Naloxone Distribution

PI: Jane Buxton (BC Center for Disease Control, BC)

Leadership Group: Katherine Rittenbach (University of Alberta, AB); Carole Morissette (Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, QC); Pamela Leece (Ontario Public Health, 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. This project is made up of four sub-projects.

 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cross-sectional effort was conducted some years ago but was limited to the state of ‘take-home naloxone’ and is now outdated.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 include:

  • Undertake and regularly update a comprehensive review of naloxone availability and distribution across Canada,
  • Disseminate and distribute final scan to key stakeholders and policymakers to inform research and policy/practice

Development of Naloxone ‘Best Practice’ Guideline

Key parameters of current naloxone legislation/regulations, modes/products, availability, distribution practice vary considerably across Canadian jurisdictions, with some more developed/advanced than others or not fully aware of or based on current evidence. Objectives include:

  • Create an evidence-based ‘best practice’ document based on available evidence on practice and outcomes (including useful outcome indicators),
  • Disseminate and distribute document to help advance evidence-informed availability and practice development of naloxone availability and distribution

‘Repository’ of Canadian Data/Outcomes on Naloxone Distribution

This project provides an opportunity to centrally collect and document data through a central repository for existing and emerging process, evaluation and outcomes data re: naloxone distribution in Canada considered beneficial for evidence-based research and policy development. Objectives include:

  • Relevant process and outcome data (scientific/peer-reviewed as well as ‘grey’/informally published) on naloxone distribution, outcomes etc. in Canada will be identified and collected on an ongoing basis and developed into an accessible repository (e.g., CRISM website)

 Facilitating/supporting further evaluation/outcome research on naloxone distribution in Canada

As described, little process or outcome research – including outcome measurement indicators – on naloxone distribution and use (e.g., impact on utilization, overdose outcomes, mortality) exists in Canada to date. Objectives include:

  • Create proposals, and concrete empirical data/analyses (e.g., reports/publications) on naloxone uptake/dissemination, outcomes (e.g., re: opioid overdose, mortality)
  • Develop a knowledge mobilization strategy to disseminate these materials and engage providers and other stakeholders