Harm reduction workers advocate for safer delivery program to prevent deaths

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Harm reduction workers say controlled consumption sites and safer supply programs should be expanded to prevent further overdose deaths in Toronto, a call that follows several recent suspected opioid deaths.

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Toronto Public Health recently issued a drug warning, saying there were 10 suspected opioid overdose-related deaths between July 17 and 21.

Dayn Kent, Coordinator of the Consumption and Treatment Service at the Regent Park Community Health Center, said he has read multiple reports of people dying of an overdose in the city that he saw a few days earlier at the center’s guarded consumption area — a hygienic area for people to bring their own drugs to use in the presence of trained staff.

“We see people on Tuesdays and we don’t see them on Wednesdays and Thursdays, and we get a message that they died of an overdose on Friday because they were using when a service wasn’t open,” he said.

Kent said these notices and warnings indicate “system-wide failures” because some of those most vulnerable to overdoses are individuals who had access to treatment programs in prison and were released from prison without follow-up support, or individuals who had no access. to supervised consumption or a safer supply location in the city due to their limited opening hours.

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“Most sites are open during the day. There are no 24 hour sites. There are no seven days a week sites. So people use (drugs) safely when they have the opportunity,” Kent said.

“But if that option isn’t available, they’re still going to use it.”

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Kent said “robust” safer delivery programs — providing prescription drugs as an alternative to illegal drugs — are needed to tackle Toronto’s “toxic stockpile.” These programs must be “consistent and permanent” to ensure that people who use substances can do so safely and feel supported in the long run, he added.

Hayley Thompson, project manager for the Toronto Drug Control Service, shared a similar sentiment.

Thompson said the recent drug warning issued in Toronto “reflects the effects of an increasingly toxic and volatile supply, especially fentanyl” and that policy responses are not moving quickly enough to “reduce new tragedies”.

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She said controlled places of consumption and safer delivery programs need to be “scaled up” to prevent overdose deaths as the supply of illegal drugs “becomes more toxic and unpredictable”. The average amount of fentanyl detected in an expected fentanyl sample in the city is about four percent, which could be fatal for someone who has never used fentanyl, but that percentage has risen to 5.8 percent in the past two weeks, Thompson noted. . .

“We have some safer opioid delivery pilots in the province and downtown Toronto, but not nearly enough people are accessing them who are benefiting and then able to better understand their tolerances and their needs,” she added.

“Ultimately, we would like to see an established, regulated system for opioids and non-medical drugs, as we have the policy responses at our disposal to drastically reduce what we see in terms of both fatal and non-fatal overdoses. ”

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The Ontario Ministry of Health did not respond to a request for comment.

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In a statement, Toronto Public Health said the COVID-19 pandemic has “exacerbated the opioid crisis, contributing to an unprecedented increase in opioid-related deaths.” Preliminary data from the Toronto Overdose Information System shows that there were 511 confirmed deaths from opioid toxicity in the city in 2021 and 539 such deaths in 2020 – a record number.

“The increased contamination of other drugs besides opioids means that what we’re seeing goes beyond an opioid poisoning crisis and is now most accurately described as a drug poisoning crisis,” the public health unit said.

In response to the drug poisoning crisis, TPH said it launched the Toronto Overdose Action Plan in 2017, followed by an updated plan in 2019, and “continues to implement a number of urgent actions”, working across boroughs and with local community and health providers. . This includes mobilizing more than 60 agencies across Toronto to offer damage mitigation supplies and services in more than 100 locations.

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Nick Boyce, director of the Ontario Harm Reduction Network, said governments should support safer alternatives to illegal drugs to prevent further overdose deaths.

“Until the federal government decriminalizes and regulates drugs, and other levels of government support safer alternatives, such as pharmaceutical grade options, we will continue to see warnings and people will continue to die needless deaths from the volatile, toxic unregulated drug supply,” Boyce said. .

In a June report, Toronto’s medical health officer recommended that the city’s Health Council reiterate its call on the federal government to support the “immediate scale-up” of prevention, harm reduction and treatment services and additional safer delivery options in Toronto.

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TPH filed a petition with Health Canada in January to decriminalize illegal drugs for personal use through an exemption from the federal Controlled Drugs and Substances Act. Health Canada has approved a similar request in British Columbia.

The public health unit said it has had “active discussions” with Health Canada officials and has since “maintained extensive contacts with a range of stakeholders, including people who use drugs”.

“The decriminalization of illegal drugs for personal use can reduce stigma, discrimination and risky behavior that can lead to overdose and other harm. This change has the potential to improve health outcomes,” added TPH.

In a statement, Health Canada said TPH’s request is still under review.

The department added that the federal government has approved a number of prescription drugs that counties, territories and authorized health professionals can access for drug treatment and safer sourcing programs, and has invested more than $64 million to support 17 safer sourcing projects. in Ontario, British Columbia, Quebec and New Brunswick.

“The Government of Canada is committed to working with all partners to address the overdose crisis, save lives and support people who use drugs,” said Health Canada.

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