All-level responses needed for city drug crises
On Feb. 6, the alarming news rippled across social media. Outside a church in downtown Belleville, Ont., emergency officials had responded to 13 overdose incidents in less than an hour. Police asked the public to “avoid unnecessary travel to the downtown core” and give emergency personnel space to do their jobs.
By the end of the day, a city that typically gets one or two emergency overdose calls in a 24-hour period had responded to 17 overdoses, or — more accurately — poisonings from a contaminated drug supply.
Overnight, the small city became emblematic of a public health emergency sweeping the province. Testing ultimately confirmed local opioids had been cut with benzodiazepines (a class of commonly prescribed sedatives) along with the animal tranquillizer xylazine. Neither
contaminant responds to naloxone, the life-saving drug widely used to reverse opioid overdoses.
Two days and six more poisonings later, Belleville Mayor Neil Ellis declared an addiction emergency. The community had been fortunate: everyone was revived. That wasn't the case last November, when Belleville recorded 90 drug poisonings in a week; one death was reported.
Ellis has made it clear his city — indeed, every city — lacks the resources to respond adequately to a crisis with roots in three areas of provincial responsibility: drug addiction, mental health and homelessness. He asked for help, noting solutions will require all levels of government working together.
As in other towns, visible drug use in this small waterfront city has worsened noticeably since COVID-19. Last summer, I drove past a family crossing a busy intersection wearing no shoes. Around the corner, a man sitting outside a dollar store rolled up his sleeve and tapped a vein, as customers walked by. He was perhaps 30 metres from a pharmacy, where free naloxone kits would be available on demand. As opioid use goes, it's not the worst contingency plan.
He did not ask for help, and passersby did not intervene. Where would they go? Belleville has one emergency shelter with 21 beds, and one shelter for women and children escaping violence. The last point-in-time count (PITC) in Hastings County, conducted in November
2021, identified 237 people experiencing homelessness, including 26 children.
The PITC data were collected by Bridge Street United Church, the same location where the recent drug crisis unfolded. The John Howard Society operates a drop-in centre and meal program there, but the need is overwhelming.
The city has invested $2 million to convert a banquet space into The Bridge, a planned 24-hour hub with wraparound services to support mental health, addictions and homelessness. Ellis asked the province to match that investment with $2 million in capital funds, to get the integrated care facility up and running. So far, the province has responded with a one-time cash infusion of $216,000 to support local addictions and mental health services, but no capital funding.
The federal government supports safer supply pilot projects in select provinces, including Ontario. The Substance Use and Addictions Program provides access to an unpoisoned drug supply, through medical prescriptions. Together with supervised consumption sites, they help people at all stages of addiction and recovery access health care and addiction support. The harm-reduction strategies are proven to save lives. The nearest safer supply program to Belleville is an hour and a half away, in Peterborough.
Premier Ford signalled he was not considering safer supply. Last fall, his government paused new supervised consumption sites while undertaking a review of all sites.
Mirroring the struggles of other cities, Belleville is investigating options to fund a new facility on its own. “We don't have time to wait,” the mayor said simply.