April saw spike in overdoses, report says

Stakeholders call on Ottawa to help with prevention plan

Toronto paramedics responded to more suspected opioid overdoses deaths in April — in the midst of the COVID-19 pandemic — than any month since September 2017.

That data is at the centre of a report to be considered by the board of health next week that recommends asking the federal government for help as part of the city’s overdose prevention plan to prevent further deaths.

“The ongoing opioid poisoning crisis in Toronto and across Canada has intensified and been further compounded by the COVID-19 global pandem- ic,” the staff report says.

“These dual public health crises are having significant impacts on people who use drugs in our community as well as their families, friends and loved ones. Services that people rely on, many of them life-saving, have closed or significantly reduced their service hours and/ or capacity.”

During the first four months of this year, paramedics responded to 1,307 suspected opioid overdose calls, including 7771 involving deaths, the report says. There were 25 calls involving deaths in April alone. The recommendations include asking the federal government to make an exemption for people to possess all currently illegal drugs for personal use during the pandemic while in- creasing harm reduction and treatment services. It also recommends the board ask the federal government to approve opioid therapy at a city-run site.

The report, signed by medical officer of health Dr. Eileen de Villa, says in order to achieve “substantive change” related to drug use, decriminalization is needed — something the board has previously requested.

The city is also looking at ways to address the issue of tainted drug supply, such as offering injectable opioid agonist therapy ( iOAT) and oral programs that have been piloted in Toronto in smaller initiatives already, the report says.

A funding application made to Health Canada in 2019 for the iOAT program at the Works — a supervised consumption site run by the city — was earlier rejected. It has been resubmitted, Toronto Public Health staff say in the report, in the context of the pandemic. The federal government has said that the cost of the program — about $8.5 million over five years, which is largely for the drugs not covered under provincial drug benefits — is too high.

“Safer supply programs (along with other prescribing practic- es and harm reduction services) reduce the risk of overdose,” the report says about the renewed request for funding. “They also facilitate self-isolation or quarantine for people who use drugs with COVID-19 by reducing the risk of the negative health consequences associated with withdrawal, and therefore contribute to preventing community transmis- sion of COVID-19.”

Coun. Joe Cressy, who chairs the city’s board of health, said it’s no coincidence the number of overdoses have spiked during the pandemic.

“In the context of COVID-19, we have seen an acute and dan- gerous challenge with overdoses. The combination of reduced harm reduction services coupled with an extremely dangerous tainted drug supply has created havoc on the streets for people who use drugs,” he said. “These deaths are preventable if we employ a public health approach to stop them and that’s what our medical officer of health is calling on us to do.”

Toronto opened its first legal supervised injection site, the Works located on Victoria Street, in 2017. That site was closed in March and part of April after an outbreak at the site, which is also home to Toronto Public Health’s headquarters.

Though changes have been made at supervised consumption sites to prevent further virus spread, that reduced capacity and fewer open hours as well people staying away due to concerns over infection have all led to fewer visits overall, the report says.