Epidemic of opioid overdoses during lockdown

Unregulated drugs and isolation cause increase in opioid-related deaths

An alarming number of overdose calls were made to Toronto paramedics on Jan. 29 and into Jan. 30. Over 24 hours, Toronto Paramedics Services attended to about 40 suspected overdoses, including three deaths.

The Works, a harm reduction program provided by Toronto Public Health since 1989, recorded this as the highest number of overdose suspected calls since 2017.

The spike in calls brought attention to how overdoses have continued to rise since the lockdown began, creating a second epidemic within the pandemic.

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The opioid epidemic is surging as opioids are being used alone, an “unregulated drug supply” is available, and mental health issues have surged due to prolonged isolation, say those involved in fighting this latest epidemic.

In a November 2020 study, Public Health Ontario reported a 38.2-percent increase in opioid-related deaths in the first 15 weeks of the COVID-19 pandemic with 695 deaths, an average of 46 weekly. A significant increase in hotels or motels was indicated, showing that is where many of Ontario’s homeless have been relocated.

Susan Shepherd, Toronto Drug Strategy Secretariat, said she is aware of the detrimental effects of social distancing when it comes to harm reduction.

“The overdose emergency continues to be an urgent public health issue in Toronto and across Ontario, and has been exacerbated by the COVID-19 pandemic,” Shepherd said. “We are very concerned about the impact that COVID-19 is having on people who use drugs and people with substance use issues.”

Many of the services people have relied on, including lifesaving services, have had to reduce capacity to accommodate necessary public health precautions, such as physical distancing, to prevent the spread of COVID-19, she said.

 

Overdoses in homeless shelters

As part of the City’s three-tiered COVID-19 response, several make-shift shelters set up in community centres throughout Toronto, relocated to hotels such as the Roehampton Hotel at Eglinton Avenue East and Mt. Pleasant Road.

As someone born and raised in the area, Bobby Parker believes moving clients to the midtown area was not the best idea.

“Growing up I saw a large group of people move in the neighbourhood in the 70s. Back then, Eglinton was actually the top of Toronto and I used to see a lot of cops and a lot of drug dealers,” Parker. “But it’s a different area now and there are small apartments, that are already being threatened to be torn down, so the stress of people living there has obviously gone up.”

The Roehampton is close to the secondary school where Parker grew up. “So dropping a bunch of addicts and dealers into a pot like that is, in my opinion, a bad decision,” he said.

The city reported  more than double the number of overdose deaths in Toronto shelters — from 13 in 2019 to 37 in 2020. When clients are isolated they cannot be monitored the way they were in a normal shelter setting causing some to overdose alone in their room.

The Integrated Prevention & Harm Reduction Initiative (iPhare) was created to combat opioid-related deaths in shelters which began rolling out services in December 2020.

Through iPHARE, the city is providing intensive mental health case management supports and is working with shelters to ensure every location has a plan for overdose prevention and response, peer witnessing, mandatory staff training, wellness checks and access to onsite harm reduction supplies, including naloxone, Shepherd said.

 

Unregulated drug supply

“Another contributing factor to the overdose crisis is Toronto’s unregulated drug supply, which remains unpredictable and toxic,” Shepherd said.

The Works reported Toronto’s several unregulated drugs, making opioids more fatal, have been found in circulation, she said.

“In 2020, drug-checking services in Toronto found unexpected, highly potent drugs in unregulated drug supply samples, including carfentanil (a highly potent fentanyl analogue), etizolam (a benzodiazepine-related drug), AMB-FUBINACA and ACHMINACA (synthetic cannabinoids), and xylazine (an animal tranquilizer),” Shepherd said. “These drugs increase the risk of overdose and death when combined with opioids.”

Opioid “antagonists” naloxone, also branded as Narcan, can prevent opioid related deaths but are ineffective against drugs like benzodiazepines, xylazine and synthetic cannabinoids.

Parker can attest they can be crucial when preventing opioid-related deaths.

He was able to save the life of a shelter resident while carrying a free Nar-can kit.

“I gave him the naloxone right away,” said Parker. “There were no cops or EMTs around and we handled it ourselves, and he lived.”

Naloxone  has proven to be life-saving when dealing with opioid overdoses and free kits are available at some pharmacies and at The Works locations throughout the city.


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Posted: Feb 16 2021 10:41 am
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