Drug Poisoning

Reducing the risk of drug poisoning is crucial for community safety. By educating individuals, providing support services, and promoting responsible medication use, we can reduce the harms associated with substance use.

Tips for Reducing Your Risk

• Test a small amount of any drug before using. 
• Avoid mixing drugs.
• Never use alone. 
• If you are alone, contact the National Overdose Response Service (NORS) virtual safe consumption at 1-888-668-NORS (6677), or use the buddy system and call a friend. 
• Call 9-1-1 in the event of an overdose/poisoning. Recognize signs of an overdose.
• Keep a naloxone kit on hand. You can get a naloxone kit at many pharmacies and local needle exchange sites. List of naloxone supply locations in Ontario. 

Consumption and Treatment Site

Find a Consumption and Treatment Services (CTS)site near you, which provides supervised drug consumption and overdose prevention services.

Reverse an Overdose. Carry Naloxone.

• Naloxone is a drug that can temporarily reverse an opioid overdose. If using opioids, it is important to know:
• how to recognize an opioid overdose
• how to use a naloxone kit
• where to get a free naloxone kit

It is also important to know that even if you reverse an opioid overdose using naloxone, you should still call 9-1-1 for emergency help. A person can overdose again when the naloxone wears off, even if they haven’t used more drugs, because the drug may still be in their body.

HKPR District Health Unit provides access to harm reduction supplies and services that can help prevent the spread of infections and diseases. Needle safety, emphasizes on the proper disposal of used needles and the significance of using safe supplies. 

Use HKPR District Health Unit's Needle Exchange and Harm Reduction Program or the Ontario Harm Reduction Distribution Program.

Find a program in your area that provides an outpatient or inpatient treatment option that matches your needs.

The province is ensuring that Ontarians receive the care they need, when and where they need it and the supports necessary to address their addiction struggles and live fulfilling lives.

ConnexOntario provides free and confidential health services for people experiencing problems with alcohol and drugs, mental illness or gambling by connecting them with services in their community that best match their treatment needs. These include outpatient day/evening programs and bed-based support, which requires individuals to live in residence at treatment centres.  You can connect with someone for information and referral to services in your community 24 hours a day, seven days a week by:

• phone: toll-free at 1-866-531-2600
• live online chat
• email

On the ConnexOntario website you can find locations and hours for some of these services and information on:

Rapid Access Addiction Medicine clinics No appointment or referral is needed to get help, including prescriptions for opioid agonist therapies (such as suboxone or methadone) and counselling referrals if you don’t have a primary care provider

Register with Breaking Free for a free and confidential recovery support program where you learn positive coping skills and proven behaviour change techniques that can help reduce risky opioid use. 

Speak to your doctor, nurse practitioner, other health care provider, at the HKPR District Health Unit or harm reduction program about connecting you to the right supports.

If chronic pain plays a role in your opioid use, you may be a candidate for a referral to one of Ontario’s 18 chronic pain clinics. Talk to your doctor or nurse practitioner to see if this would be a good option for you.

If you need help finding a doctor, nurse practitioner or other health care provider, visit Health811 online or call 8-1-1 to speak with a registered nurse available 24 hours a day to help with any non-emergency health matter and find local services in your area.

Benzodiazepines are medicines that calm the brain, making you feel drowsy or relaxed. They are often prescribed  for helping with sleep, seizures, or anxiety.

Benzodiazepines can be taken as:

• Liquid
• Tablet
• Capsule 

What are the Risks?

Short-term effects of benzodiazepines:

The most common short-term side effects of benzodiazepines can include:

• dizziness
• confusion
• drowsiness
• constipation
• memory loss
• slurred speech
• muscle weakness
• loss of coordination and balance

Some people can also experience:

• delusions
• hallucinations
• skin reactions
• sudden anxiety
• euphoria (a feeling of well-being)
• restlessness and agitation
• irritability and aggressiveness

Long-term effects of benzodiazepines:

The long-term effects of benzodiazepines can include:

• physical dependence
• problems learning or concentrating

Mixing benzodiazepines with other depressants such as alcohol and/or opioids can be dangerous. Combining these substances increases the risk of overdose, because they all have sedative properties.

* HKPR District Health Unit provides access to harm reduction supplies and services that can help prevent the spread of infections and diseases. Needle safety, emphasizes on the proper disposal of used needles and the significance of using clean and sterile supplies. Reverse an Overdose. Carry free Naloxone kits that can be picked up at any of our offices.

Fentanyl is a very potent opioid pain reliever. Even a very small amount can lead to drug poisoning or worse.

It's mostly used in hospitals, but doctors can prescribe it for severe pain.

Fentanyl can be taken as:

• Tablets
• Shots
• Patches on your skin

What are the Risks?

Its often mixed with other drugs, without people knowing. Using fentanyl with alcohol, benzodiazepines, or other opioids makes the risk of overdose even higher. You might not even realize you're taking it because it has no smell or taste.

* HKPR District Health Unit provides access to harm reduction supplies and services that can help prevent the spread of infections and diseases. Needle safety, emphasizes on the proper disposal of used needles and the significance of using clean and sterile supplies. Reverse an Overdose. Carry free Naloxone kits that can be picked up at any of our offices.

Medetomidine/Dexmedetomidine are anesthetic drugs, considered to be more potent than xylazine (longer acting and produce greater sedation). Medetomidine is a tranquilizer approved only for use on animals. Dexmedetomidine is approved for use on humans, as well as animals, for sedation and pain relief. Note that we report these drugs together because they have very similar chemical structures, and we cannot currently differentiate between them.

What are the Risks?

Using high-potency opioids in combination with medetomidine/dexmedetomidine increases the risk of dangerous suppression of vitals (e.g., slowing down of breathing, blood pressure, heart rate).

* HKPR District Health Unit provides access to harm reduction supplies and services that can help prevent the spread of infections and diseases. Needle safety, emphasizes on the proper disposal of used needles and the significance of using clean and sterile supplies. Reverse an Overdose. Carry free Naloxone kits that can be picked up at any of our offices.

Nitazenes are a type of high-potency opioid considered to be stronger than fentanyl. They were developed to relieve pain but never approved for clinical use. They were first identified in Canada’s unregulated supply in 2019. They are known on the streets as "Pyro". 

What are the Risks?

• Nitazenes are increasingly found in Canada’s unregulated drug supply by drug-checking services  
• Nitazenes, like fentanyl, have been found in drugs that are expected to be lower-strength opioids (e.g., drugs acquired from the unregulated supply expected to be oxycodone, hydromorphone, Percocets). 
• The risk of overdose is increased due to the high potency, particularly for people who do not use fentanyl or who have lower opioid tolerances.
• Nitazenes are opioids so naloxone should reverse overdoses. Increased doses of naloxone may be required to reverse the effects of an overdose involving nitazenes. Until more information is known, continue to follow existing overdose response protocols. Ensure you give the body time to respond to the naloxone before giving another dose (approx. 2-4 minutes if the overdose is severe) and give breaths every 5 seconds. 
• Fentanyl test strips DO NOT detect nitazenes. Currently, it is unclear how well available nitazene test strips or emerging onsite drug-checking technologies work to detect nitazenes.  

* HKPR District Health Unit provides access to harm reduction supplies and services that can help prevent the spread of infections and diseases. Needle safety, emphasizes on the proper disposal of used needles and the significance of using clean and sterile supplies. Reverse an Overdose. Carry free Naloxone kits that can be picked up at any of our offices.

Opioids are a family of drugs (whether purchased legally or illegally) that have pain relieving effects. Opioids slow down basic functions in the body like breathing, heart rate, and blood pressure, and can sometimes produce a “high” or euphoria which can make them addictive.

Common types of opioids include: 

• Fentanyl 
• Morphine 
• Codeine (found in Tylenol 2, Tylenol 3, Tylenol 4) 
• Oxycodone (OxyContin) 
• Heroin 
• Hydrocodone (Vicodin) 
• Hydromorphone (Dilaudid) 
• Percodan (Percocet) 
• Methadone

What are the Risks?

Opioids carry risks including addiction, overdose, tolerance, withdrawal, physical health complications, mental health effects, social and economic consequences, risk of infectious diseases, and fatalities. It's important for healthcare providers to carefully weigh the benefits and risks and explore alternative pain management strategies when possible. For more information visit our Opioids and Naloxone webpage.

* HKPR District Health Unit provides access to harm reduction supplies and services that can help prevent the spread of infections and diseases. Needle safety, emphasizes on the proper disposal of used needles and the significance of using clean and sterile supplies. Reverse an Overdose. Carry free Naloxone kits that can be picked up at any of our offices.

Xylazine is a potent, non-opioid sedative, pain-reliever, and muscle relaxant that is showing up in parts of Ontario’s drug supply. Commonly known as “tranq” or “tranq dope” when combined with Fentanyl. Wounds associated with Xylazine use can take a long time to heal.

Xylazine can be:

• Smoked
• Snorted
• Injected
• Swallowed

What are the Risks?

Xylazine can cause:

• difficulty breathing
• loss of consciousness
• decreased heart rate and blood pressure
• severe skin wounds and tissue damage that, if left untreated, may result in amputation. HKPR district health unit offers wound care kits.
• It is often mixed with opioids, like fentanyl, which increases the risk of overdose and other negative effects as xylazine and opioids can both affect breathing.

* HKPR District Health Unit provides access to harm reduction supplies and services that can help prevent the spread of infections and diseases. Needle safety, emphasizes on the proper disposal of used needles and the significance of using clean and sterile supplies. Reverse an Overdose. Carry free Naloxone kits that can be picked up at any of our offices.

Please contact your local Needle Syringe Program site to check if they carry these.

Benzodiazepine test strip kits are available through outreach to help you understand what is in your drug supply.

For more information from the manufacturer: Benzodiazepine

Fentanyl test strip kits are available through outreach to help you understand what is in your drug supply.

Contents: 5 Fentanyl test strips 5 Micro scoops 5 Medicine cups 5 Castile soap wipes 10 Sterile water 1 Education sheet

For more information from the manufacturer: Fentanyl

**Please be aware that there is another brand of Fentanyl test strip: BTNX Fentanyl

Xylazine test strip kits are available through outreach to help you understand what is in your drug supply.

Contents: 5 Xylazine test strips 5 Micro scoops 5 Medicine cups 5 Castile soap wipes 10 Sterile water 1 Education sheet

For more information from the manufacturer: Xylazine