Ontario boosts funding to fight opioid crisis

theglobeandmail.com
By KAREN HOWLETT
Aug. 28, 2017

The Ontario government is promising extra money to fight the opioid crisis after more than 700 health-care workers called on the province to use emergency planning measures to address a spike in overdoses.

"It is clear that more needs to be done," Premier Kathleen Wynne in a statement on Monday, vowing to commit "significant" additional resources to address the crisis.

Health Minister Eric Hoskins will announce details of the funding at a news conference on Tuesday at Toronto's St. Michael's Hospital. The funding will be for everything from harm-reduction measures such as wider distribution of the overdose antidote naloxone to more services for treating addiction.

An open letter delivered on Monday to Ms. Wynne and members of her cabinet from more than 700 physicians, nurses and other front-line health-care workers in nearly five dozen cities and towns calls on the province to follow the lead of British Columbia and declare a public-health emergency.

The letter says health-care providers are concerned about the lack of clear, decisive action by the province in response to a disturbing increase in overdoses linked to opioids. Delays in taking action, the letter says, have led to unnecessary deaths.

"The consequences have been clear: lives lost, families destroyed and harm-reduction and health-care worker burnout," the letter says.

At least 2,458 people died of opioid-related overdoses in Canada in 2016 - an average of almost seven a day - according to the first attempt to measure the toll the drugs have taken from coast to coast. But that national snapshot is far from complete: The numbers released in June by a federal-provincial-territorial special advisory committee do not include Quebec, and the data collected from Ontario and Newfoundland and Labrador are from 2015.

Fentanyl, a powerful synthetic opioid that is being cut into a growing number of street drugs, is behind a sharp spike in overdoses. No province has been hit as hard as British Columbia, which has been in a state of emergency for more than a year and is on pace for up to 1,500 overdose fatalities this year. But fentanyl is rapidly moving east, and Toronto and other cities in Ontario are now grappling with a string of overdoses.

Declaring an emergency would allow the province to respond more effectively to the crisis by increasing funding for front-line harm-reduction workers, and rapidly setting up additional overdose prevention sites and opioid treatment programs, the letter says.

This month, Health Canada approved an application from Toronto Public Health to open a supervised injection site several months earlier than anticipated. An interim site opened on Aug. 21 in the building where a permanent site is to open this fall. The Ontario government has provided $3.5-million in funding for this and two other supervised injection sites.

Ms. Wynne promised the additional funding during a private, one-hour meeting on Monday, said Alexander Caudarella, an addiction medicine physician who signed the letter and attended the meeting. However, he said, the Premier stopped short of agreeing to enact the province's emergency powers.

In an effort to help policy makers and health-care workers in Ontario better understand the scope of the opioid overdose problem, the government introduced an online surveillance system in May that makes a wide range of data publicly available, including the number of hospitalizations and emergency department visits from drug overdoses dating back to 2003.

The data show a marked rise in many regions of the province in the number of emergency department visits in recent months.

Ms. Wynne assured everyone during the meeting that the new funds will be immediately available, Dr. Caudarella said. Declaring an emergency would essentially decentralize how the money is allocated, he said.

"Local hospitals and front-line workers would have a lot more control in telling the government what they need and when they need it," he said.

"I think the Premier heard that they had felt excluded up until now from a lot of that decision making."

Declaring an emergency would also be symbolically important, Dr. Caudarella said, as it would send a powerful message that those on the front lines of the epidemic are not alone, "and that the lives of those who use drugs and their families have value."

Ontario Progressive Conservative Leader Patrick Brown called on Ms. Wynne on Monday to create a ministerial task force to address the crisis.