Revisions to the Practice Guidelines for Medication Practices Appendix: Administration of Naloxone

The Ontario College of Social Workers and Social Service Workers (the College) is pleased to announce that College Council recently approved the revision to the Appendix on the administration of Naloxone, which forms part of the Practice Guidelines for Medication Practices available on the College website.

The revisions to the Appendix on the administration of Naloxone clarifies that College registrants with the appropriate training can administer Naloxone without a formal delegation process. Please view the revised Practice Guidelines for Medication Practices and the Appendix on the administration of Naloxone here.

Identifying needed revisions

In June 2023, the College met with the Ministry of Health to discuss the administration of Naloxone by College registrants for suspected opioid overdoses. The following key points were identified:

  • College registrants working in shelters, group homes, and other community-based settings where vulnerable clients are at high risk of overdosing are concerned that their practice does not fall under the emergency provision in the Regulated Health Professions Act, 1991.
  • College registrants may fear potential repercussions from the College if they administer Naloxone without a formal delegation in place.
  • Some organizations may face challenges in implementing a formal delegation process for the administration of Naloxone.

In addition, the Ontario Naloxone Program identified that 80% of Narcan kits contain intranasal Naloxone. The Ontario College of Pharmacists released a guideline on July 1st, 2023, explaining the difference between intranasal and inhaled routes of administration and that the former is not a controlled act. Specifically, “[u]nlike administering a substance by inhalation, intranasal administration of a substance is not a controlled act governed by legislation and may be performed by anyone provided they have the knowledge and skill to do so safely.”

In response to the ongoing impact of the opioid crisis, Public Health Units (PHUs) became designated Naloxone distribution leads in 2018. PHUs have trained staff at all organizations participating in the Ontario Naloxone Program. Training in administering Naloxone and opioid overdose response is available through local PHUs and follows Ontario’s 5-step overdose response framework.

For more information

For all inquiries related to the updated Practice Guidelines for Medication Practices and the administration of Naloxone, contact the College’s Professional Practice Department at