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Category: Supervised Consumption Services

  • 9/30

    9/30

    930-Campaign-2013_Banner_FINAL

    It’s 9/30 and way past time for the federal government to get moving on safer consumption services.

    September 30, 2013 (9/30) marks the two-year anniversary of Canada’s Supreme Court decision that unanimously granted constitutional protection to Vancouver’s supervised injection site, Insite. To mark this important anniversary, the Canadian Drug Policy Coalition is spearheading a campaign to let our federal government know that there is widespread support for safer consumption services. In conjunction with the Canadian HIV/AIDS Legal Network and PIVOT Legal Society, we’ve created a sign-on letter to federal Minister of Health Rona Ambrose. Our letter demands that the federal government get going in the right direction to support the scale up of these important and life-saving services.

    That decision recognized the improved public health and public order that stems from the implementation of this service. The Court also recognized that, under the Canadian Charter of Rights and Freedoms, people who need such life-saving health services should not face possible criminal prosecution and imprisonment for attempting to use them. The decision created an important precedent supportive of expanding similar services in other communities.

    An overwhelming amount of research evidence on supervised injection sites (SIS) has been published in a wide range of scientific and medical journals since Insite first opened its doors in 2003. The evidence of Insite’s positive benefits is conclusive and these services should be scaled up where needed across Canada. Indeed numerous localities are working towards this.

    Supervised consumption services (SCS) have been proven to:

    • decrease overdose death and injury;
    • decrease risk behaviours associated with HIV and hepatitis C infection;
    • increase access to health services for people who are most marginalized;
    • save health care costs; and
    • decrease open drug use and publicly discarded drug use equipment.

    Furthermore, the evidence shows that such services do not increase crime, nor do they increase drug use.

    There are over 90 SCSs operating around the world today, and considerable research about the positive public health and safety outcomes of SISs. There is also broad agreement among health professionals that SCSs should be part of a comprehensive continuum of health services for people who use drugs.

    INSITE, Vancouver BC
    INSITE, Vancouver BC

    On September 30, 2011, the Supreme Court of Canada (SCC) ruled that it would infringe constitutional rights to security of the person to deny an exemption from the provisions of the Controlled Drugs and Substances Act so that Insite could operate without staff or users fearing criminal prosecution when using this health service. The Court declared unequivocally: “Insite saves lives. Its benefits have been proven.” The Court also stated: “Where, as here, a supervised injection site will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety, the Minister should generally grant an exemption.”

    All across Canada organizations of people who use drugs, front-line organizations, researchers, professionals, and community members who work with people who use drugs, are demanding increased access to supervised consumption services. It is unacceptable that a decade after Insite first opened, Vancouver remains the only city in Canada with a sanctioned supervised consumption service – and only one such service of this sort, which numerous studies have demonstrated is simply inadequate to meet local needs.

    It is unethical, unconstitutional and damaging to both public health and the public purse to block access to supervised consumption services which save lives and prevent the spread of infection.

    It’s time to stand up for people’s lives and take the leadership to ensure that supervised consumption services become a part of the continuum of care for people who use drugs in Canada.

  • New Supervised Injection Rules: Does the Government Really Care about Communities?

    New Supervised Injection Rules: Does the Government Really Care about Communities?

    On June 6, 2013, the Conservative government tabled amendments to the Controlled Drugs and Substances Act that creates 20 additional conditions required for applications for supervised consumption services. Entitled the “Respect for Communities Act”, these amendments essentially give police, public safety officials, and municipalities a veto over health services. The tabling of these amendments is clearly an attempt to head off applications expected within the year from a number of Canadian cities. Media coverage was swift and mixed. But the both the Canadian Medical Association and the Canadian Nurses Association quickly condemned the legislation and chastised the government for letting fear trump sound scientific evidence. Immediately following the release the Canadian HIV/AIDS Legal Network, the Canadian Drug Policy Coalition and PIVOT Legal Society issued a media release challenging these amendments.

    The new requirements will not only be costly and time consuming but they will likely prevent the expansion of these much-needed services. The intention of the legislation seems to be to give a broad range of community members an opportunity to comment on any proposal to create a service. There’s a sense of grievance in the government’s press releases that somehow communities have been excluded from playing a role in deciding the fate of these services. It seems ironic given the heavy-handed approach used by the Harper government, that suddenly they care about what communities think. What’s more likely is that they care about what the opponents of these services think. Of course communities should play a part in these discussions. But we can’t let one group of people, guided by fear and ignorance, prevent the implementation of life-saving and cost-effective services.

    No sooner had the legislation been tabled than an email blast from the Conservative Party to its members whipped up fears about supervised consumption services. Entitled “Keep heroin out of our backyards”, the CP missive uses language like “do you want a supervised drug consumption site in your community”. Clearly this is an attempt to stir up opposition to these life-saving services and to the people who use these services. Do they not realize that the “addicts” they fear so much are potentially their family and friends? We need to stop treating substance use as an “us” and “them” issue. At some point in our lives, many of us have been, or will be, touched by drugs and alcohol.

    In the last 20 years, supervised injection services (SIS) have been integrated into drug treatment and harm reduction programs in Western Europe, Australia and Canada. These services grew out of the recognition that low-threshold, easily accessible programs to reduce the incidence of blood-borne pathogens were effective and cost efficient. Since 2003, the city of Vancouver has been the location of a rigorously evaluated and highly successful stand-alone supervised injection site (SIS). More than 30 peer-reviewed studies describing the impacts of Insite indicate that it has several beneficial outcomes. The service is used by the people it was intended to serve, which includes over 10,000 clients. It is being used by people who would otherwise inject drugs in public spaces. Insite has reduced the sharing of needles and provided education on safer injecting practices. Insite has promoted entry into treatment for drug dependence and has improved public order. It has also been found to reduce overdose deaths and provide safety for women who inject drugs.

  • Safer Consumption Services – Plans are Underway for More Than Two

    Safer Consumption Services – Plans are Underway for More Than Two

    Several cities in Canada are planning for the implementation of safer consumption services in their communities.

    That was the conclusion of the speakers at a lively event on the feasibility of scaling up supervised consumption services in Canada held at the recent Canadian Association of HIV Care (CAHR) conference in Vancouver. Sponsored by the Dr. Peter Centre, the Canadian HIV/AIDS Legal Network and the Canadian Drug Policy Coalition, this half-day workshop brought together speakers from Ottawa, Montreal, Toronto and Vancouver to discuss their plans for the scale-up of these services across the country.

    The most famous of these services is Insite, located in Vancouver, BC. The vast amount of evidence from the reviews conducted on Insite suggest that this unique service has several beneficial outcomes: it is used by the people it was intended to serve, which includes over 10,000 clients. And it’s being used by people who might ordinary inject drugs in public. This service has also reduced risk behaviours by reducing the sharing of needles and providing education on safer injecting practices. Insite has promoted entry into treatment for drug dependency and has improved public order. It has also been found to reduce overdose deaths, provide safety for women who inject drugs, and does not lead to increased drug use or increased crime.[i]

    But public opposition and political fears still plague the scale up of these services. Despite well-documented benefits, opponents still claim that these services “promote” illegal drug use. These claims are based on the false assumption that failing to provide health care services to people who use drugs will dissuade drug use itself. All this does is drive people away from health care and into less safe injecting practices that can result in injury, infection and death. These opponents fail to appreciate that these services promote engagement in health care for hard-to-reach populations, and protect the dignity of people who use drugs by prioritizing their health care concerns.

    Formal opposition coming from the federal government has stalled the implementation of these beneficial services even in BC. In 2007, the federal government refused to grant a continuation of the legal exemption to Insite (Section 56 of the Controlled Drugs and Substances Act (CDSA)). Proponents of the site, including the PHS Community Services Society, VANDU, and Vancouver Coastal Health, challenged this refusal all the way to Canada’s Supreme Court. In 2011, that Court ruled in favour of the exemption noting the rights of people to access this health service, and ordered the federal Minister of Health to grant a continuation of the exemption. Future sites will be required to make an application for a section 56 exemption to avoid criminal charge for violations of the CDSA.

    It looks like the process of making an application for a Section 56 exemption will be onerous. Because of these challenges, some speakers at the CAHR conference urged the audience to consider other options like less expensive unsanctioned sites that use peer-run models of care.

    The need is clear – the will is there – the results are in.  Let’s urge the federal government to make access to these services as easy as possible so we can save lives, prevent illness and protect the dignity of people who use drugs.

    If you would like to help us advance the implementation of safer consumption services in Canada, please consider making a donation to the CDPC. And if you would like to keep up to date with our campaigns, sign up to our mailing list.

     

  • 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 Insite Story: Transforming Health Care Services through Leadership, Risk Tolerance and Innovation

    The Insite Story: Transforming Health Care Services through Leadership, Risk Tolerance and Innovation

    It has been said that “an essential aspect of creativity is not being afraid to fail.” A PricewaterhouseCoopers’ survey conducted among the Times 1000 leading companies found that one of the common characteristics among the most innovative companies is that they take a balanced view of risk-taking behaviours. But a recent Conference Board of Canada survey conducted among Canadian health care executives confirmed that Canadian health care leaders have low tolerance for risk. Boards are perceived to be more risk-averse than executive teams by a fairly wide margin. As seen in the chart below, 57 per cent of respondents agreed or strongly agreed that their executive teams are risk-tolerant, compared to the 37 per cent who agreed or strongly agreed that their boards are risk tolerant, a difference of 20 points.

    blog-121812-2At a recent meeting of the Centre for the Advancement of Health Innovations in Vancouver, Insite, North America’s first legal supervised injection site for drug users, exemplified the importance of adopting a balanced approach towards risks. Insite’s leaders have taken bold actions, many of which carried significant risks, to implement innovative and transformative health care services.

    Insite was created to provide needed services to a population group that has suffered social stigma, abuse and social exclusion in Canada: drug-addicts. Before Insite, there were very few effective solutions to protect drug users from HIV and drug overdose but Insite has changed this reality.It offers clean injection supplies, withdrawal management support, detoxification areas and transitional recovery housing. A team of mental health workers, counsellors, nurses and physicians work with people with drug addiction to educate, intervene when necessary, plan a path to recovery and assist with re-integration in the wider community.

    And the results are outstanding: thirty-three per cent of Insite users are more likely to go to detox if they use the site once a week; 70 per cent are less likely to report syringe sharing, thus reducing HIV risk behaviour; and fatal overdoses within 500 metres of Insite decreased by 35 per cent after the facility opened compared to a decrease of 9 per cent in the rest of Vancouver. The benefits also extend to the heath care system and society: it has been estimated that supervised injection can save $14 million and 920 life years over 10 years due to a reduction in HIV, hepatitis and other medical interventions.

    Despite these proven benefits, Insite has had to fight legal battles to prove legitimacy. In 2006, the federal government deferred the decision to extend Insite’s special exemption from the Controlled Drugs and Substances Act, citing a lack of evidence to support the benefits of supervised injection. In a brave demonstration of leadership, Insite’s supporters took the matter to the Supreme Court of Canada, which in 2011, ruled unanimously to uphold Insite‘s exemption, allowing the facility to stay open indefinitely. Over the past nine years, more than one million injections have taken place at Insite under supervision and with clean equipment. It is the busiest supervised injection site in the world with over 1,200 visits every day.

    Insite’s leaders did not run away or gave up on their vision when the many obstacles appeared; they relentlessly focused on implementing change and appropriately and effectively managing the risks associated with a program of this nature. And these efforts have paid off: by partnering with the local health authority, Insite has been able to effectively bringing innovative health care services to marginalized populations who were previously unreachable.

    The program continues to work with low-income people to bring more opportunities for this hard-to-reach population to control their addictions and access effective, culturally appropriate chronic disease management and disease prevention programs. Insite’s daring leaders were not paralyzed by fear of failure. They are transforming health care services by demonstrating that the “best health care solution lies in treating all people humanely”.

    – Jeannette Lye

    Jeannette is a graduate of the School of Public Administration at Dalhousie University and in addition holds a Master of Science in Cultural Psychology from Brunel University and an undergraduate degree in psychology from Acadia University. This blog post was originally published on ConferenceBoard.ca

  • 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.

  • Syringe Exchange in Prison – A Matter of Human Rights

    Syringe Exchange in Prison – A Matter of Human Rights

    People do not surrender their human rights when they enter prison.  Instead, they are dependent on the criminal justice system to uphold their human rights — including their right to health. Prison health is public health.

    These statements may seem self-evident to some, but the right to adequate health care services is the basis of a new legal case brought against the Canadian federal government.

    Syringe exchange programs are a crucial component of a comprehensive strategy to prevent the spread of infectious diseases but the federal correctional service does not permit this life-saving health service in Canada’s federal prisons. To challenge this policy, the Canadian HIV/AIDS Legal Network, Prisoners with HIV/AIDS Support Action Network (PASAN), CATIE, the Canadian Aboriginal AIDS Network (CAAN) and Steven Simons, a former federal prisoner, launched a lawsuit against the Government of Canada today over its failure to protect the health of people in prison through its ongoing refusal to implement clean needle and syringe programs.

    Drug use in prisons is a reality. A 2007 survey by the Correctional Service of Canada (CSC) revealed that 17% of men and 14% of women had injected drugs while in prison. Some prisoners are not ready to partake in treatment, treatment may be unavailable or treatment may not be appropriate.

    Despite the fact that drug use and possession is illegal in prison and despite prison systems’ efforts to prevent drugs from entering the prisons, drugs remain widely available. In fact, no prison system in the world has been able to keep drugs completely out. Sharing syringes is a pretty efficient way of sharing blood-born illnesses. People in prison have rates of HIV and Hep C that are at least 10 and 30 times higher than the population as a whole, and much of this infection is occurring because prisoners do not have access to sterile injection equipment.

    This legal case challenges the belief that people revoke their rights when they enter a prison. In fact, prisoners retain all the human rights available to the population at large, except those that are necessarily restricted by incarceration. This includes the right to the highest attainable standard of health, a right enshrined in several U.N. Treaties and Conventions. This right encompasses measures such as syringe exchange that have been shown repeatedly to prevent the transmission of diseases.

    There’s also sound reasons to think that prison syringe exchange services are good for all of us. These services are available in many parts of the world and evaluations have found that they reduce needle sharing, do not lead to increased drug use or injecting, help reduce drug overdoses, facilitate referrals of users to drug treatment programmes, and have not resulted in needles or syringes being used as weapons against staff. When these services were introduced in Swiss prisons, staff were initially relunctant, but because syringe exchange reduced the likelihood of a needle stick they realized that distribution of sterile injection equipment was in their own interest, and felt safer than before the distribution started.

    The vast majority of prisoners eventually return to the community, so illnesses that are acquired in prison do not necessarily stay in prison. This means that when we protect the health of prisoners we protect the health of everyone in our communities. Prisoners are part of our lives too – they are mothers, fathers, brothers, sisters, friends and loved ones. While you may not think you know a prisoner, chances are you will – and you will have concern for their health and well being.

  • 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