted an event to provide education on substance use and addictions to the community. At this event, the ONP team collaborated with Essex-Windsor EMS to provide naloxone and overdose response training, naloxone kits, and fentanyl test strips. In 2024, the ONP team along with the Windsor-Essex Community Opioid and Substance Use Strategy (WECOSS) plan to expand these overdose prevention trainings across four events to be hosted in Windsor.