Opioid Inhibitor FAQ

TAKE-HOME NALOXONE (THN) - INJECTABLE AND NARCAN^® NASAL SPRAY KITS FAQ

The Opioid Overdose Crisis/Epidemic is real, and it is a public health emergency.  Pharmacists have a social responsibility to do our part to respond to this crisis, and our role is absolutely essential.

It is also an opportunity to further demonstrate pharmacists’ value to the public, and one of the rare activities for which we are compensated.  We must not miss this opportunity. 

Marchese Pharmacy has been a strong advocate for pharmacists in naloxone training.  We have provided kits, guidance, and support to pharmacists across Ontario.

The Ontario Pharmacists Association (OPA) provides an excellent list of helpful FAQs for Take-Home Naloxone (THN) found here.

The Ministry of Health and Long-Term Care has an FAQ document on how to bill naloxone kits: NEW: Updated to include naloxone nasal spray:

Here are some highlights, as well as some additions of our own:

1. Q: Do I need formal training to dispense and bill naloxone to ODB?

   1. No.  However, it is strongly recommended that you obtain formal training for quality/standard of practice as well as liability reasons.  Training is also FREE through OPA, even if you are not a member: Click on the words “PRICING AND REGISTRATION” at the bottom of the webpage and select the appropriate option to register.

2. Q: Where can I order naloxone kits?

   1. Marchese Pharmacy supplies naloxone kits to pharmacies. Order online here for quantities of 15 or more. Please call 1-800-356-3365 or email sales@marchesehealthcare.ca if you wish to purchase less than 15 of each type of kit.

3. Q: Do I need special insurance coverage to dispense naloxone?

   1.  No.  Your professional liability insurance that meets OCP requirements for licensure is enough. 

4. Q: Do I have to report sales to the Ministry?

   1.  Where possible, pharmacists are now required to report sales. Click here for the reporting form.

5. Q:  Do I need first aid training to dispense naloxone?

   1.   No, but it is highly recommended.  All pharmacists should maintain current first aid knowledge.

6. Q: Should I bother with naloxone?  I don’t dispense methadone.

1.  Yes!  Opioid overdose is a real risk for many other individuals:

   a)   Opioid-naïve patients
   b)   Opioid dosage changes
   c)   Opioid users recently discharged after a period incarceration (during which their tolerance to opioids may be lost)
   d)   Family, friends, co-workers, close contacts of those at risk should get a kit to be prepared for an emergency
7. Q: Can I only give one kit a year (like a flu shot)?

   1.  No!  You can now dispense a maximum of two kits at a time.  Clients may request replacement kits (up to 2) at any time, with no limits.  They should be able to show you a training/identifier card to prove they do not require training.

8. Q: Is the nasal spray covered now? 

   1.  Naloxone (Narcan^®) nasal spray is covered, effective Tuesday, March 27, 2018.  There are some important conditions.  Read them here. 

9. Q: Does Marchese provide nasal spray kits? 

1.  YES!  We are able to provide nasal spray kits right now! 

10. Q: Is the spray better than injectable?

    1.  The spray has much more naloxone. However, nasal absorption is variable and may be affected by presence of mucous, vomit, and damage to the mucosa. Do what is in the best interests of the patient. You may consider offering one of each type of kit, especially if they ask. Just remember you cannot dispense more than two kits at a time.

11. Q: What kind of customization can Marchese provide for kits? 

    1. We can provide:

       a)   training cards with your logo in full colour
       b)   kit cases in black for injectable, or blue for nasal spray
       c)   SAVE ME cards with a QR code link to a training video
       d)   serialization of kits
       e)   injection training kits with sterile water instead of naloxone

12. Q: Where can I get more information?

    1. Contact our Pharmacy Manager, Faisal Khawaja, at 1-800-356-3365 x570