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Opioids

Opioids are medications that relieve pain. When used properly, they can help. But when misused, they can cause addiction, overdose and death.

About opioids

What are opioids?

Opioids are substances that can be used to treat pain, severe cough and diarrhea. Some people use opioids because of its euphoric effects or to feel “high.” Examples of opioids include fentanyl, heroin, morphine, oxycodone, codeine and hydromorphone. Opioids can be addictive, and if taken at high doses, can cause coma or death. Special types of opioids, including Methadone and Suboxone, are used in opioid treatment programs.

What is fentanyl?

Fentanyl is an opioid medication legally prescribed to treat severe or chronic pain. Fentanyl is 100 times stronger than morphine and 40 times stronger than heroin.

Fentanyl may also be acquired illegally through fraudulent prescriptions, overprescribing, pharmacy robberies, break and enters or when legitimate prescriptions are used by someone other than the person who was prescribed with the medication. Synthetic fentanyl is trafficked and sold in many different forms including patch, powder, pill and liquid. Drugs sold illegally can be laced or contaminated with fentanyl making them more potent and increasing the risk of overdose.

Fentanyl sold illegally comes in many different forms. Fentanyl use and overdose has been on the rise in Ontario over the last several years.

What is an overdose?

An overdose occurs when a person uses a drug or combination of drugs in greater volumes 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 benzos (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/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. Use with a friend, but do not share needles. Leave door unlocked and let someone know that you are about to use beforehand
  • 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

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.

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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 distributing naloxone to your clients, please see the section on ‘What is York Region doing?’ below for information about naloxone distribution

Where can I get naloxone?

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

  • Naloxone is available at participating pharmacies and community organizations. A list of locations offering naloxone can be found at ontario.ca/page/where-get-free-naloxone-kit
  • You can also get naloxone through York Region Public Health by contacting:
    • The 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”
  • Some community organizations in York Region also distribute naloxone. Please see the list of organizations in the section on ‘What is York Region doing?’ below.

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.

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What is York Region doing?

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.

Opioid Action Plan

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

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York Region Public Health’s Harm Reduction Program

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.” 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:

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:

Additional resources

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Reporting bad drugs in York Region

ReportBadDrugsYR is an anonymous, online reporting tool for community partners and the public. Anyone with a concern or bad experience with illegal drugs or overdoses in the community can use the tool to share information with York Region Public Health.

The information you provide will be reviewed by York Region Public Health staff and used to inform public health actions in the community. The reports are anonymous and no personal or identifying information will be collected. If you have any questions or feedback, please contact the York Region Public Health Substance Use Prevention and Harm Reduction Program at 1-877-464-9675 ext. 76683 or substance@york.ca

This reporting tool is not for emergencies. If you are experiencing an emergency, call 911 immediately.



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