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Naloxone Distribution Form

Ontario Naloxone Program (ONP)

As part of the Ontario Harm Reduction Program Enhancement, the ONP has expanded access to free naloxone nasal spray kits for clients who are at high risk of an opioid overdose as well as their friends and family.

Naloxone is a medication that can reverse the effects of an opioid overdose.  The Windsor-Essex County Health Unit (WECHU) is committed to increasing access to harm reduction services to prevent opioid overdose-related deaths.

Eligibility Criteria

Eligible organizations include Community Health Centers, Outreach Organizations, Shelters, and Withdrawal Management programs who work directly with clients who may be at risk of an opioid overdose.  To determine if your organization falls into the outreach or withdrawal management program categories, your organization must meet the following criteria:

  • Work directly with drug-using populations at risk of opioid overdose through harm reduction programming, outreach and/or social determinants of health;
  • Reach a difficult to reach (priority) population not otherwise served where there is known drug using/opioid activity.

Agency Requirements

  • Enter into a Service Agreement with WECHU, after consulting with their own experts about distributing naloxone kits;
  • Need to have a general liability insurance coverage of a minimum of $5,000,000;
  • Develop and/or adopt program related policies and procedures related to naloxone kit distribution, storage and training; and,
  • Arrange training and education for staff with support from WECHU and/or other community partners.


The Health Unit will provide free training and resources to administer and dispense naloxone to your clients. This means that a minimum of one staff member from each agency must receive in person training from WECHU. The remaining staff must be trained using the train-the-trainer guide provided by WECHU. The training provided by WECHU will encompass recognizing and responding to an overdose, naloxone administration, naloxone distribution, online data entry, storage and handling of naloxone and ordering protocols.

Agency Commitments

By signing a Service Agreement for naloxone distribution, an agency is committing to:

  • Providing naloxone kits to eligible clients
  • Ensuring that at least one staff is trained by WECHU and then all other staff involved with the distribution of naloxone are trained utilizing the train-the-trainer model
  • Ensuring that protocols are followed (including the use, storage and distribution of naloxone)
  • Collecting and reporting data to WECHU on a quarterly basis

Should you have any questions, please do not hesitate to contact our Lead Naloxone RN, at 519-258-2146, ext. 3100, or email