INTRANASAL NALOXONE: ELIMINATING PREVENTABLE BARRIERS FOR USE (2025)

Issue

The toxic drug supply and overdose deaths in BC have deeply affected both individuals and businesses. While intranasal naloxone can prevent these deaths, access remains limited.

Given the high occurrence of illicit drug overdoses by males, ages 30-59 working in trades, now is the time to invest in tools which reduce barriers to use and are well suited to their work environments. By working together with the business community to make intranasal naloxone available without barriers, lives will be saved.

Background

In 2024, 70% of people who died from illicit drug overdoses in BC were between 30-59 years old, and 74% were men. Female deaths have risen steadily since 2016, now 50% higher than in 2020, especially in Northern and Island Health authorities.[1]

A 2018 Fraser Health report noted that of those experiencing overdoses, “a disproportionate number of men were currently or formerly employed in trade industries.”[2] The Government of Canada[3] confirms that since 2016, about 3 in 4 opioid-related deaths were male, with 30% -50% working in trades at the time of death.

The opioid crisis affects not only social systems but also businesses, especially in trades and technical fields where recruitment and retention of skilled workers are key concerns. The Province of British Columbia should urgently make nasal naloxone available for free to save lives, support our businesses, and workers.

While BC has made progress to address the toxic drug crisis, such as through the Take Home Naloxone program, increasing support at Overdose Emergency Response centres, and by supporting mental health and addiction care in BC, nasal naloxone is not freely available throughout the province.

Narcan Nasal Spray is available at no cost to all residents of the Northwest Territories, Ontario, Quebec, and the Yukon, and is also available for Veteran Affairs Canada clients and First Nations Health Authority clients in BC.[4] In November 2024, the Province commenced a pilot project[5] to distribute nasal naloxone through the BCCDC Take Home Naloxone program[6] for residents; unfortunately, private businesses remain ineligible to receive naloxone through this program.[7]

The Province of British Columbia could do more to save lives by making intranasal naloxone permanently free of charge at pharmacies for both residents and businesses.

Nasal naloxone (Narcan) is easier to use than injectable naloxone, with 90% of untrained users able to administer a full dose, compared to just 60% of trained users with injectable naloxone.[8] Nasal naloxone is also more practical for job sites, especially in trades, because:[9]

• Workers typically wear heavy protective gear, making injections difficult.
• Work sites can be dirty, risking needle contamination.
• The nearest responder may not have medical training or comfort to use syringes.
• Nasal kits are compact, easy to carry, and quick to use.

Figure 1: Administering Naloxone[10]

BC must expand access to nasal naloxone to prevent more deaths. Businesses can partner with healthcare and government to provide training and support for employees struggling with substance use while ensuring nasal naloxone is readily available.

There is a strong correlation between alcohol, drug use and overdose risk. In the 2018 Coroners’ Investigation findings, 37% of illicit drug overdose deaths involved alcohol, and fentanyl was detected in 71% of those cases. [11] In a 2023 Skilled Trades Research report, 59% of respondents report binge drinking, 40% report use of Cannabis and 35% report use of other drugs (stimulants, psychedelics, opioids and sedatives).[12]

With this in mind, nasal naloxone should be available free of charge for businesses through pharmacies, enabling liquor primary establishments (bars, pubs, nightclubs, etc.),[13] liquor stores, and rural licensee retail stores, the opportunity to access naloxone at their choosing. This will help to address barriers to access associated with retail store hours of pharmacies. Expanding access to nasal naloxone in these spaces can prevent deaths from overdoses, particularly when combined with alcohol.

THE CHAMBER RECOMMENDS

That the Provincial Government:

1. Make intranasal naloxone available at no cost via BC pharmacies, ensuring its availability to both individuals and businesses.
2. Facilitate connections between businesses and ministry agencies by collaborating with business organizations (like Chambers of Commerce and Boards of Trade) and local Community Action Tables (CATs) to ensure access for businesses to training and resources for intranasal naloxone deployment.