Empowering Change: McMaster’s Innovative Strategy in Hamilton’s Battle Against Opioids

In the year 2023 alone, Hamilton Paramedic Services responded to over 900 suspected opioid overdose incidents, equating to about 80 emergency calls per month (City of Hamilton, 2023). These numbers have only increased in more recent years and have become an important reminder of this critical gap in public health. This gap, however, is not isolated to major city areas, it also exists on university campuses. A strong reminder of this is the unfortunate and tragic death of Cailin Sidney McIntyire-Starko, a University of Victoria student, following a witnessed fentanyl overdose (Carey & Gangdev, 2024). Across the city, life-saving measures are being reimagined to identify and fill these gaps. Just as Automated External Defibrillators (AEDs) and specialized response teams like McMaster’s Emergency First Response Team (EFRT) have become staples in public spaces, a growing number of voices are calling for similar harm reduction strategies to be embedded within our universities. 

At McMaster University, this call to action has sparked a transformative initiative. Medical student – Bhavya Gandhi and Undergraduate Kinesiology student – Imeth Illamperuma have spearheaded a project to install 32 naloxone kits in strategic locations around the University campus. Naloxone, the life-saving medication capable of reversing opioid overdoses in a matter of minutes, can now be accessed by students, faculty, and staff, increasing accessible emergency care. In keeping with McMaster’s reputation as the home of evidence-based medicine, every step of this initiative was designed and implemented using rigorous, evidence-based practices, ensuring that our approach meets the highest standards of public health intervention.

The inspiration for this initiative emerged from the shared recognition of the realities faced by the community. Bhavya, as a former advanced medical first responder (AMFR) part of the Erindale College Special Response Team (ECSpeRT), was trained in the effectiveness and importance of naloxone in an opioid overdose. During his time in this role, Bhavya did not have access to naloxone due to regulatory policies. As a medical student, Bhavya has had the opportunity to learn about and implement various harm reduction measures, especially in clinical settings such as family medicine and emergency medicine where preventative medicine is a central component of patient care. Through these experiences, he was reminded of the helplessness he felt as an AMFR and decided to lead change in order to prevent anyone else from experiencing this in the future. Imeth, a research student at the Centre for Addiction and Mental Health (CAMH), witnessed firsthand the life-saving impact of harm reduction measures on patients who use substances. In addition, his student house located in Ward-2 of Hamilton where the majority of opioid-related paramedic incidents occur (City of Hamilton, 2025), Imeth experienced the crisis up close, which inspired him to found McMaster SHIELD (Support Harm Reduction Information Education Life-saving Devices). SHIELD played an integral role in the project’s rollout, actively working to destigmatize harm reduction and spread crucial information about naloxone and its life-saving ability.

Recognizing that the university environment is both a microcosm of society and a fertile ground for innovative solutions, Bhavya organized this initiative starting in February 2024 with Imeth joining subsequently later that year to bridge the gap between community needs and campus safety. The goal was not only to provide a practical tool but also to ignite a culture of preparedness, increase public education and destigmatize conversations around opioid use and naloxone.

This initiative involved multiple stages. First, approval and interest were required from all stakeholders, including university health services and other McMaster administration, EFRT, and various faculties across campus. Extensive administrative support was provided especially by Cheryl Beecroft and Dane DeMan from University Health and Safety. While working towards this, insight into the legalities and public health implications regarding this project were required. Next, Bhavya consulted multiple physicians and pharmacists who were experts in naloxone and opioid overdoses to clarify this and the feasibility of placing naloxone on a university campus. This survey included consideration of the risks and benefits of naloxone placement, potential side effects, and application of the Good Samaritan Drug Overdose Act (Health Canada, 2017). Finally, utilizing research-based methods, Imeth and his SHIELD team of nine undergraduate students systematically surveyed campus grounds, gathering coordinates and images. Imeth identified high foot traffic areas and pinpointed strategic locations on the east, west, and southern sections of campus to ensure naloxone access for off-campus students. An anonymous, altruistic and philanthropic pharmacist offered to support this initiative following extensive discussions with experts working in harm reduction. 32 naloxone kits were procured with the support of this pharmacist and placed in the calculated locations, with the addition of a curated map of AED and naloxone kit placements for increased accessibility.

Stigma towards harm reduction on university campuses initially posed a barrier. Some stakeholders had reservations initially as to the need for these kits on campus, which inspired a range of engagement in open dialogue, informational sessions and evidence based research to bridge this gap. As Dworkis et al. (2018) noted, “approximately 40% of all opioid-related EMS runs in Cambridge, MA, would be accessible within 200 meters of PDN sites placed at cluster centroids”. In addition Dworkis et al. (2022) noted that deploying public access naloxone kits using coordinate related blue light phones would increase access to 91.5% on their college campus. This data justified our decision to use a 200-meter radius for effective naloxone coverage. Every step from navigating legalities and overcoming skepticism to managing technical placement details, transformed challenges into opportunities for creating a safer, more responsive campus environment.

The initial rollout has been met with enthusiastic support and the impact is already visible. Looking ahead, Bhavya and Imeth plan to expand their program further by incorporating regular training sessions, refining kit placement based on community feedback, and exploring partnerships with other universities across Hamilton. Their vision is one of hope and resilience: a community where immediate intervention is not only possible but normalized, and where every individual is empowered to be a first responder in times of crisis. As Hamilton continues to navigate the challenges of the opioid epidemic, initiatives like this offer a beacon of optimism, a reminder that local innovation can lead to life-saving change.

Works Cited: 

Dworkis, D. A., Tang, W., Ritcheson, N. C., Raviv, O., Fowler, A., Ellig, K., Goley, S., & Arora, S. 

(2022). Blue light phones as potential locations for deploying public access naloxone kits on a college campus. Journal of American college health : J of ACH, 70(1), 18–21. https://doi.org/10.1080/07448481.2020.1726931

Dworkis, D., Weiner, S., Liao, V., Rabickow, D., & Goldberg, S. (2018). Geospatial Clustering of 

Opioid-Related Emergency Medical Services Runs for Public Deployment of Naloxone. Western Journal of Emergency Medicine, 19(4), 641–648. https://doi.org/10.5811/westjem.2018.4.37054

Hamilton Opioid Information System | City of Hamilton. (n.d.). Www.hamilton.ca. 

https://www.hamilton.ca/people-programs/public-health/alcohol-drugs-gambling/hamilton-opioid-information-system

Health Canada. (2017, October 6). About the Good Samaritan Drug Overdose Act. Government 

of Canada. https://www.canada.ca/en/health-canada/services/opioids/about-good-samaritan-drug-overdose-act.html

UVic student’s parents call for naloxone in dorms after death. (n.d.). Vancouver.citynews.ca. 

https://vancouver.citynews.ca/2024/05/16/university-victoria-student-toxic-drug-death-coroner-investigation/