Naloxone kits mandatory in some Ontario workplaces, aimed at saving lives in Thunder Bay and beyond

As the number of overdose-related deaths continues to rise in Ontario, the provincial government has made it mandatory for some workplaces to have naloxone kits on hand to reverse the effects of an opioid overdose.

Ontario reported 1,853 opioid-related deaths between January and September 2022, according to the latest available data from Statistics Canada. 

Thunder Bay had the highest opioid toxicity mortality rate in the province in 2022, at 77.2 per 100,000 population, significantly higher than the provincial rate of 17.6 per 100,000, according to preliminary data from the Office of the Chief Coroner released last month. The northwestern Ontario city also led the province in opioid deaths per capita in 2021.

Under the new legislation, workplaces must have naloxone kits if these three scenarios apply:

• There is a risk of a worker opioid overdose.
• There is a risk someone overdoses while in a workplace where they perform work for the employer.
• The risk is posed by someone who performs work for the employer.

"My goal is by the end of this decade to have a naloxone kit in every single workplace across the province," Monte McNaughton, Ontario's labour minister told CBC News.

Essentially, the legislation only covers employees at their place of work; the OHSA requirements do not apply if the risk of an opioid overdose is created by a customer, patient or other member of the public in or near a workplace.

A workplace may be considered at high risk of having an employee overdose if:

• An employer has witnessed a staff member using opioids at work.
• They have seen drug supplies on site.
• They've witnessed an employee overdose at work in the past.
• An employee has voluntarily disclosed they use opioids.
• A health and safety, human resources or union representative has told an employer there is a high risk.

The Ministry of Labour is easing into the legislation with an education-first approach, "and as time goes on, enforcement will be beefed up," McNaughton said.

"We want people to come forward. We are doing this to save lives, to reduce the stigma, to increase awareness for opioid addiction out there," he said.

Workplaces that meet the criteria for mandatory naloxone but do not provide it may face fines.

However, McNaughton said, "I believe that employers out there overwhelmingly do a good job. They want to do a good job to help their employees and the general public."

Naloxone isn't harmful to a person who hasn't overdosed but is given the medication. Regardless, under the Good Samaritan Act, anyone administering naloxone to someone who has overdosed is protected from being arrested.

Construction industry targeted

The construction and manufacturing sectors accounted for 45 per cent of workplaces in Ontario's Naloxone Program.

According to Public Health Ontario, the construction industry is disproportionately impacted by the opioid problem —nearly one in 13 opioid-related deaths occurred among construction workers between 2018 and 2020. Among the construction workers who died, over half were employed at the time, the report says.

Harold Lindstrom, manager of the Construction Association of Thunder Bay, said contractors have been gearing up for the naloxone requirements since January and most workplaces in the sector already have the kits. 

Most businesses have received their kits at no cost, whether from the Red Cross, NorWest Community Health Centres or a pharmacy, and training is available online or from a health-care professional.

"Lots of companies have established already that … all their employees that come in, it's part of their initial training when they come on," Lindstrom said.

CBC News reached out for statistics from the Workplace Safety and Insurance Board, but was told no data was available on overdose deaths among Thunder Bay construction workers specifically.

Juanita Lawson is chief executive officer of NorWest Community Health Centres, which houses northwestern Ontario's only safe consumption site, Path 525, at its Thunder Bay office.

Research in British Columbia has shown workplace culture has a significant impact on whether people talk about substance use and treatment, and there is a need to foster a safer environment for these discussions, said Lawson. 

"There's a growing demand for skilled trades, but we also know there's higher injuries, right, as a result of the work that they're doing. And so with that then comes more pain-related management that needs to take place," Lawson said.

Work is underway for new programs in northwestern Ontario that are focused on mental health and addictions treatment among people in the construction and mining sectors, she said.

Preventive measures needed

While having naloxone readily available is important, Lawson said more needs to be done to prevent opioid-related overdoses from happening.

Progress has been made locally, with the opening of Path 525, the Rapid Access Addiction Medicine Clinic, and the new drug analyzer that can test street drugs for deadly substances. 

But one of the biggest challenges is reaching those who are hesitant to access support, she said.

"There's still this need to really reach a group of people … where we realize and recognize that they will probably never ever come into a consumption and treatment service," Lawson said.

Research is underway in partnership with Lakehead University in Thunder Bay to look at what is happening among people using substances and what their concerns are, and what may lead them to use alone, something that puts them at greater risk of harm.

Lawson encourages people to download the free Lifeguard Digital Health app, available in Thunder Bay, Sioux Lookout, Fort Frances, Rainy River and Greenstone.

The app includes a use-alone timer, which sends an alert to medical professionals if a person doesn't stop the timer, meaning they may have overdosed, and information about how to use naloxone, and how to access mental health and addictions support.

"Naloxone in workplaces is really important, but again, I think it's part of the conversation and it can't be the only thing that we offer," Lawson said.

"Those [preventive] pieces are really, really important in all of our workplaces and all of our lives — that we need to have conversations that are supportive."

More information about the naloxone requirements is available on the provincial government's website.