Naloxone kits in the workplace
Effective as of the start of this month, June 1, 2023, some employers will need to supply naloxone kits in their workplace. This new requirement arises because of changes to the Occupational Health and Safety Act (the "OHSA"), passed as part of the Working for Workers Act, 2022. Here is what you need to know about this new requirement.
What is naloxone?
Naloxone is a drug that can temporarily reverse the effects of an opioid overdose. Common opioids include morphine, heroine, oxycodone, fentanyl, codeine, and hydromorphone. [1]
What is a naloxone kit?
A naloxone kit is a kit that contains naloxone, as well as the required equipment to safely administer it. The Ontario government has specified that a naloxone kit should contain the following contents:
Nasal spray kit:
- 1 hard case
- 2 doses of naloxone hydrochloride intra-nasal spray (4mg/0.1 ml)
- 1 one way rescue breathing barrier
- 1 pair of non-latex gloves
Injectable kit:
- 1 hard case
- 2 (0.4mg/ 1 mL) vials or ampoules of naloxone
- 2 safety-engineered syringes with 25g 1" needles attached
- 2 alcohol swabs
- 2 devices for opening ampoules safely
- 1 one way rescue breathing barrier
- 1 pair of non-latex gloves
It is further specified that employers who are required to have naloxone kits are responsible for ensuring they are in good condition and stored properly. This includes making sure that no items in the kit, such as the naloxone, are expired.
Who needs to have a naloxone kit in their workplace?
Not every employer needs to have a naloxone kit in their workplace. Rather, the OHSA stipulates the requirement is triggered when the "employer becomes aware, or ought reasonably to be aware, that there may be a risk of worker having an opioid overdose at a workplace where that worker performs work for the employer".
The Ontario government has indicated that the requirement will be triggered where all of the following scenarios are present:
- There is a risk of a worker opioid overdose;
- There is a risk that the worker overdoses while in a workplace where they perform work for the employer; and
- The risk is posed by a worker who performs work for the employer.
This criterion makes clear that it must be a worker of the employer, not a third party, who is at risk of the overdose, and further, that the risk is present at the workplace.
For example, if an employer knows a worker has an opioid addiction, they may want to seriously consider and evaluate the risk of the worker bringing opioids on premise or taking them prior to work, such than an overdose could result at the workplace. On the other hand, if the employer knows an employee is temporarily taking prescribed opioids under medical supervision, the requirement may not apply.
Do employers need to inquire about opioid use?
No. The OHSA does not impose a duty to inquire, and the government guidance confirms that is the case. However, employers may become alert to opioid use through other means, such as seeing paraphernalia at the workplace, observing a worker use opioids or overhearing them discuss it, or voluntary disclosure by the worker, such as for an accommodation request.
Does any training need to be provided on naloxone kits?
Yes, if an employer is required to have a naloxone kit, they must also provide training on it. The employer must ensure that "at any time there are workers in the workplace, the naloxone kit is in the charge of a worker who works in the vicinity of the kit and who has received… training."
While the OHSA does not require a set number of workers to receive the training, employers may need to have multiple workers trained, depending on the nature of the workplace. For example, if there are multiple workplaces with multiple kits, multiple workers will need to be trained. Likewise, if employees work shift work, the employer will need to ensure that someone on each shift is trained.
The OHSA specifies that the training must include the following:
- Training on how recognize an opioid overdose;
- To administer naloxone; and
- To acquaint the worker with any hazards related to the administration of naloxone.
Employers may be able to access free naloxone training and kits through Canadian Red Cross or St. John Ambulance, with more information available here: Naloxone in the workplace | ontario.ca
What personal information can be disclosed to comply with the naloxone requirements?
Employers should only disclose personal information that is reasonably necessary to comply with the naloxone requirements.
The government guidance suggests that a worker in charge of a naloxone kit could be told there is a risk of a worker having an opioid overdose, so they are prepared to respond. However, the worker does not necessarily need to know all of the personal information the employer has about the worker who is at risk.
Are there any other obligations related to overdoses and naloxone in the workplace?
Employers are reminded that all their other obligations under the OHSA continue to apply in the context of overdoses and naloxone in the workplace. This includes, without limitation, the employer's general duty to take every precaution reasonable in the circumstances for the protection of the worker.
If an employee is experiencing an overdoes or other medical issue, employers must take appropriate steps which may include immediately seeking appropriate medical attention for the employee or calling 911.
Takeaways:
With this new requirement in effect, employers should think carefully about whether they need to have a naloxone kit in their workplace. Failing to comply with this requirement could not only result in the employer being offside the OHSA and subject to sanction, but also have real life consequences should an occasion arise where naloxone is needed. Employers who do not meet the threshold of requiring a naloxone kit may want to consider whether to voluntarily have a naloxone kit and provide training, given the potentially life saving effects.
If you have questions about your workplace's occupational health and safety obligations, please do not hesitate to reach out to a member of the Lee Workplace Law team.
[1] Naloxone in the workplace, https://www.ontario.ca/page/naloxone-workplace#:~:text=Starting%20June%201%2C%202023%2C%20employers,through%20Ontario's%20Workplace%20Naloxone%20Prologram.
