Health unit sounds alarm on deepening regional opioid crisis

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SUDBURY – The board of directors for Public Health Sudbury and Districts (PHSD) sounded the alarm on the deepening opioid crisis at its May 20 board meeting and will consider the development of a regional coalition to address the issue. 

Delegate and public health nurse Josée Joliat presented an update to the board on the work of the City of Greater Sudbury Community Drug Strategy (CDS) called Sounding the Alarm. Ms. Joliat noted the Northeast has been disproportionately impacted by rates of opioid related deaths with rates rising significantly in half of Ontario’s public health units during the pandemic. 

The opioid crisis has escalated across Canada since the beginning of the COVID-19 pandemic with more than 19,000 apparent opioid related deaths reported nationally from January 2016 to September 2020.

A recent report from Public Health Ontario showed that five Northern Ontario health units reported some of the highest opioid related deaths per 100,000 population in Ontario. Four of the five health units are located in Northeastern Ontario, including Sudbury and Districts, Porcupine, Algoma and North Bay and Parry Sound. Thunder Bay in Northwestern Ontario also reported a significant rate of opioid related deaths. 

PHSD currently has the highest opioid related death rate in Ontario and this nearly doubled in 2020 when compared to 2019. The rate of deaths attributed to opioid overdoses was 105 in 2020 compared to 56 in 2019. This equates to a rate of 52.4 percent for 2020 and 28 percent for 2019, compared to Ontario rates of 16.4 percent and 10.4 percent respectively. 

Ms. Joliat suggested these deaths may be due to the lower availability of services in rural and remote regions which makes it difficult to reach those persons at highest risk of overdose. “There’s not just one solution and no silver bullet,” she said. “We need for everyone in the community to do what they can individually and collectively.”

She noted the need for both immediate and long-term strategies to address the crisis. Immediate actions could include a safe consumption site, naloxone, sterile supplies and needle exchanges and increased outreach. Medium-term strategies could include supervised consumption and treatment as well as a safe supply. Long-term strategies could include anti-stigma education, prevention, housing and a focus on social determinants of health. 

The CDS completed a needs assessment and feasibility study on the implementation of a supervised consumption site to be located in the City of Greater Sudbury in June 2020. They are waiting on an application for federal exemption from Health Canada. There are currently 19 sites in operation in eight cities across Ontario but only one is located in Northern Ontario, in Thunder Bay. 

“We are losing our community members at an alarming rate,” Ms. Joliat said. “We need to intensify our work with partners to explore all options for immediate and long-term opioid related issues.” She suggested PHSD consider the benefits of a Northern Ontario or Northeastern Ontario regional coalition to amplify regional concerns and invest in potential strategies and resources. 

Medical Officer of Health Dr. Penny Sutcliffe stated, “Although the presentation is predominantly focused on CDS and Sudbury, I wouldn’t want to leave the impression the issue is only in Sudbury. It is district-wide and as you will see in the motion later on, I think there is a really good reason for this to be beyond our borders,” in Northeast or Northern Ontario.

Dr. Sutcliffe added that harm reduction in the form of a supervised consumption site actually increases community safety. “It allows people to feel connected and not stigmatized in a place they can use safely,” she said. “This does enhance safety, particularly in areas where we are seeing drug use occurring.”

In its motion, the board pointed to Ontario Public Health Standards that require boards of health to collaborate with local partners in health and other sectors “to develop programs and services that address varying substance use patterns in order to reduce the burdens associated with substance use.” The board recognized the leadership of the CDS, its needs assessment and feasibility study as part of community risk mitigation strategies and the need to secure a space location for a supervised consumption site. 

“Recent tragic death statistics are a resounding alarm for the need for all parties to double down on efforts currently underway and to explore innovative approaches–addressing immediate, medium- and long-term issues–to save lives, prevent opioid use and end stigma,” the motion stated. 

The board unanimously voted to both intensify local partnerships and explore a regional coalition of public health boards and other relevant agencies, and to receive timely status updates on opioid impacts and approaches.