Taking Action to Prevent Opioid Addiction and Overdose
Here's what Ontario is Doing to Combat the Opioid Crisis
BACKGROUND information for: Ontario Expanding Opioid Response as Crisis Grows
The province is continuing to take action and make significant investments to combat the opioid crisis. These comprehensive initiatives include:
- Formed the Methadone Treatment and Services Advisory Committee to provide advice to the Minister of Health and Long-Term Care.
- Created the Executive Steering Committee on Opioid Surveillance in Ontario to support the development of an opioid surveillance system across sectors, including identifying existing surveillance methods, strategies for strengthening data collection, and gaps in current data sources.
- Completed the Final Report of the Methadone Treatment and Services Advisory Committee.
- Building on the free naloxone program for clients of needle exchange programs and hepatitis C teams, expanded access to free naloxone in pharmacies. Naloxone is now available in over 2,000 pharmacies in over 260 cities and towns across Ontario.
- Released the Strategy to Prevent Opioid Addiction and Overdose, a comprehensive plan to ensure people in pain receive appropriate treatment, increase access to holistic treatment for those with opioid use disorder, and improve the safety and health of people who use opioids, including access to the life-saving drug naloxone.
- Launched a pilot program to grant health care providers access to patient dispensing history at the point of prescribing. Work is ongoing to expand access to all providers across the province.
- Increased access to buprenorphine/naloxone (brand name Suboxone) by moving it to a General Benefit on the Ontario Drug Benefit (ODB) Formulary. Buprenorphine/naloxone is proven to be more effective and safer than methadone for many people with opioid use disorder.
- Expanded training and support to primary care providers, via case-based learning and video-conferencing sessions, to support effective management and treatment of chronic pain.
- Appointed Dr. David Williams, Ontario's Chief Medical Officer of Health, as Ontario's Provincial Overdose Coordinator to increase access to information concerning fatal and non-fatal opioid-related overdoses.
- Provincial expansion of the fentanyl Patch for Patch program.
- Invested $17 million annually in 17 multidisciplinary chronic pain management programs across Ontario.
- Worked with the federal, provincial and territorial governments to establish a Special Advisory Committee (SAC) on the Epidemic of Opioid Overdoses to focus on urgent issues related to overdoses and deaths linked to the use of opioids, including those laced with bootleg fentanyl and carfentanil.
- Delisted high strength, long-acting opioids from the Ontario Drug Benefit Formulary.
- Committed to providing funding support for supervised injection services in Toronto and Ottawa, and developed a provincial framework to work with other municipalities that may also submit a request.
- Expanded access to buprenorphine/naloxone by working with the College of Nurses to enable Nurse Practitioner prescribing.
- Worked with the Ministry of Community Safety and Correctional Services to complete implementation of the take-home naloxone program for at-risk inmates released from all 26 provincial correctional institutions.
- Enhanced reporting of opioid overdoses in emergency departments by working with hospitals to collect data on a weekly basis.
- Invested additional funding to expand programs in the 17 existing chronic pain clinics and to create an 18th chronic pain clinic to serve Sudbury and the surrounding area.
- Invested $245 million over three years to enhance referral pathways for the treatment of back pain and other bone and joint conditions, including using new digital tools like eReferrals and the expansion of a central intake system for each LHIN.
- Publicly launched the Interactive Opioid Tool, which provides opioid-related mortality and morbidity data for all Public Health Units and Local Health Integration Networks across Ontario.
- Made nasal spray naloxone available in all provincial correctional institutions for a nurse or operational manager to administer when opioid overdose is suspected. Started to roll out training across the province for correctional officers to use naloxone.
- Announced a new annual investment for more front line workers at public health units to support local opioid response initiatives, including expanding naloxone distribution through eligible community-based organizations, such as shelters, outreach organizations, AIDS Service Organizations, Community Health Centres, Aboriginal Health Access Centres, and withdrawal management programs. Public health units are also working to establish or enhance existing local opioid initiatives.
- Hosted a meeting of mayors from across Ontario to discuss local opioid issues in their respective communities and seek advice to further strengthen Ontario's response to this crisis.
- Updated the Opioid Strategy to incorporate feedback from broad public consultations with health care providers, professional associations and colleges, academics, front-line workers, and people with lived experience and their friends and families.
- Announced an investment of $222 million over three years to fight the opioid crisis, including over $15 million to support health care providers on appropriate pain management and opioid prescribing; over $7.6 million to increase addictions treatment in primary care; $70 million on long-term support for people who have addiction disorders; $9 million to add more front line harm-reduction outreach workers in communities across the province; and, beginning in 2018-19, $20 million over two years for specialized support for Indigenous communities and developmentally appropriate care for youth.
- Updated the Interactive Opioid Tool to include emergency department visit data from April 1 - September 30, 2017.
- Provided immediate investments to help community-based addiction organizations in their response to this crisis, including adding more front line workers to provide counselling, case management and other wrap around supports. In addition, funding will continue to enhance withdrawal management and rapid access to addictions medicine clinics, including buprenorphine/naloxone treatment, counselling and urgently needed community-level connections to longer-term comprehensive care.
- Expanding treatment for opioid use disorder throughout family health teams across the province by partnering with the Centre for Addiction and Mental Health (CAMH).
- Enhancing community-based and residential treatment options to help people in crisis and connect patients with appropriate treatment options.
- Creating new harm reduction/peer outreach worker positions to connect vulnerable populations with necessary harm reduction supports.
- Increased investments to support existing harm reduction programs, including existing Needle Exchange/Syringe Programs and the Ontario Harm Reduction Distribution Program.
- Providing increased funding to the Ontario Naloxone Program in order to address increasing demand for naloxone and program growth.
- Invested in additional education and training resources for health care providers, such as one-on-one educational outreach services and mentorship opportunities.
- Supplying fentanyl test strips in all operational supervised injection services and pop-up sites.
- Expanding access to provincially funded naloxone through front line community organizations such as shelters, outreach programs, AIDS Service Organizations, Community Health Centres, Aboriginal Health Access Centres, and withdrawal management programs.
- Working with Health Quality Ontario and other system partners to implement a comprehensive continuing professional development model to provide coordinated education, training and support to health care providers on appropriate opioid and opioid replacement therapy prescribing.
- Established an Opioid Emergency Task Force that includes front-line workers and people with lived experience to strengthen the province's coordinated response to the opioid crisis.
- Opening and expanding Rapid Access Addiction Medicine clinics across the province in over 30 communities.
- Expanding access to provincially funded naloxone kits by offering it to interested police and fire services.
- Launching targeted public education campaign to raise awareness about the potential dangers of opioids -- and how people can protect themselves and their loved ones against harm and death.
In Spring/Summer 2018, Ontario will:
- Expand specialized services, including culturally appropriate care for Indigenous communities and developmentally appropriate care for youth 25 and under.
- Release Health Quality Ontario's new evidence-based quality standards on appropriate opioid prescribing for acute pain, appropriate opioid prescribing for chronic pain, and opioid use disorder. Drafts of these standards were publicly posted on Health Quality Ontario's website for comment in September 2017.
- Provide new funding to support the distribution of naloxone kits from hospital emergency departments, increasing access to naloxone for those who need it.
- Providing mentoring, education and other supports for physicians to learn best practices for supporting people with opioid use disorder, and for safe opioid prescribing and effective approaches to managing pain.
- Providing new funding to support the creation of at least three new supervised injection services, in addition to the four sites that the Ontario government is funding in Toronto and Ottawa. The province will also support other supervised injection services proposals that meet provincial funding criteria.
- Continuing to explore opportunities to make nasal spray naloxone available to more Ontarians.
- Continuing to work with Indigenous partners to increase access to culturally appropriate mental health and addictions services.
- Improving patient education and access to information related to opioid use and related harms.
- Equipping health care providers with more training tools, supports and resources to deliver comprehensive and integrated care for chronic pain.