‘There are people dying’: SMDHU calls for action amid spike in opioid deaths

The Simcoe Muskoka District Health Unit (SMDHU) is sounding the alarm over a spike in opioid-related deaths.

According to SMDHU, there was a 70 per cent rise in opioid-related overdoses during the first 19 months of the pandemic, from March 2020 to September 2021, compared to pre-pandemic volumes.

Dr. Lisa Simon, an associate medical officer of health, says the biggest culprit is fentanyl, a synthetic opioid often laced into a wide range of street drugs.

"Often people do know they are taking it, but sometimes they don't," Simon says.

"You don't know the potency of what you're consuming, how much, what exactly it is, and so there is great risk for overdose death."

While the problem has risen substantially during the pandemic, Simon says it was already a significant issue across Simcoe Muskoka for several years.

The SMDHU first noted a considerable increase in overdose deaths related to fentanyl in 2017.

CONTRIBUTING FACTORS

According to Simon, the rise of overdoses can be attributed to multiple factors.

"Part of it is that the actual street drug supply itself has changed during COVID, and also people's ability to access the services they might usually in terms of health and social services has changed.

People might be using substances differently because of stress. They might be more likely to use a loan because of physical distancing."

PARAMEDICS AND NALOXONE

The County of Simcoe Paramedics (CSPS) has noticed the increase, with suspected opioid overdoses accounting for 18 per cent of all overdoses in the region. That's up from 14 per cent in both 2019 and 2020.

"Opioid and overdose-related calls for us remain a constant pressure," says JC Gilbert, the deputy chief for CSPS.

"In general, for the more severe ones, we'll always start with supporting ventilation. In the absence of them, look to stimulate and rouse the individual, and in an extreme circumstance, we'll move to a medication called Narcan to hopefully reverse the effect of the medication causing the overdose."

Narcan is often the brand name for naloxone, a common treatment for severe overdoses.

Paramedics report a rise in medication administration, with 201 instances in 2021 compared to 170 in 2020 and 104 in 2019.

While naloxone can play a critical role in treatment, Gilbert says it's best to call 911 after it's administered.

"Always make sure that medical attention is sought afterwards because, as I said earlier, the lifespan of that antidote is much shorter than the medication itself or the drug itself that the overdose is influencing."

SUPERVISED CONSUMPTION SITE

The SMDHU has been working on a harm reduction strategy, which includes increasing the administration of naloxone to partners throughout the region.

It is also working with the local branch of the Canadian Mental Health Association to expedite the approval of a supervised consumption site (SCS).

That site, if approved, would be located at 11 Innisfil Street in Barrie.

The health unit's associate medical officer of health says SCS are known to work.

"We know that they give people a safer place to use where they can be supervised, and so there is an opportunity to reduce overdose deaths, reverse overdoses and prevent use of the health-care system for that purpose," Simon notes.

She also says SCS allow people to connect with health-care services and social services, including treatment and housing support.

"Certainly, we're in a crisis situation like we are now where every day there are people dying of street drug-related overdose deaths in our region," says Simon. "We absolutely need something like a supervised consumption site."

Recently the health unit brought the issue to its board of health, which then advocated the provincial government for needed support.

Some of the recommendations requested include:

• Creating a multi-sector task force bringing multiple partners together;
• Scaling up harm reduction resources, including timely approval of supervised consumption sites;
• Scaling up treatment options for opioid use disorder;
• Investing in initiatives to help prevent substance use initiation and substance use disorders and promoting positive mental health from a young age.

According to Simon, preliminary data through February 2022, which is not confirmed, shows the rising trend does not appear to be reversing.