Sample Overdose Policy

Sample policy document for use by organizations participating in the Facility Overdose Response Box program.

Sample Overdose Policy - Editable Pages

Editable pages of the sample policy document for use by organizations participating in the Facility Overdose Response Box Program

Overdose Prevention and Response Protocol Recommendations For Service Providers

Recommendations from Vancouver Coastal Health and Fraser Health for developing overdose prevention and response policies and protocols.

Training Checklist and Package

Training Manual: Overdose Prevention, Recognition and Response

Training Manual: Responding to Overdose in the Workplace

Overdose Intervention Knowledge Assessment (Editable)

Overdose Intervention Knowledge Assessment Answer Key

Record of Employee Competencies

Certificate of Training Completion

Certificate of Training Completion (wallet-sized)

Implementation Checklist

Resource Binder Table of Contents (Editable)

An example Table of Contents to support sites to policies and procedures related to responding to an overdose in teh workplace. This document is editable. 

Naloxone Decals (Ready to Print)

F.O.R.B Registration Package

This FORB application package includes all required forms and agreements.  

First Supply Order Form

Submit this form the first time you order F.O.R.B supplies.

Refill Order Form

Use this form to refill naloxone and supplies for your kits and boxes. 

If you are looking for additional kits and boxes for your sites due to an increase in staff, or due to lost or damaged supplies, please email naloxone@bccdc.ca for support. 

Naloxone Administration Form

1. Plastic Toolbox
2. Instruction Cards (Overdose Recognition and Response)
3. Vanishpoint® Syringes
4. Breathing Masks with One-Way Valve
5. Pill Bottle (for storing naloxone)
6. Ampoule Breakers (to protect fingers when opening naloxone ampoule)
7. Non-Latex Gloves
8. Naloxone (0.4 mg/mL, 1mL ampoules) in original packaging
9. No longer in box

Instruction Cards (included with your Facility Overdose Response Box)

Best For:

• Sites that have not experienced an overdose on-site
• Outreach Staff

Contents

• 3 x Naloxone, 0.4 mg/mL, 1 mL ampoule in capped and labelled amber medication bottle
• 3 x Vanish Point® 3 mL syringe
• 1 x pair of non-latex gloves
• 1 x Individual breathing mask in pouch

Naloxone should be stored at room temperature and away from direct light. 

Naloxone and Temperature

Plastic ampoule breakers are hollow cylinders with 2 different ends - one with "claws" and one without.

The end with the "claws" will slide over the "neck" of the ampoule. The neck is the narrower part without the sticker.

Slide the ampoule breaker "claws" first, over the neck.

Keep sliding until the claws reach the wider body of the ampoule.