By Vipal Monga

By his own account, Leon “Pops” Alward should be dead. The 47-year-old Toronto resident has overdosed five times in the past four years after injecting the synthetic opioid fentanyl. He is still alive today because in four of those five emergencies, he received timely shots of naloxone, an opioid antidote.

Mr. Alward, like any Ontario resident, can get as much naloxone as he needs free from one of the more than 2,800 pharmacies that stock the medication in the province. The federal government made the drug available without a prescription in 2016, and Canada’s provinces have developed a range of approaches to delivering it to users. In Ontario, Canada’s most populous province, authorities began two years ago distributing it to drugstores and jails, and later expanded the program to include homeless shelters and drug-rehabilitation centers.

Canada serves as a model for those lobbying for similar access to naloxone in the U.S., where a patchwork of state laws governs the medication’s availability. The federal government has deemed naloxone a prescription drug, but the U.S. Food and Drug Administration began working two years ago on helping drugmakers develop an over-the-counter version.