Ontario Harm Reduction Conference April 30 to May 2, 2017 Toronto, Ontario

Transcription

1 Ontario Harm Reduction Conference April 30 to May 2, 2017 Toronto, Ontario Views expressed in the attached document do not necessarily represent those of the Ministry of Health and Long Term Care or those of Kingston Community Health Centres. If you have any questions related to the document, you are encouraged to contact the source.

2 Ontario Naloxone Program Joanne Lush AIDS & Hepatitis C Programs, Provincial Programs Branch Negotiations and Accountability Management Division Ontario Ministry of Health and Long-Term Care May 1, 2017

3 Support for Harm Reduction Scientifically demonstrated to reduce risks of contracting HIV and HCV; Cost-effective and cost-saving compared to burden of disease and associated long-term costs of health care treatment; Effective in connecting clients with drug treatment programs, HIV and HCV related care, opioid agonist therapy, naloxone distribution programs and primary care services. Community-based take home naloxone programs have been shown to reduce negative health outcomes associated with opioid overdose. Strategy to Prevent Opioid Addiction and Overdose Transformation Agenda Ontario Hepatitis C Strategy Harm Reduction Programs Patients First HIV/AIDS Strategy for Ontario Excellent Care for All Act, 2010 Mental Health and Addictions Strategy 2

4 Current MOHLTC support for harm reduction services Provincial Programs Branch (NAMD) is a lead for harm reduction programs managing funding and accountability, for key harm reduction stakeholders: outreach to people who use drugs (IDU + Hep C teams), Distribution of harm reduction materials, including naloxone (OHRDP, ONP) KTE activities and network support (OHSUTP, OHRDP, etc ) Disease Prevention Policy & Programs Branch (PPHD) manages funding and accountability for: Needle Exchange Programs Acute Care Enhanced Surveillance system supervised injection services (SIS) Additional MOHLTC related funding includes: Ontario Public Drugs Program Ontario Naloxone Program for Pharmacies & Opioid Agonist Therapy (OAT). Strategic Policy and Programs Division complementary services for people on OAT 3

5 Naloxone An opiate antagonist which works by displacing opioids from their receptor sites. It is indicated for the treatment of respiratory depression caused by opioids Naloxone can reverse the effects of overdose if used within a short period following an opioid overdose and can be administered intravenously, intramuscularly, nasally & subcutaneously Outside of EMS and hospital settings, dosages used include: 0.4mg (1ml) injectable dose and 4.0mg (0.1ml) nasal spray dose Both products when indicated for emergency use for opioid overdose outside hospital settings, have been classified as Schedule II (behind the counter) drugs in NAPRA's National Drug Schedule 4

6 Ontario Naloxone Program (ONP) One of several publicly funded naloxone distribution programs by MOHLTC Established on October 7, 2013 Aligns with a recommendation from the Minister s Expert Working Group on Narcotic Addiction, to: Increase and sustain the availability of Naloxone overdose prevention kits and harm reduction information and materials via public health units across the province. 5

7 ONP Eligible sites Core Needle Exchange Programs (NEPs/NSPs) housed at public health units (PHUs) Community-based organizations that have been contracted to manage core NEPs/NSPs by their local PHU Provincial Hepatitis C Teams Currently: 40 of 52 eligible sites are participating 6

8 Who can access naloxone through the ONP? Active clients of NEPs/NSPs and Hepatitis C Teams who are at-risk of opioid overdose Friends and family of these clients Newly released inmates who are at-risk of opioid overdose Other organizations may refer their clients to ONP sites if they fit this criteria above individuals can be referred to the ONPP For more information and where to find a naloxone kit near you: ontario.ca/page/get-naloxone-kits-free 7

9 Transition to Nasal Spray On January 1, 2017, the ONP migrated to nasal spray naloxone (Narcan Nasal Spray) Between January 1 and March 21, 2017, ONP sites ordered 3,559 pre-assembled nasal spray naloxone kits 8

10 9 Pre-assembled nasal spray naloxone kit

11 ONP data Between October 7, 2013 & December 31, 2016: ONP sites distributed 8,460 injectable naloxone kits 1,365 administrations of naloxone, that was provided through the ONP, were reported 911 was reported to have been called 523 times when naloxone, that was provided through the ONP, was used 10

12 Transition to Chest Compressions On April 19, 2017, the Chief Medical Officer of Health released new resuscitation guidelines to be included in publicly funded naloxone kits: [C]hest compressions only is the most appropriate resuscitation measure for lay people who are not trained in CPR to administer during an opioid overdose. This intervention is preferred because it can address the effects of both a respiratory and cardiac arrest, and it can significantly improve a victim s chance of survival. 11

13 Expansion of ONP The government is currently exploring additional access points for publicly funded naloxone Ministry planning for ONP expanded access will begin later in 2017/18. As previously, we will be looking to existing ONP sites to advise us on potential sites in their community (post survey) Potential new sites for ONP include community health centres, AIDS service organizations, outreach programs, and shelters Organizations that are not eligible to access publicly funded naloxone are able to purchase it directly from the manufacturer 12

14 Promoting Access to Naloxone The ministry launched a new Ontario.ca website about naloxone and opioid overdose for the general public in March, including a locator tool to direct Ontarians to participating ONP, ONPP and MCSCS sites - Ontario.ca/OpioidOverdose ( In the coming weeks, the ministry s professionals webpages ( ) will be updated to provide professionals with information on Ontario s publicly-funded naloxone programs (e.g. information on program eligibility criteria) On April 11th, the ministry launched a communications campaign promoting the ONP and ONPP. Campaign components include print and social media, local media interviews, and YouTube videos 13

15 14 Other publicly funded naloxone distribution programs

16 Provincial Correctional Facilities Take Home Naloxone Program Collaborative initiative between MCSCS and MOHLTC Currently 10 facilities participating Full implementation to provincial correctional facilities expected by April 30, 2017 From Oct 31, 2016 to: April 2, 2017: 572 nasal spray naloxone kits have been distributed 15

17 Ontario Naloxone Program for Pharmacies Managed by Ontario Public Drug Programs (OPDP) and currently distributes injectable naloxone kits As of March 31, 2017, over 17,500 injectable naloxone kits have been distributed by over 1000 participating pharmacies in over 200 cities Participating pharmacies procure necessary kit supplies and assemble the kits themselves OPDP continues to work with stakeholders and partners in the pharmacy sector, who have been active in delivering pharmacy services. They have been communicating to their members about new developments and information involving the ONPP, as well as encouraging participation 16

18 Questions? For more information and where to find a naloxone kit near you: ontario.ca/page/get-naloxone-kits-free Contact for ONP: For more information about ONP, contact Ken English (ken.english@ontario.ca ) or Christine Conrad (christine.conrad@ontario.ca ) Contact for ONPP: For more information about ONPP, talk to a pharmacist who is participating in the ONPP, or PublicDrugPrgrms.moh@ontario.ca 17