Opioid use an issue across the region, councillors stress

WATERLOO REGION — Opioid use is a problem across Waterloo Region and not particular to one city, several regional councillors and staff stressed at a meeting on Tuesday.

“We have to get our mindset away from one area,” said Coun. Sue Foxton, North Dumfries mayor.

Councillors listened to presentations and delegations during a wide-ranging update lasting four hours on harmreduction efforts and the response to the opioid crisis in the region.

Cambridge Mayor Doug Craig said there’s a common perception of a bigger issue in Cambridge, but that’s related to the advocacy groups working to address opioid use in the city. In that way, he said, it’s not what’s going wrong in Cambridge but rather what’s going right.

“There is a sort of self exposure,” Craig said.

Coun. Elizabeth Clarke asked Waterloo Regional Police Chief Bryan Larkin specifically if there was a disproportionate problem in Cambridge.

“It’s fairly spread out across the region,” Larkin said.

He said drug use is more of an issue in particular areas of Cambridge, but the same is true in Kitchener and Waterloo. Clarke followed by asking if there are more needles being discarded improperly in Cambridge.

Karen Quigley-Hobbs, the region’s director of infectious disease, dental and sexual health, said part of the issue in Cambridge is there’s a large group living outdoors where there isn’t easy access to needle disposal containers that are strategically installed in public areas in the region.

“There aren’t disposal options in more secluded areas,” Quigley-Hobbs said.

Opioid-related calls for emergency services predominantly are in the region’s urban centres, Larkin said. On average, police get 45 calls a month.

“We also average seven deaths a month from overdoses,” Larkin said.

So far this year, there have been 65 overdose deaths in the region: 29 in Kitchener, 27 in Cambridge, nine in Waterloo, and none in rural areas.

Larkin said more public awareness is needed about the scope of the opioid problem, saying there would be more calls for action if there were a similar number of deaths on the region’s roadways.

“We still have to educate our community that this is a significant challenge,” Larkin said.

He said that before 2015, despite previous drug epidemics in the region, the impact on police services wasn’t tracked. Then “we started to see some significant demand on our resources” in responding to overdose calls.

Rob Crossan, deputy chief of paramedic services, said the service is predicting 700 opioid-related calls for medical help by end of year — a 145 per cent increase from two years ago. However, he said that still accounts for less than two per cent of ambulance calls.

“It’s not overwhelming,” Crossan said. “It’s not the main driver of our call volume increase.”

Safe injection sites were talked about repeatedly during the meeting. The region is exploring the feasibility of supervised injection services with the aim of reducing overdose deaths and disease transmission, public drug use and unsafe needle disposal.

These sites will not be standalone, but integrated with other services, Quigley-Hobbs said. She called it “one tool” in tackling the opioid issue.

According to a 2016 survey, one in 10 drug users in the region experienced an overdose. Often, fentanyl — a very potent opioid that can be added to other drugs — is implicated.

“In many cases, it’s unintentionally used,” Quigley-Hobbs said. “It puts an individual at higher risk for overdose and deaths.”

Several councillors raised some of the fears they’re hearing about safe injection sites, such as increased drug and criminal activity in the area.

Larkin was asked how police would handle these sites, and he said it would be a “complex balancing act” looking at the perceptions of both the public and users.

Craig said there’s a lot of misinformation on social media, and the majority in Cambridge seems opposed to a safe injection site being located there.

“They don’t really have all the information,” he said.

Craig called for more community engagement, saying getting information out is “absolutely key.”

Three delegations spoke about the sites, asking councillors to not hurry the decision.

“We are opposed to rushing into such a serious step,” said Dan Clements of For A Better Cambridge.

The grassroots group, which says it’s not for or against supervised injection sites, wants council to look at what’s happening in other communities that have the sites, what effect the new rapid access treatment clinics will have after they’re opened in Kitchener and Cambridge, and offer better support services first.

Cambridge resident Cindy Watson said the model of supervised injection sites is broken, and the region should look for another that both helps drug users and protects the community.

“Public health should encompass all of the public,” Watson said. “Who is our advocate?” A few councillors took issue with that suggestion.

Foxton pointed out that’s why council gathered a group of professionals to get more information.

“There isn’t just one solution. We’re not knee-jerking,” Foxton said.

“This is a problem vastly greater than I think even the public imagines.”

Watson said the sites also won’t solve the problem of improperly disposed needles.

When asked earlier about how the needle program is working, Quigley-Hobbs said the region is not seeing high levels of transmission of HIV and hepatitis C. Disposal containers are full regularly after a slow start.

“Can it be better? Yes,” she said.

She said the needle return rate was at about 40 per cent last year, a significant increase from about one in four in 2014.

Last year, she said about 600,000 syringes were handed out.

“That seems very, very high,” Coun. Sean Strickland said. “There’s a lot of syringes that aren’t coming back.”

He said it is encouraging to see the amount of collaboration happening in the region to deal with the opioid issue.

“It is a crisis,” Strickland said. “I think the question is what do we want to do about it.”