Drug crisis demands urgent action, experts say
Toronto Police issued an alert Tuesday after seven people fatally overdosed on drugs since Aug. 2 in the downtown core, indicating an overdose crisis in the city.
Sarah Ovens, a volunteer with Moss Park Overdose Prevention Society (OPS) who lost loved ones to opioid-related deaths, said “more people will die” if the government puts public health clinics on permanent hold.
“We’re in the biggest public health crisis right now. To put public health clinics on hold is going to lead to more people dying,” she said.
Ontario Health Minister Christine Elliott announced Monday the province will hold off on opening three new overdose prevention sites intended to help fight the opioid crisis.
Elliott said the Progressive Conservative government will make a decision on the sites, as well as more permanent facilities aimed at fighting the opioid crisis, by the end of September. She said the sites set to open in Thunder Bay, St. Catherines and Toronto will be put on hold as the government decides if they “have merit.”
Toronto Overdose Prevention Society condemned the “attempt by the Minister of Health to impede the response to an epidemic” in a press release.
“We call on the Ministry of Health to immediately reverse the ‘pause,’ and allow the OPS that have already been approved to open immediately, and to facilitate applications for more OPS communities across the province,” the society stated.
The alert stated a deadly batch of fentanyl or carfentanil is responsible for the overdoses. Both of the synthetic painkillers are more powerful than morphine.
Particularly dangerous is carfentanil, which is 100 times more potent than fentanyl. It was originally developed for veterinarians to sedate elephants and other large animals.
Figures from Toronto Public Health show fentanyl replaced heroin and morphine as the most commonly present opioid in overdose deaths in 2016. Fentanyl was present in 48 per cent of accidental opioid deaths compared to 31 per cent in 2015.
“In the nine months that we operated out of Moss Park, we responded to over 200 overdoses, and we gave out hundreds and hundreds of naloxone kits, and there was a huge need a year ago,” Oven said. “That need has not abated since.”
Toronto City Councillor Joe Cressy, Ward 20 (Trinity-Spadina), an outspoken advocate for harm reduction, responded to the opioid crisis on Twitter.
Overdoses are now the leading cause of death of young people in Ontario. The number of preventable deaths are accelerating rapidly. The evidence is clear – a comprehensive public health approach including treatment and harm reduction is required. The crisis demands urgent action.
— Joe Cressy (@joe_cressy) August 15, 2018
Data from the City of Toronto website indicate 303 opioid overdose deaths took place in Toronto in 2017 including accidental deaths and suicides. This is a 63 per cent increase from 2016 and a 121 per cent increase since 2015.
An unsanctioned OPS tent in Moss Park, set up by the Toronto Overdose Prevention Society (TOPS) and the Toronto Harm Reduction Alliance (THRA), opened last August, amid the city’s worst overdose crisis. At least 187 overdose deaths occurred between May and Oct. 2017 in Toronto, more than double during the same period in 2016.
Ovens said the proposed sites would have provided “vital” services now offered at the Moss Park site: supervision of injections, reversal of overdoses, wound care and referrals to other health services. They help people ostracized in society, including the homeless, those convicted of crimes, people dealing with adversity and those living precariously, she said.
“Spots need to be available anywhere overdoses are happening,” Ovens said. “It’s not that hard to do do, and it doesn’t require a lot of resources, so I don’t see why they can’t address the problem properly.”
In the city, overdose prevention sites are temporary facilities approved by the province to address an immediate need in a community. Supervised injection sites — also known as safe consumption sites — are permanent locations approved by the federal government after an extensive application process.
Four agencies provide supervised injection services in Toronto that are federally approved but provincially funded. In addition, there are four overdose prevention sites in the city that are provincially approved and funded.
Multiple studies, including dozens on Vancouver’s premier supervised injection site, Insite, have found that supervised injection sites meant fewer overdose deaths and infectious diseases from sharing needles.
Ovens said the number of overdoses has increased due to the stigma around drug use.
“We know that criminalization is really responsible for this crisis for fear, and to seek help and criminal repercussions and criminalization has allowed for the proliferation of fentanyl,” Ovens said.
The Trudeau government, however, rejected calls to decriminalize all illicit drug use in Canada.
“It really motivates people to create stronger and stronger substances which are going to be easier to smuggle and transport and sell to more people,” Ovens said. “Decriminalization and a regulated safe supply is only going to address this crisis.”
Toronto’s Public Health Medical Officer Dr. Eileen de Villa said Supervised Injection Services and Overdose Prevention Sites provide many health benefits, including reversing overdoses and saving lives.
“We believe that these health services continue to be part of a comprehensive approach to the overdose emergency, along with harm reduction, prevention and treatment services, in response to this very challenging and complex health issue affecting so many people in our community and beyond,” de Villa said.