Despite a lack of real time, up-to-date information on the “complete picture” of the fentanyl-driven opioid crisis in Ontario, Toronto is hoping to learn from cities like Vancouver to tackle the growing issue of overdose deaths by increasing access to antidote medication and bringing the issue out of the “shadows.”
Toronto Mayor John Tory met with stakeholders from more than 20 organizations Monday for the first ever Toronto Overdose Early Warning and Alert Partnership, including police, paramedics, the coroner’s office, the Centre for Addiction and Mental Health, hospital emergency departments, harm reduction services and drug users to address the growing problem in the city.
Tory said he wrote to Vancouver Mayor Gregor Robertson late last year to “express condolences” and offer help on the opioid overdose crisis and the more than 100 deaths in the city in November alone, which led to a response from Robertson to “get ready” for the spread of the “epidemic.”
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“I was horrified as any human being would be at this kind of loss of life in a single month in a Canadian city, and as mayor of Canada’s largest city I wanted to do something,” he said.
“What we’d seen in Vancouver was something that could expand in that terrifying manner here just as easily and you want to be ready to deal with that if god forbid it should happen.”
Tory said Robertson also advised the Toronto mayor should advocate on behalf of the communities that were “suffering” from fentanyl and opioid abuse firsthand and the millions of Canadians “quite frankly who care” about the issue.
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“The prevalence of fentanyl and other highly addictive and dangerous opioids in Vancouver has reached a crisis point,” Tory said.
“We heard some statistics today in Toronto that indicate we haven’t reached the same stage here as yet, which is why I’m very thankful we have been acting and continue to act to make sure we do everything we can to stop that from happening, but certainly in Vancouver it is a crisis point.”
Tory said the opioid overdose issue in Vancouver was of national importance and said leaders of Canadian cities have an obligation to make a difference from an advocacy and action perspective.
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READ MORE: Fentanyl deaths on the rise in Ontario as drug creeps eastward from western Canada
“Fentanyl, as Mayor Robertson explained to me and others have explained as well, is a growing danger to recreational drug users as well as those with serious addictions,” adding that there has been an “evolution” as to how the drug is being used.
“As it spread out into recreational drug users it also spread out across the geography. And the crisis is spreading across the country, even if our numbers are not as current as they should be.”
WATCH: Toronto mayor holds first meeting with medical, city officials to tackle opioid crisis. Marianne Dimain reports. (Jan. 9)
Michael Parkinson, a drug strategy specialist with the Waterloo Region Crime Prevention council, said it’s much harder to help recreational users than seasoned opioid addicts.
“People who are using drugs occasionally is a much harder group to reach because they’re not traditionally frequenting public health units and other services,” he said.
“It’s absolutely critical that municipalities right across Ontario and not just Toronto move quickly to engage all the stakeholders that have a stake in reducing opioid-related deaths and harms. You really do need an all-hands-on-deck approach because we do know that no one single level of government, no one stakeholder is going to put a plug in this epidemic.”
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Tory said the issue of outdated overdose statistics is something that is recognized across the province as not being as “coordinated as they should be,” adding that officials were looking at ways to “better share information on a more up-to-date basis.”
“But we’re taking the information very seriously that we’ve received from Vancouver,” Tory said, adding police seized more than three kilograms of fentanyl last year — a 750 per cent increase over 2015 — and paramedics used more naloxone last year than in the two years prior combined.
“So these are indications of a growing problem and fortunately we’ve had the resources to be addressing that in an increasingly intense way.”
Dr. Barbara Yaffe, Toronto’s acting medical officer of health, said although the group is working with “preliminary data” from the coroner’s office that is generally 18 months out of date, the most current statistics show there were 253 drug overdoses in Toronto in 2015.
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That number was comparable to the previous year, but Yaffe said the rate of fentanyl-related drug overdoses had almost doubled from 23 to 42, signalling a growing problem in the city.
“They are looking for this, it’s just that it takes them quite a long time to do their detailed investigation and we routinely get the data about a year and a half after, which is kind of late,” she said.
“We know that deaths are just the tip of the iceberg. What we want to know about is overdoses, not just deaths. And so that’s why we’re looking at bringing these groups together.”
Coun. Joe Cressy said the number of “preventable” opioid overdose deaths in the city are on the rise, but the issue needs to be brought into the light.
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“If we don’t act, more people will die needlessly. That’s why we’re here,” he said, adding a comprehensive approach is needed to support people who use drugs and prevent them from dying.
“People use drugs for all sorts of reasons. But the policy response must also be complex otherwise it doesn’t work.”
Cressy said the Preventing Overdose in Toronto (POINT) program had distributed more than 3,500 naloxone kits in the last four years, leading to 545 overdose “reversals,” and a Toronto Public Health website allows users to report drugs to health professionals to address the growing problem.
READ MORE: Ontario expands use of overdose antidote medication to battle growing opioid crisis
“We’ve done a lot, and we can and we must do better because if we don’t, people will continue to die in escalating numbers,” he said, adding an overdose action plan is being finalized with a report set for release in March.
“But far too often it was in the shadows because drug use was marginalized and it was stigmatized. Far too often people died alone and they died alone in stairwells and in alleys.”
“And if it takes a crisis to bring the overdose situation to light, if it takes a crisis to make us think about drug use differently to make us think about drug use from a public health framework, than that’s what it takes and that’s where we are today and our job is to make sure that nobody, not a single person dies of an overdose if we can stop it.”
With files from Allison Vuchnich and Veronica Tang
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