Beyond the DPIN: Naloxone, Avoiding Assumptions, and Providing Anti-Racist Care
CPSM attended the 2026 Manitoba Harm Reduction Conference in September. The three-day event brought together professionals, peers, advocates, researchers, Elders, Knowledge Keepers, and community leaders from across Manitoba and Canada. The theme “Harm Reduction Saves Lives” resonated with many, particularly those who have lost someone to an overdose.
Narcan® (Naloxone) is a life-saving tool that can temporarily reverse the effects of an opioid overdose. The Government of Canada encourages people who use drugs – and those close to them – to get naloxone kits to protect themselves and others who are at risk of opioid overdose.
The Restorative Practices Program and the Prescribing Practices Program at CPSM became aware of a concerning situation involving naloxone.
Several Indigenous persons experienced stigmatizing treatment and anti-Indigenous racism when accessing their own health care because naloxone was dispensed on their medication record, as part of their role as frontline staff of an inner-city community centre.
Keep reading to learn more about this case example, naloxone, and how you can promote anti-oppressive and anti-racist practices.
Practicing Medicine to Eliminate Anti-Indigenous Racism
What Anti-Indigenous Racism Looked Like in This Case
Promoting Anti-Oppressive and Anti-Racist Practices
Harm Reduction Resources & Narcan® Kits
Context for This Case
In Manitoba, naloxone kits are available:
- From the provincial Take-Home Naloxone Distribution Program, that distributes kits to frontline organizations (these kits are given to patients at no cost).
- By purchasing a kit from a pharmacy (~$25).
- For individuals with Non-Insured Health Benefits (NIHB) coverage (only), from the Naloxone Nasal Spray NIHB Program when prescribed by a pharmacist, physician, or nurse practitioner.
The supply for frontline agencies – from the provincial Take-Home Naloxone Distribution Program – is often limited. These kits contain vials of injectable naloxone. In comparison, the kits covered by the NIHB program contain naloxone nasal spray, which is much preferred for public use. Less risk can be associated with spraying a solution into the nose compared to injecting naloxone into a large muscle. . Regardless of the route, both types of naloxone come with harm-reduction education on safe use and administration.
When nasal-spray kits are covered by NIHB and dispensed by pharmacies, they are entered into Manitoba's Drug Program Information Network (DPIN), per direction of the College of Pharmacists of Manitoba. Otherwise, naloxone is not a prescription drug.
To promote public safety and harm reduction, community agency staff will use their own NIHB coverage to access naloxone for extra kits for distribution in frontline work. Kits can be requested for a client’s personal use, or to protect a person who may be at risk of opioid overdose. This is acceptable practice under the Naloxone Nasal Spray NIHB Program.
Practicing Medicine to Eliminate Anti-Indigenous Racism
The Standard of Practice for Practicing Medicine to Eliminate Anti-Indigenous Racism was launched June 2025 and is rooted in three main principles:
- Understanding and acknowledging anti-Indigenous racism and its negative impacts on the health of Indigenous people.
- Identifying anti-Indigenous racism in the health care system and in the practice of medicine.
- Taking action to address anti-Indigenous racism.
The first step is defining what anti-Indigenous racism looks like and what it feels like in the health system. See Part 1 - Practicing Medicine to Eliminate Anti-Indigenous Racism for more.
What Anti-Indigenous Racism Looked Like in This Case
Several frontline staff – who got naloxone kits under their own treaty number through NIHB for outreach work – experienced racism when attempting to access their own health care. They were treated as “drug seeking” because their DPIN showed regular dispenses of naloxone.
They were asked, “Are you still using naloxone?” The physicians (CPSM registrants) involved allegedly assumed, upon reviewing the DPIN, that the frontline individuals must be using drugs because naloxone was prescribed to them. Because of assumptions like this, their presenting medical concerns were not adequately addressed, and they did not receive appropriate care.
This is stigmatizing and anti-Indigenous racial treatment, which is problematic and therefore should not be tolerated when Indigenous people seek health care.
Promoting Anti-Oppressive and Anti-Racist Practices
Certainly, seeing naloxone on DPIN can be discussed with a patient, as it may be relevant to their care. However, this must be done with a non-stigmatizing and non-racialized approach. Reassure the individual that this is an open conversation, to just ask questions. Do not make assumptions or judgements while listening to the individual. The assumption of drug use or drug seeking could be erroneous and harmful.
If patients are struggling with substance use, accessing health care can present both opportunities and significant risks. These individuals often fear judgment, stigmatization, and receive inadequate care. They may avoid or postpone accessing care until their illness has progressed to critical severity. However, this can be an opportune time to engage patients in harm reduction and addiction care for overall improved health outcomes. See below for local resources.
CPSM is committed to taking action against anti-Indigenous racism. CPSM is also invested in guiding and supporting registrants in their own learning journey. Manitoba physicians, residents, clinical assistants, physician assistants, and medical learners can recognize and call out acts of racism against Indigenous persons and medical practitioners.
The Restorative Practices Program is here to help. RPP focuses on reconciliation through relationship-building and education to bring healing and prevent future harm.
Download a printable poster to learn more about the program.
Harm Reduction Resources & Narcan® Kits
Harm reduction is used along the continuum of treatment for substance use disorder, to promote safety and improve health outcomes with patients – regardless of their readiness to stop or decrease substance use. There is ample evidence to support harm-reduction interventions for all people who use drugs, including those engaged in Opioid Agonist Therapy or other treatment (see: OAT Manual In-Hospital Care of Individuals with Opioid Use Disorder).
Specific interventions with strong evidence include:
- Harm reduction supply distribution (e.g., needle/syringe programs)
- Supervised consumption/overdose prevention sites, and
- Take-home naloxone training/kits.
At risk patients can be given a community resource list for same-day/next-day care and encouraged to visit Street Connections to access Narcan® kits, safer use supplies, and support in the community.
For more information on opioids and overdose, visit www.canada.ca/opioids. For more on local harm reduction, see the resources listed below.
Rapid Access to Addiction Medicine (RAAM) Clinics
Manitoba Harm Reduction Network
CATIE (HIV & Hepatitis C Information)