Description and evaluation of a national humanitarian opioid poisoning education and naloxone distribution program

Canada's opioid poisoning crisis claimed 49,105 lives from January 2016 to June 2024. Opioid poisoning education and naloxone distribution programs can reduce fatalities, although access remains inconsistent across Canada. These programs have mostly been delivered in person through community, healthcare, and social service agencies.

The Canadian Red Cross implemented a national, free, bilingual, virtually accessible, opioid harm reduction program, leveraging its experience in first aid education and community relationships as a humanitarian organization. The Opioid Harm Reduction program launched three new courses and added opioid poisoning content to four existing courses. Courses were adapted continually based on the feedback of people with lived experience of drug use and program participants. The program was delivered from January 2021 to March 2024 and evaluated through quantitative and qualitative methods.

The program delivered 1,386,995 trainings and successfully reached diverse groups, including those from Indigenous (5.3%) and rural (25.2%) communities, but had an underrepresentation of men (34.3%) and individuals working in the construction industry (4.8%). Participants' self-reported knowledge and confidence in responding to opioid poisoning increased across all courses (p < 0.001), particularly for learners without prior training. In total, 24,098 intranasal naloxone kits were distributed, 60.4% to Ontario, Manitoba, and British Columbia. Most participant feedback (82%) received was positive, highlighting the course's simplicity and focus on stigma.

The Canadian Red Cross Opioid Harm Reduction program advanced harm reduction, increased awareness of opioid poisonings, and situated the response to the opioid poisoning crisis as a community health effort.