90,000 free naloxone kits distributed by Ontario pharmacies in under 2 years

About half the people who picked up a naloxone kit under a provincial government program that made them available for free at pharmacies were not opioid users themselves, according to a study by researchers at St. Michael's Hospital. 

From the program's inception in July 2016 to March 2018, 90,000 opioid overdose antidote kits were distributed to 61,000 people, the researchers say.

The authors of the study aren't certain why about half of those people were not opioid users, but they have a theory.

"We assume that these people are friends and family of people who are at risk of an opioid overdose and want to have a naloxone kit on hand in case they are able to intervene to help save that person's life," said Dr. Tara Gomes, corresponding author of the study and a clinician-scientist with the Li Ka Shing Knowledge Institute at St. Michael's.

Under the program, naloxone — a drug that can temporarily reverse an opioid overdose through either an injection or a nasal spray — was distributed to just over half of the 5,000 pharmacies in Ontario.

The Ontario Naloxone Program for Pharmacies was part of a plan created to address the opioid crisis, which has been connected to 12,800 deaths since 2016, according to statistics from the Public Health Agency of Canada (PHAC).

In Ontario alone, PHAC statistics show there were 459 opioid-related deaths between January and March of 2019.

The researchers aren't certain if there has been an impact on the number of overdoses as a result, though the uptake of people with the life-saving tool is positive, Gomes said.

"That's a very important advantage of this program … It provides a fairly low barrier for people to find these kits," Gomes added.

Dr. Rita Shahin, an associate medical officer of health in Toronto, said it's important to distribute naloxone kits through multiple channels. For instance, distributing kits through pharmacies reaches people who might not otherwise have access to the drug. 

The study, conducted by researchers at St. Michael's Hospital of Unity Health Toronto and ICES, also found that fewer than 30 pharmacies in Ontario distributed about one third of the kits.

Gomes said geography is one of the reasons for this. Pharmacies in certain cities where there are a lot of people at risk of an overdose, "those are the pharmacies that are more comfortable with dispensing naloxone."

Gomes said a cluster of pharmacies really bought into the idea of distributing naloxone but she thinks all pharmacies should be making the kit available to their clients. 

Some pharmacies may hesitate to distribute naloxone, thinking their clients don't need it or are "not wanting to invite people into their pharmacy who might use drugs because of the stigma that's associated to drug use," Gomes said.

"It would be great for the program to continue to expand," Shahin said.

Gomes said researchers are currently conducting a full evaluation of the program to compare fatal overdose figures in areas where naloxone has been widely distributed and areas where pharmacies have declined to participate.