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Alberta's provincial take-home naloxone program: A multi-sectoral and multi-jurisdictional response to overdose

Lisa K. Freeman, Stacey Bourque, Nick Etches, Karin Goodison, Claire O’Gorman, Kay Rittenbach, Christopher A. Sikora, Mark Yarema

Abstract


SETTING: Alberta is a prairie province located in western Canada, with a population of approximately 4.3 million. In 2016, 363 Albertans died from apparent drug overdoses related to fentanyl, an opioid 50–100 times more toxic than morphine. This surpassed the number of deaths from motor vehicle collisions and homicides combined.

INTERVENTION: Naloxone is a safe, effective, opioid antagonist that may quickly reverse an opioid overdose. In July 2015, a committee of community-based harm reduction programs in Alberta implemented a geographically restricted take-home naloxone (THN) program. The successes and limitations of this program demonstrated the need for an expanded, multi-sectoral, multi-jurisdictional response. The provincial health authority, Alberta Health Services (AHS), used previously established incident command system processes to coordinate implementation of a provincial THN program.

OUTCOMES: Alberta’s provincial THN program was implemented on December 23, 2015. This collaborative program resulted in a coordinated response across jurisdictional levels with wide geographical reach. Between December 2015 and December 2016, 953 locations, including many community pharmacies, registered to dispense THN kits, 9572 kits were distributed, and 472 reversals were reported. The provincial supply of THN kits more than tripled from 3000 to 10 000.

IMPLICATIONS: Alberta was uniquely poised to deliver a large, province-wide, multi-sectoral and multi-jurisdictional THN program as part of a comprehensive response to increasing opioid-related morbidity and mortality. The speed at which AHS was able to roll out the program was made possible by work done previously and the willingness of multiple jurisdictions to work together to build on and expand the program.


Keywords


Fentanyl; take-home naloxone; harm reduction; opioid overdose

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DOI: http://dx.doi.org/10.17269/cjph.108.5989