A naloxone kit next to a first aid kit at an Ellis Don construction site in Mississauga, Ont. on June 30. Ontario is the first place in North America to require naloxone kits to temporarily reverse overdoses on high-risk job sites.Duane Cole/The Globe and Mail
At the front of a temporary office on a sprawling construction site in Mississauga, a small black zippered pouch perches on a shelf beside a first aid kit. It looks like a toiletry bag, save for the bold white writing that reads “NALOXONE.”
The kit contains a life-saving medication also known as Narcan, which is used to counter the effects of opioid overdoses. Naloxone comes in an easy-to-administer nasal spray, or a needle, and can temporarily reverse an overdose in seconds, buying precious time before paramedics arrive.
Advocates have long promoted naloxone as a last line of defense against an epidemic of toxic street drugs that has claimed thousands of lives throughout Canada. And now the kits are growing more widespread in Ontario, because the province recently became the first jurisdiction in North America to require them at many job sites.
The Ontario government announced in June that employers in the industries where opioid use is believed to be most common must carry naloxone kits and train staff members on how to use them. The affected workplaces include those in retail, health care, accommodation, food services and arts and entertainment.
But almost half of the province’s kits are being sent to construction and manufacturing, which have been hit hardest by the opioid crisis.
According to provincial statistics, 30 per cent of workers who died from opioid-related causes in 2020 were employed in construction, an industry where insiders have pointed to injuries, mental health problems and a “work hard play hard” culture as reasons for the prevalence of addiction.
Over all, according to Public Health Ontario, more than 2,800 Ontarians died from opioid-related causes in 2021. The potent synthetic opioid fentanyl, which other street drugs are sometimes laced with, was involved in 86 per cent of Canada’s accidental opioid deaths that year. In 2022, more than 2,500 people died from opioid-related causes in Ontario, according to provincial statistics.
Ontario Labour Minister Monte McNaughton said in an interview that the government chose to focus on workplaces where there is a high risk of overdose. But he said all employers can benefit from naloxone.
“My goal is to have this in every workplace by the end of the decade,” he said. “More kits in more hands means more saved lives.”
He said one of the benefits of the program has been an opening up of the conversation about addiction and the related stigma. He said this has encouraged people to come forward and ask for support.
But the issue of naloxone kits has been controversial.
During the recent Toronto mayoral campaign, candidate and former Toronto police chief Mark Saunders – who was endorsed by Ontario Premier Doug Ford – released a short video that bemoaned the fact that some families keep naloxone kits at their front doors “in case someone accidentally gets spiked by a needle.” But experts in the field say that statement is misleading and ignores the obvious benefits of the kits.
Mr. McNaughton does not share Mr. Saunders’ criticism. “People are saying we just would let that person die? That’s ridiculous,” he said. “It’s one tool to save lives and combat the opioid epidemic that we have in Ontario.” British Columbia has also purchased kits for construction sites, and has had informal talks with Mr. McNaughton’s office about an expanded version of the program.
Judi Frank, an Alberta-based adviser for the Canadian Red Cross who also volunteers with the organization’s opioid harm reduction program, said there is a need for naloxone programs across the country. She said most deaths from opioids occur because of accidental poisoning from drugs laced with fentanyl, not intentional use.
“Education and awareness that opioid use is not a choice and it can happen to anyone is a big part of what we are trying to do, along with providing the naloxone kits,” she said.
At the construction site in Mississauga, Steve Chaplin opened a naloxone kit to show how easy it is to use the nasal spray. He is senior vice-president for health and safety at the construction company EllisDon, and chair of the Ministry of Labour’s prevention council for workplace health and safety.
Although the kits are legally required only in Ontario, EllisDon has distributed them at its work sites across the country, a process it began about a year before the provincial mandate.
“If one goes missing, we simply replace it, because that means somebody took it. And we’re actually okay with that,” Mr. Chaplin said. “Not everybody likes to go to a pharmacy to get them.”
He said he’s not aware of anyone having used a kit at any of the company’s work sites in Ontario. But he said naloxone is still a worthwhile preventative measure, even for members of the public who come by the sites.
He noted that the kits are not just for heavy drug users. They can also help treat adverse reactions to prescription drugs, or mixtures of medications. A kit could be used to treat a child who had accidentally ingested something from a medicine cabinet at home.
“This would be something that would be good to have at home as a ‘just in case,’ ” he said. “And so that’s what we teach our employees as well. It’s good for the workplace, it’s good for home.”
“This becomes an early intervention that can give you those moments until paramedics or others can come by. I don’t actually see any downside of it.”
Ken Van Sickle, an EllisDon senior site superintendent, said that although he has never witnessed an overdose during his 25 years in the industry, he’s fully supportive of the initiative.
“Why not have another weapon in the arsenal? If you can save someone, we most certainly would do it,” he said. ”We take first aid courses, we do all kinds of safety protocols. Why not include that?”
Jerry Barbosa, the senior health, safety and environment coordinator at the construction site, said the biggest substance issue for construction workers 20 years ago was alcohol.
Both men are now trained in first aid and the use of naloxone kits.
“It’s a life and death situation,” Mr. Barbosa said. “We’re not thinking about the politics or anything like that. We’re just trying to help save a life.”