Today, Mayor John Tory proclaimed August 31 as Overdose Awareness Day in the City of Toronto. This day is dedicated to raising awareness about the devastating impact of the ongoing opioid poisoning crisis in Toronto and to helping reduce stigma and discrimination against people who use drugs.
The overdose emergency continues to be an urgent public health issue in Toronto and across Ontario. The toxic drug supply is a major driver of overdose and overdose death. Over the course of the COVID-19 pandemic, there has been a dramatic increase in the number of both fatal and non-fatal overdoses across our city.
Preliminary data from the Office of the Chief Coroner for Ontario shows that in 2020, there were 530 confirmed opioid toxicity deaths in Toronto, an 81 per cent increase compared to 2019 when there were 293 recorded deaths. In the first quarter of 2021, preliminary data on confirmed opioid toxicity deaths indicates there were 142 confirmed opioid toxicity deaths in Toronto, a 60 per cent increase compared to what was seen in the first quarter of 2020.
Last month, there were 562 non-fatal and 26 fatal calls attended by Toronto Paramedic Services. The number of non-fatal calls due to suspected opioid overdoses is the highest on record since the City started monitoring these data in 2017. This data is provided with respect and a deep appreciation for its meaning, and how they refer to loved ones, friends, families and colleagues. The tragic and substantial losses that people face from the drug poisoning crisis, and the grief experienced, are immeasurable.
There are several factors that have contributed to these increases, including:
The increasing toxicity of the unregulated drug supply has had a significant impact on the drug poisoning crisis. Drug checking services in Toronto continue to find unexpected, highly -potent drugs in samples checked in recent months, including “ultra-potent” opioids such as carfentanil and highly-potent nitazene opioids.
There has also been additional efforts to respond to the noted increases in overdoses among people who are experiencing homelessness or are underhoused. Many of these individuals have moved into single room hotels or shelters and the risk of using alone has increased.
In June, the City’s Shelter, Support and Housing Administration, in collaboration with Toronto Public Health (TPH), issued an updated harm reduction directive (Funding Submissions, Directives & Bulletins) for City-operated and funded shelters and 24-hour respite sites, including the COVID-19 temporary hotel programs. The directive provides updated requirements for overdose prevention and response strategies along with resources (Guidance Document for Harm Reduction in Shelter and Hotel Sites: A 10-Point Plan) to support service providers. This initiative built on the December 2020 launch of the Integrated Prevention and Harm Reduction Initiative (iPHARE), which provided $7 million in funding to community agencies to address drug-related deaths in Toronto’s shelter system. This has included co-ordinating and providing evidence-based harm reduction support at the City’s physical distancing hotels and shelters, including supervised consumption, harm reduction supply distribution, counselling and support for people who use drugs, naloxone distribution, harm reduction training and options for overdose response. Further information on iPHARE is available at Integrated Prevention & Harm Reduction Initiative (iPHARE).
There is much work being done through the dedicated community of people working in harm reduction across the City to reduce the harms of the toxic drug supply and to support people who use drugs. TPH also remains committed in its work to implement the Toronto Overdose Action Plan (Toronto Drug Strategy) and to address emerging issues, working with City and community partners. In April 2021, TPH received funding from Health Canada to operate a safer supply clinic that offers injectable opioid agonist treatment (iOAT). This program is the first in Toronto to offer injectable hydromorphone for people with opioid use disorder, who do not respond to currently available services and remain at high risk of overdose. TPH began enrolling its first clients in early June.
Through The Works harm reduction program, TPH continues to provide overdose recognition and response training, distribute the lifesaving medication naloxone, offer supervised consumption and other harm reduction services, and support agencies across the city in providing local harm reduction services. This August 31 also marks the 10th anniversary of The Works naloxone distribution program. TPH also issues alerts on key drug-related issues such as when potent drugs are circulating. In addition, TPH created a COVID-19 guidance document to help harm reduction programs operate more safely.
TPH and the Board of Health continue to advocate for the expansion of all critical services that support people who use drugs, including harm reduction and evidence-based treatment. Decriminalization of the simple possession of drugs, and expanded safer supply programs that provide alternatives to the city’s unregulated drug supply, along with health and social supports for people who use drugs, are urgently needed. Further action from all orders of government are needed more than ever to address the opioid overdose public health emergency and to save lives.
“Today, we acknowledge the immeasurable grief, pain and impact of the opioid crisis on those that suffer – those who use drugs and in the grip of addiction – and the hundreds of friends, families, and colleagues who continue to suffer as a result. This has become a full blown health crisis and it deserves the same level attention as other health related issues. We require a commitment and further action from every level of government to address this crisis and to save lives. I will continue to advocate on behalf of our City to the other levels of government and call on them to provide funding to cities who are on the frontlines addressing the opioid crisis.”
– Mayor John Tory
“Today, we recognize a difficult day as we acknowledge International Overdose Awareness Day in Toronto. Every year, we are faced with the sadness and pain felt by so many of us in communities across our city as we lose loved ones and are forever changed by the devastation caused by our opioid overdose emergency. We know these deaths are preventable and that makes these losses even harder to bear. When we look at the impact the COVID-19 pandemic continues to have on this crisis, and what that means for the people who use drugs, their family members and friends, and the service providers who work so hard to support them each and every day, I remain vigilant and determined in making sure we do everything we can to lessen the effects of this crisis on our city.”
– Dr. Eileen de Villa, Medical Officer of Health
“Today, as we mourn those we have lost and stand in solidarity with their friends and families, we also commit to doing everything we can to end this crisis and save lives. Today we grieve, we remember, and we demand better. The need for action to prevent fatal overdoses has never been more urgent. Last year alone, we lost 530 people in our city to opioid overdoses – friends, loved ones, members of our communities. These deaths are devastating, and preventable. It’s time for everyone – and all levels of government – to treat this crisis as the urgent health issue it is.”
– Councillor Joe Cressy (Spadina-Fort York), Chair of the Toronto Board of Health
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