The Ontario government is combatting the opioid crisis by investing $222-million over 2.5 years on harm reduction and treatment measures, just as the province confronts a sharp increase in overdose deaths.
Opioid-related overdoses claimed the lives of 865 people in Ontario in 2016, a 19-per-cent increase over the previous year, according to figures released on Tuesday that provide fresh evidence of an escalating epidemic.
The fatality figures are nine months out of date. But Ontario Health Minister Eric Hoskins told The Globe and Mail in an interview that he is nervously looking to Western Canada, the region hardest hit by the epidemic. "I am worried," he said.
British Columbia is on pace for approximately 1,500 overdose deaths this year and fatalities are up 50 per cent in Alberta, largely due to illicit fentanyl. In Ontario, about 30 per cent of overdose deaths in 2016 were linked to fentanyl, Dr. Hoskins told The Globe. The numbers in Ontario are "nothing compared to what we are seeing" out west, he said, but he is bracing for a possible increase.
"I'm hopeful that the measures we've put in place over the last year and a half will help flatten the curve so that we can avoid what's happening in B.C. and to a lesser extent Alberta," he said. "But it's hard to know."
The new funding announced on Tuesday builds on previous initiatives introduced by the government aimed at addressing opioid addiction and overdoses, including new chronic-pain clinics, delisting high-dose prescription opioids from the province's drug plan and treating patients with a safer but more expensive pharmaceutical therapy. "Too many lives have already been lost," Dr. Hoskins said at a news conference in Toronto.
The largest chunk of the new funding – $70-million – is earmarked for addiction-medicine clinics across the province, which provide patients with treatment, counselling and other mental-health services.
On the harm-reduction front, the government plans to spend $23-million expanding the number of supervised drug-use sites in Ontario. The province has already provided $3.5-million in funding for three supervised sites set to open in Toronto.
At an interim supervised drug-use site that opened for service on Aug. 21 in Toronto, 13 opioid overdoses have been reversed and only one person had to be sent to a hospital, Zoe Dodd, a harm-reduction worker, said at the news conference. She said there is demand for immediate funding to open more sites. "We have people volunteering their time right now," she told reporters.
The government also plans to tackle opioid overdoses by making naloxone – a first-aid drug that reverses the symptoms of an overdose – more widely available.
As part of that initiative, hospital emergency departments across the province will begin distributing take-home naloxone kits to patients treated for overdoses. Data collected by a new online surveillance system show a marked rise in many regions of Ontario in the number of emergency department visits in recent months.
Kieran Michael Moore, medical officer of health for Kingston and neighbouring communities, said all 150 emergency departments in Ontario should be handing out naloxone kits to overdose patients before they go home, but he said the vast majority are not doing this.
"This is low-hanging fruit, it's a policy gap and it isn't being addressed equally across this province," he told The Globe.
Dr. Hoskins announced the funding measures a day after more than 700 physicians, nurses and other front-line health-care workers across Ontario signed a letter calling on the province to implement emergency planning measures to address a spike in overdoses. The open letter says health-care providers are concerned about a lack of decisive action by the province.
Dr. Hoskins rejected that request, saying the province's emergency powers are typically used for situations lasting no more than 14 days.
"All of us here today know that the opioid crisis is not short term," he said. "This is a long-term crisis."