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You can’t solve Ontario’s opioid crisis by throwing money at it

Jamil Jivani, a visiting professor at Osgoode Hall Law School, is the author of Why Young Men: Rage, Race and the Crisis of Identity to be published by HarperCollins in March, 2018.

The Toronto Board of Health has joined the chorus of voices asking the Ontario government to better fight the opioid crisis. This week, the board voted unanimously to recommend the province declare the opioid crisis a provincial emergency. Last month, more than 700 health-care workers across Ontario signed an open letter also requesting Premier Kathleen Wynne declare the opioid crisis a provincial emergency.

In response to last month's open letter, Ontario's Health Minister Eric Hoskins resisted declaring an emergency and instead offered a familiar solution: spending more money. The provincial government plans to spend $222-million over three years to hire more harm-reduction workers, expand the supply of naloxone and create more clinics. Following the board of health's vote, Mr. Hoskins doubled down on his refusal to label the opioid crisis an emergency.

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Missing in this response is recognition that the opioid crisis requires more than just money to solve. It also requires dynamic leadership that can rally government agencies and others around a shared strategy to combat opioid abuse on multiple fronts. Declaring a provincial emergency or a comparable gesture would signal that the Ontario government is taking meaningful responsibility to solve the problem of opioid abuse.

For the last few months, I've been working to fight the opioid crisis with Our Ohio Renewal, an advocacy and policy research organization based in Columbus, Ohio. Ohio is one of the states hit hardest by opioid abuse in the U.S. From 2000 to 2015, unintentional drug overdoses in Ohio rose from 411 per year to 3,050. This change in overdose deaths tells the story of a growing crisis. Heroin, fentanyl, oxycodone, hydrocodone, codeine, morphine and other drugs have increased in both supply and demand throughout the state.

Ontario hasn't seen nearly as many opioid overdoses. From 2003 to 2016, overall opioid-related deaths grew from 366 to 865 a year, including a 19-per-cent increase from 2015 to 2016. Emergency department visits related to opioid abuse have more than doubled in Ontario since 2003. Toronto Public Health reports that of the 204 accidental drug-related deaths in Toronto in 2015, opioids were involved in 135 of them.

However, news headlines in Ontario have started to alarmingly mirror what I've seen in Ohio. For example, earlier this month, the Toronto Public Library announced that it will begin to train staff to administer naloxone to help reverse opioid overdose symptoms. This is a sign of how transformative the opioid crisis can be in its impact on public services, a transformation that has already taken root in other parts of North America.

I was recently in Ross County, Ohio, to learn from Community Action Agencies fighting the opioid crisis in the state. Ross County, which is home to 77,000 people, lost 44 people to drug overdoses in 2016. It's believed by many that the number is trending higher for 2017. Very quickly I learned that it's hard for people in a small community not to feel each one of those deaths personally. Dozens of family and friends are attached to each person struggling with addiction.

The transformative impact of the opioid crisis was a common theme in Ross County. A municipal court judge powerfully explained, "None of us are doing the job we trained for." He said judges, police and probation officers, teachers, coroners, social workers and others working on the ground have had their jobs change significantly over the last decade. A police officer echoed this sentiment. "Groups that used to not work together are now forced to be partners. We need all the help we can get."

Ohio also provides an example of what dynamic leadership to fight the opioid crisis can look like. Ohio Governor John Kasich has organized an Opiate Action Team, which is a collection of different government agencies leading a collective response to opioid abuse. This team has taken a look at the opioid crisis from multiple angles: law enforcement; drug education for youth; development and enforcement of medical prescription guidelines; overdose antidote access; and treatment and recovery services. This Opiate Action Team doesn't have all of the answers, but it has been able to provide leadership to the many moving parts of a government, which is necessary for a problem as complex as the opioid abuse.

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If government leaders in Ontario can develop a comprehensive strategy to fight the opioid crisis now, Ontarians might be able to avoid the heartache and loss faced in other parts of North America. There are many lives at stake when government leaders decide what to do about opioid abuse; let's hope they recognize this crisis demands more than just money.

Video: Ontario boosts funding to combat opioid crisis (The Canadian Press)
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