COMMUNITY IN CRISIS
Strategy unveiled to combat opioid epidemic
A four-pillared strategy to combat the region’s opioid crisis was unveiled Friday by local officials.
They zeroed in on improving treatment options, public awareness, physician and patient education, availability of the antioverdose drug naloxone and harm reduction measures like needle disposal boxes and investigating a safe-injection site.
“We can call it a crisis because it is affecting our community hard and our average rate of opioid-related death is way higher than the provincial average,” acting medical officer of health Dr. Wajid Ahmed said at a morning news conference to announce the strategy that’s been a year in the making.
He displayed a graph comparing the steadily climbing provincial death rate — peaking recently at 6.2 per 100,000 population — to Windsor-Essex’s 9.1 death rate, which is 46 per cent higher.
Ahmed called the comparison, taken from the province’s opioid tracker, “alarming enough” to draw up a plan to prevent what are largely preventable deaths. In Ontario, 14 per cent of the population filled an opioid prescription in 2015-16, and the Erie St. Clair health region (Windsor-Essex, Chatham-Kent and Sarnia-Lambton) had the highest rate of opioid prescriptions in the province at 18 per cent.
The impact is being felt everywhere. In the last several months, the strain on first responders like paramedics has become severe, said Tecumseh Mayor McNamara, who chairs the region’s board of health. He noted that the budget for local land ambulance is rising 19 per cent this year, driven at least partly by the increasing demands wrought by the opioid epidemic. The number of opioid-related emergency department visits have more than tripled since 2003.
“And certainly the despair within our families,” he added. “This is something that is embedded in our region.”
The strategy identifies a number of problems that need to be addressed.
Comments to surveys included: complaints that doctors and dentists were giving out huge doses of painkillers; a lack of public information to help identify when a family member is in trouble; the stigmatization of drug users that prevents them from seeking help; the lack of treatment facilities unless you have money to pay for them; and the shortage of non-abstinence treatment programs (opioid substitution therapies like methadone and suboxone).
Mayor Drew Dilkens stressed that while municipalities like Windsor can tackle the issue — the city’s 2018 budget includes money for needle disposal boxes and an outreach worker — the Ontario government needs to provide funding to help lift the strategy off the ground.
He also expressed unease about a safe-injection site. As part of the strategy, the health unit plans to do a feasibility study on one for the region. Dilkens said his impression of Vancouver’s experience with a safe injection site is there are many problems associated with it.
“Maybe the answer is yes, but I think we have to think through what that looks like to make sure we’re not solving one problem but creating a whole host of problems in the community, as well,” he said.
The four pillars identified in the strategy are: prevention and education; harm reduction; treatment and recovery and enforcement and justice. Officials warned that there was still more work to be done to identify specific actions. “We just need to be patient and we need to make sure that what we are doing is working,” Ahmed said.
Byron Klingbyle, the harm reduction co-ordinator with the AIDS Committee of Windsor, expressed frustration over the time it was taking.
“All these pillars they’re talking about, they’re all important, but to do the biggest impact to the number of fatalities, you have to address that issue first and then work on the others,” he said, explaining that providing as many people as possible with naloxone and training them how to use it will immediately save lives.
Since July, the AIDS Committee has trained people and dispensed 618 naloxone kits (they’re available free from the province), and they were used successfully 137 times. On 96 of those overdoses, the situation was bad enough that a second dose was administered. That’s 137 saved lives, Klingbyle said.
“If makes logical sense to me, I would put all my resources into that to reduce the fatalities.”
Naloxone kits have been provided to many agencies and first responders, but Windsor Police have been wary about issuing them to officers because of Ontario rules requiring the province’s Special Investigations Unit to investigate instances of death or serious injury involving an officer.
“For me, that’s a game changer,” Windsor Police Chief Al Frederick said.
“I don’t want to subject my officers to further investigation when they’re out there trying to help people.”
He said while crime rates in Windsor and the rest of the province are flat, the number of calls for service are increasing dramatically. And its largely due to more calls involving complex issues such as drug overdose and mental health.
“It’s a very complex issue,” he said of the opioid crisis. “I can’t say we’re on the winning edge of this fight just yet.”