Approximately one naloxone kit for every 100 Ontarians has been distributed
There were over 145,000 naloxone kits distributed across Ontario between July 2017 and June 2018. This is approximately one naloxone kit for every 100 Ontarians, according to a new report by researchers at ICES, St. Michael’s Hospital and the Ontario Drug Policy Research Network (ODPRN).
Naloxone is a medication that can temporarily reverse the effects of an opioid overdose. When someone overdoses on opioids, their breathing either slows or stops completely. Naloxone can help them breathe normally, regain consciousness and save their life. Naloxone can either be injected or given as a nasal spray.
“The province of Ontario has taken a proactive role in distributing naloxone kits, in an effort to combat the growing impacts of the opioid crisis. The province is largely leveraging two programs: one program directly distributes naloxone to Public Health Units and the other provides government funding for naloxone kits dispensed at any community pharmacy in Ontario,” says Mina Tadrous, lead author of the study, adjunct scientist at ICES and researcher at Women’s College Hospital.
In Ontario, you are eligible for a free naloxone kit if you are: at risk of a prescription or non-prescription opioid overdose; a family member, friend or other person able to help someone at risk of an opioid overdose; a client of a needle syringe/exchange program or hepatitis C program and/or newly released from a correctional facility.
Despite this province-wide initiative, benchmarks to distribute naloxone have not been established. One study in the UK suggested that naloxone distribution programs should establish targets of nine to 20 times the number of opioid-related deaths in the region. The researchers add that benchmarks should be based on the needs of the region which have to be based on the harms in their population and since this varies by region so should the benchmarks.
“To establish benchmark distribution metrics, we defined opioid-related harms as the number of opioid-related emergency department visits and deaths that occurred during the study period. We used the previous established benchmarks of nine as our low and 20 kits distributed per harm event as our high benchmark,” adds Tadrous.
The researchers found that the province as a whole achieved the low benchmark for naloxone distribution, with 9.6 kits distributed per opioid-related harm (106 per cent of low benchmark). However, this wasn’t the case in all public health units including Toronto which was below the low benchmark with only 4.2 kits distributed per opioid-related harm, about 46 per cent of the minimal benchmark.
Additionally, the distribution of the naloxone kits varied widely across the province. The rates ranged from 270 kits per 100,000 residents in York Region to 2,499 kits per 100,000 residents in Thunder Bay District public health unit. The researchers hope that this report can help each region achieve optimal distribution based on the needs of their community.
The researchers add that future work is needed and is currently underway to better understand if these programs have been effective in reducing fatal opioid overdoses.
The report “Naloxone Distribution Across Ontario” was published today on the ODPRN website at www.odprn.ca.
Author block: Mina Tadrous, Dana Shearer, Diana Martins, Tonya Campbell and Tara Gomes.
ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future healthcare professionals in 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
St. Michael's Hospital with Providence Healthcare and St. Joseph's Health Centre now operate under one corporate entity as of August 1, 2017. United, the three organizations serve patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education.
This Ontario Drug Policy Research Network (ODPRN), a province-wide network of researchers who provide timely, high quality, drug policy relevant research to decision makers. ODPRN researchers have expertise in pharmaceutical utilization, outcomes, economics, and policy research and leverage cutting-edge research methodology to generate and disseminate evidence on drug utilization, safety, effectiveness and costs in Ontario. The ODPRN is funded by the Ontario Ministry of Health and Long-Term Care.
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