Methamphetamine Toxicity
Methamphetamine Toxicity
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Where to Get a Naloxone Kit?

What is Naloxone?

Naloxone (NARCAN®) can be administered to someone who has overdosed on opioids to temporarily reverse the effects until medical help arrives.

Naloxone is not effective for pure methamphetamine overdoses. However, many street drugs are mixed with opioids. If you are unsure what the suspected overdose is, it is always better to call 911 and administer naloxone.

A naloxone kit with the inner contents being shown.

Where Do I Pick Up a Naloxone Kit?

Naloxone kits are available free of charge at participating local pharmacies and community-based organizations.

  • No prescription is needed.

Please be aware that not all pharmacies carry naloxone kits. It is recommended that you call ahead to check if your pharmacy has naloxone kits in stock. Alternatively, you can drop by one of the community-based organizations listed below to pick up your naloxone kit:

Naloxone 101

Stay informed! The following pamphlet describes the uses of naloxone, the contents of a naloxone kit, proper administration information, and naloxone availability across Canada. This information is supplied by the Canadian Mental Health Association.

Naloxone 101 What naloxone? Naloxone is a temporary antidote to an opioid overdose. It acts fast, forcing opioids to unbind from the receptors in the body. In Canada, naloxone is available in two forms: 1. as an injectable, and 2. As a nasal spray called Narcan. Note that naloxone only works on opioids, and not on other drugs. But if someone is having a mixed overdose, naloxone will still reverse the opioid part. Getting a naloxone kit. Naloxone is available without a prescription in Canada, so anyone can get it at a participating pharmacy. It is available over the counter, just by asking the pharmacist. Ask your campus pharmacy to carry it! Naloxone kits are available free of charge to anyone at risk of overdose, as well as to their family and friends. Each province and territory has its own way to distribute these kits. See the "Getting naloxone across Canada" on pages 6-9. Naloxone is an essential part of your first aid kit. It will save lives. Naloxone is becoming a standard part of emergency response, just like CPR and defibrillators. Your campus First Aid Kits need to include naloxone and students, faculty and staff need to be trained to use it. When an overdose occurs, we have to act fast. The person can stop breathing and suffer extensive brain damage or death while the ambulance is on its way. Just three to five minutes without oxygen can cause permanent brain injury. Canadian Mental Health Association. Carry it Toolkit, www.cmha.ca/carryit August 2019.
Naloxone 101 What's in a naloxone kit? Naloxone is available as both an injectable medication (like an EpiPen) and as a nasal spray. Both can be safely administered by a trained volunteer or bystander. Available forms of Naloxone: Intramuscular Injection Kit. A. 1 hard case B. 2 (0.4mg/1ml) vials or ampoules (a small glass container) of naloxone C. 2 safety-engineered syringes with 25g naloxone, 1" needles attached. D. 2 alcohol swabs E. 2 devices (known as "breakers", "Snappers", or "openers") for safely opening ampoules. F. 1 one-way breathing barrier G. 1 pair of non-latex gloves H. 1 card that identifies the person who is trained to give the naloxone I. 1 insert with instructions (English and French) Nasal Spray: A. 1 hard case B. 2 doses of Narcan Nasal Spray (4mg/0.1ml) C. 1 one way breathing barrier D. 1 pair of non-latex gloves E. 1 card that identifies the person who is trained to give the naloxone F. 1 insert with instructions (English and French) Note: Contents will vary slightly by province. Canadian Mental Health Association, Carry it Toolkit, www.cmha.ca/carryit August 2019
Naloxone 101 Giving Naloxone by nose (Narcan) If you're carrying a naloxone kit, get trained on how to use it. It is important to get training so that you can spot signs of overdose and learn how to respond effectively. Here are basic tips for administering naloxone by nose. Your trainer will be able to answer any questions. 1. Identify if the person is experiencing an overdose by: Checking for the signs - slowed breathing? Not breathing at all? Gurgling sounds? Clammy skin? Purple nails and lips? Shouting at them or shouting their name to try to wake them up. Doing a sternal rub for up to 30 seconds: Try to provoke a response by making a first and vigorously rubbing your knuckles along the person's breast bone. 2. If the person is unresponsive, call or have someone call 911. Stay at the scene. 3. Check the person's moth to make sure there isn't an object blocking their airway. If there's no obstruction, tilt their head back to help open up their airway. If you can see an obstruction, try to remove it if you know how. (If you can't remove the obstruction, you can still administer naloxone). 4. If the person is not breathing, perform mouth-to-mouth (rescue breathing). If they're not breathing but have a pulse, give mouth-to-mouth (1 breath every 5-6 seconds). If they have no pulse, give CPR if you know how (cycles of 30 chest compressions + 2 breaths). 5. Administer naloxone by nose. The person should be on their back with their chin pointed upwards. This will help the liquid remain in the nose and be absorbed. Remove the spray from the package. Do not test the medication. Hold your thumb on the bottom of the plunger and hold your first and middle fingers on either side of the nozzle. Gently place the tip of the nozzle into one of the person's nostrils. Your fingers should be at the base of their nostrils. Press firmly to release all of the liquid. Remove the nozzle from their nostril. Monitor the time: naloxone should stimulate a response in a few minutes. The timing of rescue breathing varies by province. Some provinces (e.g. BC, MB) advise ventilating before administering naloxone. Other provinces (e.g., ON) recommends that rescue breathing be performed after naloxone is administered. Check your province's guidelines or ask your trainer, an emergency services professional (e.g. paramedic, nurse), or your local public health unit. Canadian Mental Health Association. Carry it Toolkit, www.cmha.ca/carryit August 2019.
Naloxone 101 6. Perform mouth-to-mouth and/or chest compressions (2 per second). 7. Evaluate. If the person is unresponsive after 3 minutes: Give a second dose of naloxone using a new container. Use alternating nostrils for additional doses. Stay with them until paramedics arrive. If the person must be left unattended at any time, pace them in the recovery position (see image below). Recovery position: Head should be tilted back slightly to open airway. Hand supports head. Knee stops body from rolling onto stomach. 8. If the person wakes up: Explain what just happened to them. If police or emergency response personnel have arrived, explain that they are there to help and reassure the person that they are not in trouble. Some provinces (e.g. ON) recommends performing chest compressions or rescue breathing at this point, but opinions differ about whether to do chest compressions or not. Check your province's guidelines or ask your trainer, your local public health unit, or your local harm reduction unit. Canadian Mental Health Association. Carry it Toolkit, www.cmha.ca/carryit August 2019.
Naxolone 101 Giving Naloxone by Injection Injectable naloxone is like an EpiPen, it is every bit a life-saving measure. If you're carrying a naloxone kit, get trained on how to use it. It is important to get training so that you can spot signs of overdose and learn how to respond effectively. The directions for administering injectable naloxone vary slightly by province and territory. Ask your trainer for the instructions that apply to you or contact your local Public Health Unit or Authority. After you give naloxone. After administering naloxone, it is important to stay with the person who just experienced an overdose until emergency services arrive. Naloxone often sends the person who overdosed into withdrawal. Withdrawal is a distressing experience, because symptoms include chills, excessive sweating, fever, intense sensations of pain, nausea, muscle cramping, anxiety and a racing heart. Give the person some space and be sure not to touch them - even a light touch can feel painful during withdrawal. Stay, give the person space, and give naloxone again if necessary. If the person wakes up, try your best to keep yourself and the person calm until help arrives. Assure them that emergency services (police, ambulance) are there to help, and that the person is not in any trouble. Encourage the person to refrain from using for several hours to avoid another overdose. Naloxone is only active in the body for 10-90 minutes, whereas the effects of most opioids last much longer. This means that naloxone may need to be administered several times because, after it takes effect, it may wear off before the opioids do, causing breathing to stop again. Canadian Mental Health Association. Carry it Toolkit, www.cmha.ca/carryit August 2019.
Naloxone 101 Getting naloxone across Canada Naloxone kits are now available across Canada through pharmacies, public health units, and a range of health and social service organizations. The maximum number of kits that can be provided at any one time varies across Canada; consult your pharmacist or local health authority for province - or territory specific information or for information about Non-Insured Health Benefits Program or Veterans Affairs Canada. Here's how to get your naloxone kit - free of charge - across the country. Alberta: Free kits and training (for injectable naloxone only) are available to anyone who uses drugs and to their family and friends. The nasal spray is available for purchase at participating locations. British Columbia: The Take Home Naloxone program distributes kits free of charge to people who are at risk of overdose or to the friends and family of someone at risk. Saskatchewan: The Take Home Naloxone program distributes kits free of charge to people who are at risk of an overdose or to the friends and family of someone at risk. All other individuals can purchase kits on their own from a participating pharmacy. Adapted from CATH, Funding and Management of Naloxone Programs in Canada, 2018; Canadian Pharmacist's Association, Access to naloxone across Canada, 2017. Canadian Mental Health Association. Carry it Toolkit, www.cmha.ca/carryit August 2019.
Naloxone 101 Manitoba: The Take Home Naloxone program distributes kits free of charge to people who are at risk of an overdoses. All other individuals can purchase kits on their own from a participating pharmacy. Quebec: Anyone 14 years of age or older can obtain naloxone injectable or nasal spray for free with their Health Insurance Card from a pharmacy (all pharmacies can provide naloxone, but only some have a stable inventory). In an emergency, pharmacies will dispense naloxone without a Health Insurance Card. Anyone who consumes drugs can access naloxone through a participating community health organization. Ontario: Any individual can access nasal spray or injectable naloxone at no cost through a participating pharmacy (no OHIP or ID card required). Through the Ontario Naloxone program, anyone who uses drugs, and the friends and family of someone at risk can access nasal spray or injectable naloxone through participating community-based health organizations, needle syringe/exchange programs, or hepatitis C programs. New Brunswick: The New Brunswick Take Home Naloxone (NBTHN) program offers injectable naloxone kits free of charge to people who are at risk of an overdose and to family, friends, and those who are most likely to witness and respond to an opioid overdose. Training is required through BC's Toward the Heart's Take Home Naloxone website. Once an individual completes the training, they receive a certificate which they must show (as a printout or digitally) to collect their kit. All other individuals can purchase kits on their own from a participating survey. Canadian Mental Health Association. Carry it Toolkit, www.cmha.ca/carryit August 2019.
Naloxone 101 Nova Scotia: The Take Home Naloxone program in Nova Scotia offers training and injectable naloxone kits free of charge to people who are at risk of an overdose and to family, friends, and those who are most likely to witness and respond to an opioid overdose. Kits can also be obtained free of charge and without a health card from over 300 locations across the province. This includes 282 community pharmacies, Nova Scotia Health Authority Programs, and several Community Harm Reduction Agencies. Teachers, faculty, and students can obtain kits free of charge upon request through the provincial naloxone program. Northwest Territories: There are no restrictions on naloxone access in the Northwest Territories. Anyone - people who use drugs, friends and family, businesses - can access a free naloxone kit at community health centres and in all pharmacies across the territory (no health card or ID necessary). Prince Edward Island: The Take Home Naloxone program distributes kits free of charge to people who are at risk of an overdose or to the friends and family of someone at risk. All other individuals can purchase kits on their own from a participating pharmacy. Newfoundland and Labrador: The Take Home Naloxone program distributes kits free of charge to people who are at a risk of an overdose or to the friends and family of someone at risk. All other individuals can purchase kits on their own from a participating pharmacy. Yukon: There are no restrictions on Naloxone access in Yukon. Anyone - people who use drugs, friends and family, businesses - can access a free take-home naloxone at community health centres and in all pharmacies across the territory. Individuals who wish to purchase more kits for use in other settings (campuses, workplaces) can purchase them at a pharmacy. Canadian Mental Health Association. Carry it Toolkit, www.cmha.ca/carryit August 2019.
Naloxone 101 Nunavut: The Nunavut Take Home Naloxone Program offers training and injectable naloxone kits free of charge to people who are at risk of an overdose and to family friends, and those who are most likely to witness and respond to an opioid overdose (no ID or health card required). The Department of Health coordinates distribution of naloxone kits to take-home naloxone (THN) distribution sites; there is currently no publicly available list of distribution sites. Naloxone is not available for purchase in retail pharmacies. Veteran Affairs Canada (AVC): Eligible Veterans can receive nasal naloxone spray free of charge from pharmacies under the Program of Choice (POC) 10 coverage. Non-Insured Health Benefits Program (NIHB) Registered First Nations persons and recognized Inuit persons are eligible for nasal naloxone spray for free from pharmacies under the NIHB, though they must show their status card and personal health number to confirm their eligibility to the program. No prescription is required, as this is a Pharmacist Initiated Therapy. Clients will need to provide their 10-digit Status Number. There are no limits on quantity. NARCAN Nasal Spray and kits can be ordered through all pharmacy distributors and wholesalers. NARCAN Nasal Spray can be picked up for the client, a client's friend or their loved ones. The client requesting Naloxone does not have to specify who it is for. However, it will be billed under the name of the client requesting it. All other individuals can purchase kits on their own from a participating pharmacy. Canadian Mental Health Association. Carry it Toolkit, www.cmha.ca/carryit August 2019.

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