An overdose occurs when a person uses a drug or combination of drugs at a higher dosage level than the body can handle. The person may pass out, stop breathing, or experience heart failure, seizure or death.

What are the signs and symptoms of an opioid overdose?

Recognize the signs and symptoms of an overdose, including:

• Difficulty walking, talking and staying awake
• Blue or purple lips or nails
• Very small pupils
• Cold and clammy skin
• Dizziness and confusion
• Extreme drowsiness
• Choking, gurgling or snoring sounds
• Slow, weak or no breathing
• Inability to wake up, even when shaken or shouted at

If you think someone is overdosing, call 911 immediately. For more information about opioid overdose, visit Health Canada or Ontario.ca/opioids

Who is at risk of an opioid overdose?

You or your friend or family member is at risk of an opioid overdose if you/they:

• Are taking prescription opioids that were not prescribed to you/them and could be too strong
• Are buying opioids from the street and don’t know how strong they are
• Have bought street drugs laced with opioids
• Have overdosed on opioids before
• Are mixing opioids with other downers like alcohol or benzodiazepines (e.g., Valium, Xanax)
• Have stopped using opioids for a while (this lowers tolerance)
• Are using opioids alone
• Are using opioids in a new or different way (e.g., injecting, snorting or crushing)
• Are taking a higher dose than normal
• Are living with or have a history of mental illness (e.g., depression, psychosis)
• Are living with health issues (e.g., liver, kidney, heart, breathing issues)
• Lack sleep (impaired judgment) or food
• Are in a hurry to use
• Have a new dealer or are using unknown substances

How to reduce the risk of an opioid overdose

• Do not mix drugs or take drugs with alcohol. The risk of overdose increases if opioids are mixed with alcohol, sleeping or anxiety pills, other opioids or other prescription medications
• Do not use alone. Make sure someone is around to check on you in case you overdose
• Try a small amount first. If switching to a stronger opioid, use less and do a test dose
• Start low and go slow if using opioids after cutting down, or not using for a while
• Have and be trained to use naloxone

Create an overdose plan

Talk with your friends and family about overdose and create a realistic plan you can use in the event of an overdose. Make sure they know where you keep your naloxone.

What is naloxone?

Naloxone is a non-opioid medication that counteracts the effects of opioid overdose. Naloxone is available as an injection or a nasal spray. Always call 911 if someone is overdosing on opioids, whether or not naloxone is used.

Who can get naloxone?

• Naloxone is available without a prescription, at no cost for people who are at risk of opioid overdose and for concerned friends and family members of those at risk of opioid overdose
• If you are a community agency interested in becoming a naloxone distribution site, please contact the Substance Use Prevention and Harm Reduction Program at 1-877-464-9675 ext. 76683 or email substance@york.ca

Where can I get naloxone?

Family and friends are encouraged to pick up a naloxone kit at no cost to support those using opioids who are at risk of overdosing.

You can get naloxone from:

• Participating pharmacies: Visit ontario.ca/page/where-get-free-naloxone-kit
• Participating community agencies
  • Addiction Services for York Region 1-800-263-2288 or 905-841-7007
  • AIDS Committee of York Region 1-800-243-7717 or 905-884-0613
  • Caritas School of Life 1-800-201-8138 or 416-748-9988
  • The Krasman Centre 1-888-780-0724 or 905-780-0491
  • 360°Kids 905-475-6694; for youth and young adults aged 16 to 26
  • Inn from the Cold 905-895-8889
  • The Vitanova Foundation 905-850-3690 or 416-744-8940
• York Region Public Health
• Substance Use Prevention and Harm Reduction Program 1-877-464-9675 ext. 76683 or email substance@york.ca
• Sexual Health Clinics 1-800-361-5653 or TTY 1-866-252-9933, select “1” or “Sexual Health Line”

Where can I get help?

To get help for an addiction, please contact your health care provider, Addiction Services for York Region or access other community supports in York Region.

The Opioid Education and Response Workgroup

The Opioid Education and Response Workgroup (OERW), in consultation with people who have lived experience, developed the York Region Opioid Action Plan that outlines recommendations to reduce opioid harms under four distinct pillars:

• Prevention
• Harm reduction
• Treatment
• Enforcement and first response

In addition to actions under the four pillars, the Opioid Action Plan calls for ongoing monitoring of opioid-related trends followed by early warning and response, as required. The Plan also highlights the need to address stigma surrounding substance use and addiction and the importance of agency participation and collaboration.

The OERW is co-chaired by York Region Public Health and York Regional Police. Partners include: Addiction Services for York Region, 360 Kids, a local doctor specializing in addiction medicine, AIDS Committee of York Region, a community member, Central Local Health Integration Network, Georgina Fire and Emergency Services, Krasman Centre, Loft Crosslinks Outreach Van, Ontario Addiction Treatment Centres, Total Health Pharmacy, TrueNorth Medical Centres, Vaughan Fire and Emergency Services, York Catholic District School Board, York Region District School Board, York Region Paramedic and Senior Services, York Region Social Services, York Region Strategies and Partnerships, and York Support Services Network.

How to Participate

Community partners, stakeholders, healthcare professionals and organizations are encouraged to incorporate aspects of the York Region Opioid Action Plan in their organizational plans and professional practice.

York Region Opioid Action Plan

York Region Opioid Action Plan Executive Summary

For more information please contact the Substance Use Prevention and Harm Reduction Program at 1-877-464-9675 ext. 76683 or email substance@york.ca

This program is based on a harm reduction approach that encompasses a range of practical strategies and ideas focused on reducing the harmful consequences associated with drug use and other risky health behaviours ¹. York Region Public Health currently supports three parts of the harm reduction supplies and distribution program, including:

• Naloxone distribution
• Needle supplies/exchange
• Safer crack/crystal meth smoking supplies

Naloxone distribution

Naloxone is available at no cost in York Region at participating pharmacies, public health offices and clinics, and some community agencies. Police and fire services can also pick up naloxone from York Region Public Health.

If you are a community agency interested in becoming a naloxone distribution site, please contact the Substance Use Prevention and Harm Reduction Program at 1-877-464-9675 ext. 76683 or email substance@york.ca

You can get naloxone at no cost from:

• Participating pharmacies: Visit ontario.ca/page/where-get-free-naloxone-kit
• Participating community agencies
  • Addiction Services for York Region 1-800-263-2288 or 905-841-7007
  • AIDS Committee of York Region 1-800-243-7717 or 905-884-0613
  • Caritas School of Life 1-800-201-8138 or 416-748-9988
  • The Krasman Centre 1-888-780-0724 or 905-780-0491
  • 360° kids 905-475-6694; for youth and young adults aged 16 to 26
  • Inn from the Cold 905-895-8889
  • The Vitanova Foundation 905-850-3690 or 416-744-8940
• York Region Public Health
  • Substance Use Prevention and Harm Reduction Program 1-877-464-9675 ext. 76683 or  email substance@york.ca
  • Sexual Health Clinics 1-800-361-5653 or TTY 1-866-252-9933, select “1” or “Sexual Health Line”

Needle supplies/exchange

This program allows York Region to distribute single-use and sterile injection supplies and equipment to eligible community partners to distribute to clients. Supplies include needles, syringes, alcohol swabs, acidifiers, filters, cookers, tourniquets and personal sharps containers. York Region also has a sharps disposal program that allows clients to return used sharps for safe disposal.

If you are a community agency interested in becoming a needle supplies/exchange and distribution site, please contact the Substance Use Prevention and Harm Reduction Program at 1-877-464-9675 ext. 76683 or email substance@york.ca

Safer crack/crystal meth smoking supplies

This program allows York Region to distribute single-person use crack/crystal meth smoking supplies and equipment to eligible community partners to distribute to clients. Supplies include push sticks, screens, straight stems, bowl pipes, alcohol wipes and mouth pieces. Similar to the needle supplies/exchange program, York Region has a sharps disposal program that allows clients to return small amounts of used needles and sharps for safe disposal.

If you are a community agency interested in distributing crack/crystal meth smoking supplies, please contact the Substance Use Prevention and Harm Reduction Program at 1-877-464-9675 ext. 76683 or email substance@york.ca

Harm reduction supplies are available at no cost from:

• Loft/Crosslinks - Street Outreach Van
• AIDS Committee of York Region
• York Region Public Health - Sexual Health Clinics

Additional resources

• Government of Canada’s Opioid Page
  
• Health Quality Ontario
• Health Professionals Additional Resources
• Mobile York South Simcoe (MOBYSS)
• Ontario Drug Policy Research Network
• Ontario Harm Reduction Distribution Program
• Healthy Quality Ontario - Opioid Wisely
• Public Health Ontario’s Interactive Opioid Tool
• York Region Needle Exchange Services
• Government of Ontario – Understanding Opioids
• 310-COPE Community Crisis Response at 1-855-310-2673 or (TTY) 1-866-323-7785