Design and Evaluation of a Standardized Opioid Toxicity Prevention Pathway for Ontario

The opioid crisis in Ontario continues to drive high rates of opioid-related mortality, exacerbated by a toxic drug supply and fragmented healthcare services. Emergency departments represent critical intervention points but currently lack standardized, real-time mechanisms to identify and coordinate care for patients at risk of opioid toxicity. This study proposes the Opioid Predictive & Analytics Linkage (OPAL) framework, a standardized prevention model integrating predictive risk detection, multi-provider notifications, an evidence-based opioid care pathway, and post-discharge referral tracking to prevent opioid-related deaths. Stakeholder engagement suggests OPAL is both feasible and operationally sustainable within Ontario's healthcare infrastructure. Implementing and evaluating OPAL in real-world clinical settings may enhance early intervention, continuity of care, and ultimately reduce preventable opioid-related deaths across the province.