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Dual health crisis of drug overdoses and COVID-19 calls for harm reduction strategies

October 5, 2020  By Pauline Kerr, Local Journalism Initiative Reporter, The Walkerton Herald Times


GREY-BRUCE — Ian Reich, public health manager, made a presentation to members of the Grey Bruce Board of Health at the Sept. 25 meeting on mitigation strategies for overdose prevention during the COVID-19 pandemic.

Although COVID-19 has captured the public’s interest, overdose deaths continue, both in Grey-Bruce and across the province. There were 18 deaths in 2019, the largest number to date, and 2020 is heading in the same direction. “There were four deaths early in the year and 10 more since COVID.”

Part of the challenge, said Reich, is the conflicting messaging. While staying away from others is the key message for COVID-19, the message for drug users is, if you’re using, use together.

He told of an innovative program out of Hamilton that allows people using drugs alone to call a number, 1-888-853-8542. If there’s a problem, 911 can be dispatched to the user’s location.

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Reich spoke of the expanded Naloxone program at Hanover and District Hospital, which allows naloxone kits to be dispensed to family and friends of drug users who end up in the emergency department.

There’s a lot of community outreach going on, he said, including the needle exchange program in Wiarton. The health unit is working with New Directions in Hanover, as well as doing work in Lucknow and Owen Sound, partnering with Grey and Bruce Housing, and working with CMHC Hope Grey Bruce.

There is a new, expanded naloxone program that involves Family Health Teams, police, and EMS, allowing them to dispense naloxone and provide training on how to use it.*

The goal is to prevent deaths, Reich said.

He asked the board to endorse an open letter to the Canada’s Health Minister Patty Hajdu and the Government of Canada, and another to Ontario’s Health Minister Christine Elliott and the Government of Ontario, from the Municipal Drug Strategy Coordinators Network of Ontario.**

The letter calls for safer drug supply initiatives.

Reich explained such initiatives provide pharmaceutical-grade drugs to users as a strategy to prevent deaths. He noted 73 per cent of the drug fatalities in Grey-Bruce have involved drugs laced with fentanyl (a powerful synthetic opiate 50 to 100 times stronger than morphine) or carfentanil (100 times more toxic than fentanyl and used by veterinarians for very large animals like elephants).

The strategy does more than transition people from toxic, unregulated street drugs to safer, pharmaceutical-grade substances. It takes place in a health-care context and addresses substance use as a health issue rather than a criminal one. Participants have access to a wide range of health and social services. Such strategies have significant benefits — not just reduced deaths, but improved community safety and well-being.

As stated in the letter, COVID-19 has made the drug crisis across Canada worse. At a time when the supply of unregulated drug supply is becoming increasingly tainted and deadly, addiction services have either closed or cut hours of service. “It is now more evident than ever that urgent action is needed to address the opioid poisoning crisis that is co-occurring with the COVID-19 pandemic.”

In addition to giving “a big shout-out to the team during a time of conflicting priorities,” Reich also told board members about designing and implementing an Indigenous strategy.

During the question period that followed the presentation, board chair Mitch Twolan said this is an issue that affects “every one of our communities.”

Board member Anne Eadie, mayor of Kincardine, asked for more information about safe supply of drugs.

Reich said the person not only has access to safer drugs that aren’t tainted with toxic substances (fentanyl and carfentenil), but counselling.

“Fatalities are reduced to non-existent,” he said. “And the person is helped on their journey to recovery.”

He noted substance abuse is often the end result of traumatic events experienced in childhood, and spoke of videos on the subject by Dr. Gabor Mate, author of the book In the Realm of Hungry Ghosts.

Board member Selwyn Hicks, deputy mayor of Hanover, asked why more effort isn’t focused on childhood mental health. “Why wait until they’re adults?”

Reich agreed. “There needs to be a huge shift in funding… to address the issue.”

Dr. Ian Arra, medical officer of health, spoke of the health unit’s Healthy Babies Healthy Children program and said attention needs to be shifted to the “beginning rather than the end of the issue.”

The board voted to endorse both letters.

For more information on drug addiction, see the news release dated July 31, 2020, entitled Opioid Overdoses — Toxic Supply, posted on the Grey Bruce Public Health website.

*Naloxone, also known as Narcan, is a drug that temporarily blocks or reverses the effects of opioid drugs such as heroin, morphine and oxycodone, and more powerful synthetic opiates. Opioid drugs depress the central nervous system to the point where breathing can stop. Naloxone can help restore breathing during an opioid overdose. Naloxone can be administered by an inhaler or by injection; kits are readily available in Grey-Bruce and are designed to be used as first aid measures by people with minimal training.

**The Municipal Drug Strategy Coordinators Network of Ontario has 65-plus members who work in diverse health settings across the province, including public health units, community health centres and not-for-profit organizations. Members coordinate multi-sectoral initiatives that aim to prevent and/or reduce the harms of substance use through regionally tailored strategies incorporating prevention, harm reduction, treatment and enforcement-justice initiatives. Learn more at www.drugstrategy.ca.

– Pauline Kerr, Local Journalism Initiative Reporter, The Walkerton Herald Times

The Canadian Press Enterprises Inc., 2020


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