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); Tara Elton-Marshall (CAMH, ON); Amina Moustaquim-Barrette (BC Centre for Disease Control, BC)

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cross-sectional effort was conducted some years ago but was limited to the state of ‘take-home naloxone’ and is now outdated.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


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