Naloxone in Ontario workplaces

What you need to know as an employer

Published on

August 30, 2023

Did you know that in June, Ontario became the first jurisdiction in North America to mandate that some employers provide a naloxone kit in the workplace? Read more here.

If you have questions about what this means for you as an employer, below we’ve summarized what naloxone is, which employers are legally required to provide it, how we’ve implemented it in our workplace and more.

We’ve also included a series of links to further resources and useful information.

First things first, what is naloxone?

Naloxone (pronounced “na-LOX-own”) is a potentially life-saving medication that can temporarily reverse an opioid overdose, restore breathing within two to five minutes, and allow time for medical help to arrive. 

It is administered either as a nasal spray or an injection into a muscle. Naloxone is safe for all ages. It works only if you have opioids in your system and is safe to keep on hand because it cannot be improperly used and does not create dependence.

By adding a naloxone kit to your emergency response plan, you can boost your ability to protect the health and safety of your workers.

Read: What is in a naloxone kit?

Read: Naloxone: Save a Life (fact sheet)

What are opioids?

Opioids are drugs that are used primarily to treat pain. Since opioids can also induce euphoria (feeling high), they have the potential to be used improperly.

When people think about problematic opioid use, they often think about illegal opioids, such as heroin or fentanyl. However, problematic use can also occur when people consume a legal, prescribed opioid improperly, such as taking more than is prescribed, taking it at the wrong time, or using an opioid medicine that was not prescribed for you.

Legal opioids are prescribed by a health care professional, most often to treat pain from conditions such as sports injuries, dental procedures, short-term acute pain or long-term chronic pain. They include:

codeine
fentanyl
morphine
oxycodone
hydromorphone
medical heroin
methadone
buprenorphine

Illegal opioids are any opioids that are made, shared or sold illegally, including:

street drugs
opioids given to you by someone who is not your health care provider
opioids that are not prescribed to you but are stolen or taken from someone else

Note: It is illegal to have opioids without a prescription or to share them with someone—even if you give them away.

Anyone who consumes an opioid drug, whether legal or illegal, can overdose.

Accidental overdose is particularly common with illegal drugs because they can contain dangerous substances like fentanyl, a powerful synthetic opioid that is prescribed to treat severe pain. Fentanyl is 100 times more potent than morphine, which makes the risk of accidental overdose very high, especially since there is no way to know how much fentanyl has been mixed into illegal drugs—you can’t see, smell or taste it—and consuming as little as a few grains of salt worth of fentanyl can kill you.

Why is this legislation important?

The opioid crisis has resulted in:

More than 36,000 deaths across Canada since 2016.
An average of 20 deaths per day across Canada in 2022 alone—the majority of which were accidental overdoses.

According to the Government of Canada, 94% of opioid overdose deaths happen by accident.

Overdoses can occur anywhere, including at work, and it's not only recreational drug users who are at risk. Anyone who takes prescribed, opioid-based medication for pain management (for example, codeine, oxycodone or morphine etc.) could experience an overdose.

If administered in time, naloxone could save someone’s life.

Which employers are legally required to provide a naloxone kit in the workplace?

The legislation mandates that an employer provide a naloxone kit in the workplace when they “become aware, or ought reasonably to be aware, there may be a risk of a worker having an opioid overdose at the workplace."

Read more here: Naloxone in the workplace

Specifically, you must provide a kit and train at least two staff members per workplace to use it only if all three of the following conditions are met (if one or more of these conditions is not met, you’re not legally required to provide a naloxone kit):

There is a risk of a worker opioid overdose. You may become aware of this risk if:
• A worker opioid overdose has already occurred in your workplace.
• One of your workers has voluntarily disclosed this risk (note: you cannot ask workers to divulge this information).
• You have witnessed opioid use among workers in your workplace or discovered discarded opioid paraphernalia, such as used needles, in your workplace.
• Someone in your workplace has brought this risk to your attention.
There is a risk that the worker overdoses while in the workplace where they perform work for the employer.
• Note: The requirement does not apply if there is a risk of an overdose happening outside of your workplace (for example, at the worker’s home or an offsite location). 
The risk is posed by a worker who performs work for the employer.
• Note: While you may not legally need to provide a naloxone kit when the at-risk worker does not work for you (e.g., a contractor who works on your site), in the case of our candidates on assignment, the Ontario government considers their health and safety the joint responsibility of our client employers and our firm. Read more below.

Where can you get a free naloxone kit?

The Ontario government supports eligible employers by providing a free nasal spray naloxone kit, along with free training for up to two employees. Many pharmacies also provide free naloxone kits and online training (call ahead to make sure they have kits in stock). 

For details on free kits, please see:

Canadian Red Cross info
St. John Ambulance info
Where to get a free naloxone kit – a map showing where you can get free naloxone kits and training on how to use them.

What are the training requirements?

If you have a kit, you must ensure that you have at least two staff members trained to administer naloxone, and that these trained staff members work close to the kit, at the location where you have determined there is a risk of an opioid overdose.

The legislation states that employers can provide their own training, hire an external training provider, or include naloxone training as part of another training course such as First Aid.

Training should cover how to recognize an opioid overdose, how to administer naloxone, and the hazards related to administering naloxone. Ideally, you should train two or more people to provide as much coverage as possible.

Sign up for free online training at the Canadian Red Cross
Sign up for free online training through St John’s Ambulance (max. two employees per work location)
Watch: How to Administer Naloxone Nasal Spray (short video)

What if your employees are home-based?

Ontario’s legislation applies only when the above three conditions are met (i.e., when an at-risk employee is performing work for their employer at the employer’s workplace).

It does not apply when at-risk employees perform their work at other locations or at their home office, nor does it apply when an at-risk contractor is working on your site.

In the case of our candidates on assignment, please see below.

How have we implemented the naloxone legislation at Altis?

We take the health and safety of our employees and assigned candidates very seriously.

Even though we’re not legally required to provide a naloxone kit in our own workplace (based on our assessment, we do not meet the three conditions listed above), in the interest of the health and safety of our team members, we have placed naloxone kits in each of our offices and trained multiple staff members to use them.

How does this legislation apply to our candidates on assignment?

Our primary goal is to ensure a safe, productive working environment for our candidates on assignment.

While this new legislation doesn’t outline the roles and responsibilities of each party when an at-risk contract or temporary worker is placed by a recruitment firm, in general, the Ontario government looks at the health and safety of these candidates on assignment as a shared responsibility between recruitment firms and their client employers.

Therefore, if one of our candidates on assignment voluntarily discloses to us that they are at risk of an opioid overdose, as with all other health and safety concerns, we’ll work with our client to create a safe working environment for the candidate, informing our client of the risk and providing information about naloxone kits and training.