Massive rise in Niagara opioid overdoses
Local hospitalization rate from opioid poisoning higher than Toronto, Montreal, Quebec City and Ottawa
Niagara’s emergency rooms have seen a 65 per cent increase in the number of opioid overdose cases over last year, Niagara Health System reports.
That information mirrors new data on the opioid crisis in Canada that shows Niagara has one of the highest rates of opioid overdoses in the country.
According to data released last week by the Canadian Institute of Health Information, or CIHI, the St. Catharines–Niagara area — among areas in Alberta and Ontario — has the fourth highest per-capita rate of patients in emergency departments suffering from “opioid poisoning” for 2016-17.
The report shows only Calgary, Brantford and Edmonton have higher rates of opioid poisoning cases in emergency departments. CIHI says only Alberta and Ontario were able to provide comprehensive emergency room data for its report.
“You can consider opioid poisoning an opioid overdose. It is the most serious form of harm from opioids,” said Paul Sajan, CIHI’s manager of prescription drug abuse. He said the term “opioid poisoning” also includes patients who doctors managed to resuscitate after being clinically dead from an overdose. The data does not specify the number of deaths from overdoses.
Sajan said CIHI believes the powerful and ubiquitous opioid fentanyl is the driving force behind a rise in overdoses across Canada, including Niagara.
Dr. Rafi Setrak, head of emergency medicine for NHS, said there has been a steady rise in the number of opioid overdoses in local emergency rooms.
“So far this year, we have experienced a 65 per cent increase in the number of opioid-related overdoses at our emergency departments, as compared to the same period last year (January to August),” Setrak said Monday in an emailed statement.
“There have been 326 opioid overdoses (January to August 2017) as compared to 197 (January to August 2016).”
Setrak said the rise in cases has put some strain on emergency department resources.
“We are committed to serving our community in every way possible and working with our healthcare partners in the community,” Setrak said.
“We have a number of programs in place for people seeking help for substance use. In 2015, we introduced a new program to which our emergency department physicians can refer patients in need of addiction followup care. The Rapid Access Addictions Medicine Clinic connects people with an addictions medicine physician in our mental health and addictions program, and is helping to reduce repeat visits to the emergency department.”
While last year’s CIHI report titled Opioid-Related Harms in Canada shows a high rate of overdoses in Niagara, the study does have some limitations, Sajan said.
There is an old Armenian saying, “The fish rots from the head.”
When it comes to the Region and any city or town there are actually two heads that come into play here.
The first is the elected person such as the regional chair or the mayor whose job is to lead council, be the face of council to the public and to ensure that the chief administrative officer legally, honestly and diligently direct staff to execute the will of council. It should be understood that this leader is where the buck stops. This leader should remember that she/ he is not a dictator but that she/he must follow the will of council and never do anything to subvert that will.
The second person is the CAO who is responsible for carrying out the will of council. In performing this job, the CAO must be the keel that ensures that council does not go off course and that council does not open itself up to legal challenges. The CAO does not work for the chair or mayor, but works for council.
Both the CAO and the chair/mayor ultimately work for the ratepayer and must ensure that all decisions made are in the best interests of the ratepayer and only the ratepayer. Personal agendas, favouritism and serving any special interest groups over and above serving the ratepayer should never be tolerated.
Now here is where it gets interesting, as these two should always be looking critically at each other to ensure everything is above board. When the relationship between these two positions becomes one where neither is holding each other accountable then the ship quickly runs off course and the system becomes corrupted.
For example if a CAO notices that the chair/mayor is doing something that might be underhanded or unlawful then it is the obligation of the CAO to point it out to the chair/mayor and if nothing is done then the COO should immediately bring the incident to the attention of the entire council. Then it will be up to council to decide the course of action. If the CAO is seen to be in collaboration with the chair/mayor then the system is corrupt and needs to be fixed.
By the same token if the chair/ mayor finds out that the CAO has done anything to compromise council then that as well needs to be brought to the attention of council.
This brings me to all of the shenanigans that still seems to be happening at Niagara Region. The system is broken, not because there are no policies or procedures in place to deal with things such as inappropriate behaviour or misuse of expenses, it is simply that in this case the fish is rotting from the head. Neither the current chair nor the new CAO seem to be able to do the job that they were elected or hired to do.
I don’t know if they are not getting good advice from their advisers or they are simply ignoring or twisting that advice for their own ends, but nothing is passing the smell test.
It is refreshing to see that finally some councillors are standing up and challenging the decisions of these two individuals. We must keep in mind at all times the ultimate power lies with council, not the CAO or the chair, and it is up to council to hold them accountable.
If this council cannot stop this fish from rotting from the head then it must be up to the rest of us to stand up and speak up. The system at the region is broken for several reasons and can be fixed easily from two angles. First, the CAO and the chair need to do their jobs and, second, council as a whole needs to stand up and hold them accountable.