Rapid increase in naloxone distribution after kits became available at Ontario pharmacies

The distribution of naloxone kits in Ontario increased rapidly after they were made available free of charge through community pharmacies and reached almost 68,000 people in a two-year period, according to a study led by researchers at St. Michael's Hospital of Unity Health Toronto and ICES.

The study, published Friday in PLOS ONE, analyzed the distribution of naloxone—the life-saving medication used to reverse the effect of an opioid overdose—in Ontario between July 2016 and March 2018. The Ontario government launched the Ontario Naloxone Program for Pharmacies (ONPP) in June 2016.

During the study period, 91,069 naloxone kits were distributed through pharmacies. Naloxone dispensing through the ONPP increased considerably over this period from 1.9 kits per 100,000 residents to 54.3 kits per 100,000 residents.

Researchers also analyzed the characteristics of the 67,970 unique individuals who were dispensed naloxone in Ontario pharmacies during the study period. The median age was 38, there was a near equal gender split, and 90 per cent lived in an urban neighbourhood.

While about 40 per cent of people who were prescribed opioid agonist therapy (OAT) to treat an opioid use disorder also received naloxone through a pharmacy, only two per cent of those dispensed a prescription opioid also got a naloxone kit.

By March 2018, nearly half of all naloxone kits dispensed in pharmacies were to people with no opioid exposure or unknown opioid exposure, which likely represents friends and family of people at risk of an overdose.

"The ONPP has been a significant step in the right direction for providing broader access to an important tool that can save the life of those at risk of an opioid overdose," said Dr. Tara Gomes, corresponding author of the study and a clinician-scientist at the Li Ka Shing Knowledge Institute of St. Michael's.

"The accessibility of harm reduction programs like the ONPP are crucial to addressing the ongoing opioid crisis," said Dr. Gomes, who is also a core scientist at ICES, the not-for-profit research institute where the Ontario data were analyzed.

Almost 56 per cent of all Ontario community pharmacies dispensed naloxone during the study period, although a small number of those pharmacies dispensed the majority of the kits.