In the midst of a national opioid crisis, six people in six days have died of suspected drug overdoses in Toronto, a cluster of fatalities that has prompted the city to try to speed up its response.
Between July 27 and 30, at least 20 drug-related overdoses and four deaths occurred. On Tuesday, two young women were found dead of suspected overdoses in an apartment. The exact causes of the incidents were not confirmed in most cases but police said they suspect that fentanyl, a drug that can be fatal even in trace amounts, may have been involved.
On Thursday, Mayor John Tory met with first responders, public health officials and a few city councillors to ramp up the city's action plan, first released in March. The city will push to get three supervised drug-use sites, originally scheduled to open in November, open sooner. The city also wants to arm first responders, including police and city staff, with naloxone, a drug that can reverse the effects of an opioid overdose long enough to get someone to hospital.
Leigh Chapman, a registered nurse and harm reduction advocate, says she welcomes Mr. Tory's approach but believes more can be done to stop overdose deaths immediately.
Little has changed, she says, since her brother Brad Chapman died from a drug overdose in August, 2015, adding his death was entirely preventable just like the six people who died in Toronto.
Ms. Chapman spoke to The Globe and Mail about what she believes can be done to address the deadly overdose crisis.
How would you characterize the fentanyl threat in the Toronto area?
The fentanyl threat is very real. From what I am hearing, there is fentanyl not only just in heroin or when buying the opioid knowingly but that there is actually fentanyl in cocaine, in crack, ecstasy and other drugs. Fentanyl is an issue but this isn't a fentanyl crisis or an opioid crisis alone. This is an overdose crisis because of the criminalization and stigmatization of drug users and the lack of harm reduction services.
What factors have created the circumstances for this epidemic to exist?
One of the main issues is that people are using drugs alone, without access to a supervised facility. One woman, who died over the weekend, was found in a stairwell alone in Regent Park. Her death may have been preventable if she was in a supervised facility with access to naloxone. We cannot ignore the potency of the drug, but the social isolation and lack of support have created the circumstances for these overdoses to occur. There hasn't been any sufficient naloxone distribution and there hasn't been enough public education.
What is the feeling like on the ground at the moment?
Although I am not a front-line worker, I am closely connected to those who are and it is devastating. There is so much fear because drug users are losing their community. They are trying to do what they can to be as safe as possible by accessing the harm reduction services they can, but they are still overdosing because they are not in a supervised facility.
What kind of government support/action would you like to see?
There needs to be better funding for community health centres for naloxone distribution and overdose prevention education. There also need to be pop-up supervised injection sites. All first responders should carry naloxone and this is an epidemic so that requires everyone to be first responders. Hospitals need to start providing overdose prevention education, give out naloxone to people who have overdosed and have detox beds available. We need to ensure that the supervised injection sites and other services are staffed with registered nurses, peers and social workers.
What are your thoughts on the proposed safe drug-use site?
It will be groundbreaking for users to be able to use safely in a health care facility where there is access to naloxone and support. It acknowledges drug users as people and fosters a connection between them and those providing care and services. However, these sites are just an extension of harm reduction services, such as needle exchange and naloxone distribution. We need to stop seeing supervised injection sites as the solution because they are only a part of a cascade of services that should be offered. The other thing to note is that these sites do not include people who snort and smoke drugs.
If you could send one message to Mayor Tory and Ontario Health Minister Eric Hoskins, what would it be?
I think the one message would be to listen to those who are working on the front lines of harm reduction because they know what they need to save lives.
This interview has been edited and condensed.