I have recently completed the first in a series on opioids for The Sound @TheSoundSTC,
Niagara Region’s largest independent paper, and will be releasing it in the weeks to come.
As an addictions counsellor, I am not only qualified to speak on this issue but have experience working with street-involved youth and adults struggling with addiction and active mental health crisis.
As first printed in The Sound, March 2018:
Dozen’s Dead, Numbers Expected to Rise
I could write an opus on drugs; explain how our brains are wired with neurotransmitters or discuss how different chemicals have different rates of bioavailability, half-life, and pharmacokinetics. I could explain how the therapeutic index (TI) of a drug – the prescribed dosage – is the ratio between the effective dose (ED) and the lethal dose (LD) in 50% of the population; but, it’s time, Niagara.
We need to talk some real shit.
At least three people have died following suspected opioid overdoses in the Niagara Region between Valentine’s Day and February 20th, 2018; at least one opioid death in February could have been avoided if St Catharines had a safe injection site.
According to Niagara EMS, they responded to 155 suspected drug overdoses in 2016 and 520 in 2017. Preliminary death data, released by the province, shows 40 people died from opioid overdoses in Niagara in 2016 while numbers for 2017 are expected to at least double.
For the three months available (May-July 2017), there were 7 suspected opioid deaths in each month – 16 confirmed and 5 probable opioid overdoses – for a total of 21 deaths. In 3 months. Compare that to 40 the entire year before.
If we look further, we discover Niagara emergency departments treated 43 overdoses in July 2017, 7 of whom died (6 confirmed opioid, 1 probable). While the death data is not yet available, if the death to ER visit ratio was 7:43 (1/6) in July, and data shows 62 people were treated for opioid overdoses in both August and September, statistically speaking, 10 people probably died in each month.
That would mean we surpassed the total opioid deaths in 2016 in just 5 months of 2017 (May through September); the total lives lost to opioids in 2017 is probably around 87… if not higher.
People are dying; this is no longer a problem to be swept into the darker corners of the region. Niagara needs wider-sweeping harm reduction initiatives including a supervised injection site. Mayor Sendzik, of St Catharines, has been vocal in his support, stating he’d like to see a site open in his city as quickly as possible.
“Everyone knows someone who has struggled with addiction.
Just like lifting the stigma of mental health, we have to lift the stigma around addictions to tackle the opioid crisis.”
– Mayor Walter Sendzik, St Catharines
The City of St Catharines, which has one of the highest overdose rates in Ontario, is currently working with the Region of Niagara Public Health and a coalition of local organizations – known as the Overdose Prevention & Education Network Niagara or OPENN – to open a temporary safe injection site in St Catharines.
Public health officials anticipated the ‘nearly complete’ application for a temporary supervised injection site, once submitted, will take approximately 10-12 weeks (although I was unable to ascertain when, exactly, submission was anticipated to occur).
What Is A Supervised (or Safe) Injection Site?
Supervised injection (SI) sites are a safe place for someone to use their IV drugs; when someone uses their pre-purchased drug in a controlled environment, it allows for the immediate detection and treatment at the onset of overdose symptoms.
Administering Naloxone (formerly Narcan®), a compound which binds at the opioid receptor sites in the brain displacing the drug molecules from those receptors, in combination with respiratory and cardiac support, at the onset of overdose symptoms, saves lives.
In fact, the data shows in 86% of opioid overdoses, Naloxone is effective, and, within 10 minutes the person is conscious.
Here’s where the supervision comes in: how do you self-administer Naloxone if you have lost consciousness? How do you self-administer chest compressions? or call for EMS?
Efforts to train and pass out Naloxone kits are having a positive impact within the community but that doesn’t save the life of the man who uses, alone, in a Tim Horton’s bathroom, does it?
Benefits to the Community At Large
Don’t supervised injection sites encourage drug use? Studies show this to be false, nobody starts shooting heroin because they can do so while supervised; to say otherwise is ridiculous and contrary to the data.
A recent study in Toronto found that 36% of people who use drugs reported injecting in public places such as washrooms and alleyways. In St Catharines, we could replace alleyways with parks.
Supervised injection sites promote safety and hygiene while discouraging inappropriate disposal of used needles. Proper disposal of paraphernalia, such as needles, reduces the risk of accidental needle sticks for first responders, and in our public spaces including parks.
With some simple changes to the way we treat addiction and narcotic abuse, we can reduce the overall costs to our healthcare system – including emergency rooms and EMS resources. We end up with a net positive for the entire community.
We are not going to solve age-old issues of narcotics use, and abuse, by providing harm reduction programs and safe environments to addicts, but we may regain some of our humanity.
Every interaction a worker has with an addict or at-risk client is another opportunity for non-judgmental conversation and education; every interaction is another chance to build trust and, when the person is ready, change.
We created the stigma, the hair shirt, addicts wear; it’s time we share the burden.
This is the first in a series on opioids; check out The Sound (@TheSoundStC) for more. Up next, Social Indicators: Mental Health, Substance Abuse, and Poverty.
Emily Spanton, @FEW_Niagara
UPDATE: On February 26th, St Catharines City Council unanimously voted to support an application by Niagara Region Public Health and a collective of harm reduction and social service agencies to the Province for a temporary supervised consumption site.
|Opioid Crisis and Overdose Prevention Site
At the meeting of February 12, 2018, Mayor Sendzik provided notice that he would present the following motion:
WHEREAS the use of dangerous opioids is contributing to an epidemic of drug overdoses across the country, including 520 suspected opioid overdoses attended by Niagara EMS in 2017; and
WHEREAS the federal government has responded with temporary exemptions under the Controlled Drugs and Substances Act for overdose prevention sites; to permit temporary overdose prevention sites to respond to the opioid crisis; and
WHEREAS the Province of Ontario has created a program to establish overdose prevention sites on a time-limited basis as a low barrier, life-saving service providing supervised injection, naloxone, and the provision of harm reduction supplies, to be funded by the Ministry of Health and Long-Term Care; and
WHEREAS first responders, including St. Catharines Fire and Emergency Services, are being equipped with naloxone kits and trained to respond in the event of an overdose medical emergency call;
WHEREAS the Overdose Prevention and Education Network of Niagara (OPENN) is a network of local agencies coordinating the response to this crisis, including St. Catharines Fire and Emergency Services, Niagara Region Public Health and Positive Living Niagara;
THEREFORE BE IT RESOLVED that St. Catharines City Council supports the Opioid Prevention and Education Network of Niagara / Positive Living Niagara application to the province for a temporary overdose prevention site and requests that the City be consulted in the location of a temporary site and any future considerations for a permanent site in St. Catharines.