Introduction
As health care professionals, occupational therapists (OTs) work in a wide range of practice settings and may encounter individuals who are at risk for opioid overdose. This advisory statement aims to clarify the expectations for OTs who may encounter an individual experiencing an opioid overdose and be required to administer naloxone overdose medication.
What is naloxone?
Naloxone (Narcan ®) is a medication used to treat the effects of opioid overdose in an emergency situation. In October 2016, as part of its comprehensive opioid strategy, the Ministry of Health and Long-Term Care expanded public access to naloxone kits in an effort to prevent overdose deaths. Naloxone can be administered through intramuscular injection or by intra-nasal spray.
Naloxone and the Role of Occupational Therapists Receiving Delegation
Receiving Delegation
In Ontario, the administration of naloxone is outside the scope of occupational therapy practice as it falls under the controlled act of administering a substance by injection or inhalation. If an occupational therapist is expected to administer naloxone in the course of their role, the occupational therapist must:
- obtain appropriate training in the use of intra-nasal and/or intramuscular forms of naloxone
- receive delegation from another regulated health professional who is authorized to perform this controlled act
- be ready to safely and effectively administer naloxone and manage the outcome of the administration
- comply with their organizational policies and procedures.
Responding to an Emergency
The Regulated Health Professions Act, 1991 (RHPA) provides an exception under which the controlled act may be performed without authority or delegation. That exception applies when:
- Giving first aid or temporary assistance in an emergency – RHPA section 29(1)
Occupational therapists may find themselves in unexpected circumstances where they are required to respond to a client or other individual who is experiencing an opioid overdose. In such an instance, an occupational therapist with access to naloxone could administer the overdose medication without delegation.
Occupational therapists are encouraged to review any relevant legislation, regulations, and updates pertaining to Ontario’s Opioid Strategy and the administration of naloxone
If you have questions about occupational therapy practice and the administration of naloxone, please contact the Practice Resource Service at 1-800-890-6570 or 416-214-1177 x240 or practice@coto.org.
Resources
Controlled Acts and Delegation
https://www.coto.org/standards-and-resources/resources/controlled-acts-and-delegation
Standard for Record Keeping
https://www.coto.org/standards-and-resources/resources/standard-for-record-keeping-2023
Ontario Ministry of Health
https://www.ontario.ca/page/ontario-take-home-naloxone-programs
Regulated Health Professions Act, 1991
https://www.ontario.ca/laws/statute/91r18