Case Synopsis

A regional hospital system is exploring the possibility of making naloxone kits accessible to patients in the emergency department of its hospital sites. The current hospital staff are reluctant to distribute these kits. The organization is trying to determine the best approach to guaranteeing program participation. The expansion of hospital access to naloxone kits is a direct response to the ongoing opioid crisis across Canada. Opioid-related deaths have spiked in recent years and various national and provincial initiatives are underway to reduce these deaths. Staff reluctance to distributing lifesaving naloxone kits in emergency departments stems from their lack of understanding and knowledge about the value and benefits of introducing these types of harm-reduction strategies. Unfortunately, many frontline health workers at the hospitals view the distribution of naloxone kits as “enabling drug users”. This stigmatization of patients who have opioid addictions is a complication that is making it much more challenging for Jessica Corso and the Quality, Patient Safety, and Risk Department to introduce this initiative. The problem they face is how to ensure that health workers understand the social constraints that exacerbate addictions and the value of naloxone kit distribution in combatting them. This fictional case focuses on the social determinants of health and health equity, and how best to educate hospital staff so that they gain an understanding of inequities as they relate to health care.

Case Objectives

1. Apply health behaviour theories and frameworks to address staff reluctance to implementing a public health intervention.

2. Develop an approach to implementing the social–ecological model of health and the idea of health equity into the health care setting of a hospital.

3. Discuss the roles and responsibilities of health care organizations and health care providers in recognizing the complexity of health care issues such as addictions and substance use.

4. Relate health equity to the case as it pertains to managing health services.

Case Study Questions

1. How does the context and setting of the case influence our understanding of the problem being faced?

2. Who are the stakeholders in this case? What are their different perspectives?

3. How can organizational or behaviour theories and concepts be applied to this case?

4. What are some social determinants of health that could be at play with the ongoing opioid crisis? 5. How is this case related to health equity?


Addictions; emergency departments; harm reduction strategies; health care equity; naloxone; opioids

Additional Author Information

Kate Harold, BA, MPH

Nina Jain-Sheehan, BSc, Senior Quality & Patient Safety Specialist

Amardeep Thind, MD, PhD, Professor



Recommended Citation

Harold, K., Jain-Sheehan, N. & Thind, A. (2019). Combatting the Opioid Crisis: expanding Naloxone Kit Distribution to Niagara Health Emergency Departments. In: Sibbald, S.L. & McKinley, G. [eds] Western Public Health Casebook 2019. London, ON: Public Health Casebook Publishing.