Toronto may start bulk-buying naloxone after spate of opioid overdoses

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Mayor John Tory says there’s no “magic answer” for the spate of drug overdoses and deaths that has hit the city, but an emergency meeting this morning with health officials, police and other stakeholders committed to arming more first responders with naloxone.

Options for addressing what community health workers have described as a public health emergency — following at least 20 drug-related overdoses and four deaths in less than a week — include the possibility of bulk-buying naloxone, which can act as antidote to an opioid overdose. So far, Toronto Public Health has given out 1,043 doses of the drug to city staff and first responders, according to data from the agency, and has funding for another 6,500 kits.

Finding where overdoses are happening

The panel that met Thursday also committed to several immediate changes, including:

  • Tracking those calls where paramedics or other first responders have used naloxone

  • Using that data to create a map to identify higher-risk areas
  • Training all firefighters in those high-risk parts of the city on how to administer the antidote by the end of September

They also committed to asking police in higher risks areas to carry naloxone kits. Previously Toronto police have said they would not administer the antidote.

Before heading into the meeting, Tory said the group will discuss what is known so far about the recent overdoses and deaths and the possibility of speeding up the opening of the three supervised injections sites, which are slated to start operating in the fall.

Heroin Overdoses 20141014

An injection kit is shown at Insite, a safe injection facility in Vancouver that’s been open since 2003. Toronto wants the staff at its upcoming safe injection sites to be trained in Vancouver because of that city’s experience. (Jonathan Hayward/Canadian Press)

“If there’s a way to speed them up by three weeks, that three weeks could make a difference in saving someone’s life,” Tory said. “And so that’s the kind of thing we’ll discuss. I don’t think there’s a magic answer to this.”

Coun. Joe Mihevc said after the meeting that speeding up the opening of the supervised injection sites depends on extending the hours for construction. But it’s also critical to ensure that new staff members for the sites get proper training. Mihevc said the city would like that training to happen in Vancouver, which has been home to a supervised injection site since 2003.

That city recently opened a second such centre in June.

‘Public health emergency’

In March, Toronto city council approved its overdose prevention strategy in response to an increasing number of drug fatalities in the city — 258 in 2015, according to the most recent figures. In addition to increasing the distribution of naloxone and opening the three safe injection sites, the plan includes publishing real-time overdose data so public health officials can see whether the measures are working.

In June, the province agreed to cover five public health positions in the city, four of them full-time, to be devoted to outreach and education.

Earlier this week, Zoe Dodd, a harm-reduction worker at the South Riverdale Community Health Centre called for better coordination of targeted resources, telling CBC Radio’s Metro Morning that the city is in the grip of a “public health emergency.”

‘No silver bullet’

Coun. Joe Cressy (Ward 20, Trinity-Spadina) said Thursday that while the city has dealt with overdoses for years, “the number of people dying is growing and it is escalating rapidly.”

In addition to speeding up the distribution of naloxone and the opening of the safe injection sites, Cressy said the city could offer services such as drug testing at public venues so users can determine if drugs are laced with fentanyl or other substances, and increase addiction treatment beds. Such moves, however, require the help of the provincial and federal governments, he said.

“There’s no silver bullet to stopping overdose deaths, but if we do all of these measures, we will save lives,” Cressy said.

“We need an all-hands-on-deck approach that really ratchets this up.”

Dr. Eileen de Villa toronto medical officer of health

Dr. Eileen de Villa, Toronto’s medical officer of health, said that public health officials want to make naloxone available to drug users and to their support networks. (CBC)

With that in mind, Toronto Public Health staff have already gotten in touch with the organizers of Veld Music Festival to ensure they can respond to any drug overdoses there. Paramedics, all of whom carry the antidote, have also talked to organizers about a drug prevention strategy, said Dr. Eileen de Villa, the city’s medical officer of health.

Earlier this week, the Toronto Fire Service said select firefighters will start carrying naloxone in the fall, with full roll-out scheduled after that.

Tory said Thursday there is also growing concern about recreational drug users who may be getting drugs that are laced with fentanyl or other substances that put their lives at risk.

“In an ideal world people wouldn’t abuse alcohol, or take drugs or have mental illness issues,” Tory said. “But the bottom line is people do, they’re human beings, so our obligation is to do whatever we can to speed up or change whatever we’re doing to save lives.”

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Toronto may start bulk-buying naloxone after spate of opioid overdoses

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