1. The Take Home Naloxone Program in British Columbia, Canada Erin Gibson, Despina Tzemis, Jane Buxton BC Centre for Disease Control Harm Reduction Program outreach@towardtheheart.com Webpage: towardtheheart.com

2. Outline Background The BC Harm Reduction Program BC Take Home Naloxone (THN) Program Questions 2

3. Who we are 3

4. BC Harm Reduction Program BC CDC coordinates: ▫Harm Reduction Strategies and Services Committee ▫Drug Overdose and Alert Partnership Committee Committees: ministry of health, health authorities, first nations input, & people who use drugs, among other stakeholders. What we do: ▫Develop evidence-based policies ▫training resources ▫proper messaging & distribute safer drug use supplies ▫develop programs to address needs in the community www.towardtheheart.com 4

5. Needles/Syringes 5

6. www.towardtheheart.com/naloxone 6

7. Background: Overdose (OD) in BC Opioid OD is a public health concern in BC BC Coroner’s Service reported 275 deaths were attributed to drug overdose (2011) A cluster of drug overdose deaths were associated with high purity heroin (2011) 70 deaths were attributed to prescription opioid medication (2009) Opioid OD death can be prevented by using naloxone (also known as Narcan®). Naloxone is an opioid antagonist that works to reverse the effects of an opioid OD Take Home Naloxone (THN) Programs worldwide: US, Canada, UK, Estonia, Russia, Afghanistan, Cambodia, Australia and Africa Four programs in Canada: Edmonton (2005), Toronto (2011), Ontario (2012), and BC (2012) BC is unique because naloxone is a prescription only medication (POM). Naloxone is not available on PharmaCare. 7

8. The BC THN program The BC THN program webpage is a one-stop-shop. Information includes: FAQs Program Implementation guidelines Training resources (including videos) Program evaluation materials And much more! Visit: www.towardtheheart.com Sites in taking part in the BC THN program need to identify: an educator, prescriber, and a dispenser. The BCCDC provides the naloxone kits to THN sites. Copies of the: training attendance sheet; naloxone prescriptions; dispensing forms, and client administration form are faxed back to the BCCDC. All kits dispensed have a tracking number: important for program evaluation. 8

9. 9

10. The BC THN program The BC THN program webpage is a one-stop-shop. Information includes: FAQs Program Implementation guidelines Training resources (including videos) Program evaluation materials And much more! Visit: www.towardtheheart.com Sites in taking part in the BC THN program need to identify: an educator, prescriber, and a dispenser. The BCCDC provides the naloxone kits to THN sites. Copies of the: training attendance sheet; naloxone prescriptions; dispensing forms, and client administration form are faxed back to the BCCDC. All kits dispensed have a tracking number: important for program evaluation. 10

11. Each Kit Contains: 2 glass amps of 0.4mg/ml naloxone wrapped in gauze inside a pill bottle Label includes prescription info 2 retractable VanishPoint® safety syringes 3cc – 25g x 1” 2 alcohol swabs 2 latex gloves One-way rescue breathing barrier mask THN Administration Information Form Steps to respond to opioid overdose Recovery Position 11

12. Sites taking part Vancouver City -Insite -SALOME -VANDU -Vancouver Detox (soon) Interior BC -Vernon -Nelson -Kamloops 12

13. Legal Opinion ▫Health Canada ▫Ministry of Health ▫PIVOT legal ▫Ethicists ▫Canadian Medical Protection Association 13

14. Program to date… 300 kits sent to sites ~80 prescriptions returned ~6 OD reversals to date Focus groups/interview with stakeholders 14

15. Discussion We want to learn from your experiences Contact: outreach@towardtheheart.com outreach@towardtheheart.com 15

16. Thank you! Acknowledgements All the sites taking part in the BC THN program Our community board and those who helped/consulted with us Folk at the BC CDC who support this program Questions? Contact information: outreach@towardtheheart.com outreach@towardtheheart.com 16