Today, the City of Toronto proclaimed August 31 as Overdose Awareness Day. This day is observed annually, with local communities around the world coming together to remember those who have died due to drug poisonings and acknowledge the grief of family and friends left behind. This day also seeks to create better understanding of the increased toxicity of the unregulated drug supply and the impact of negative stigma and discrimination experienced by people who use drugs and their communities.
The drug poisoning crisis and the increasingly toxic supply of unregulated drugs continue to be urgent public health issues in Toronto and across Ontario. The toxic drug supply is a major driver of drug poisonings and drug poisoning death. Over the course of the COVID-19 pandemic, there has been a dramatic increase in the number of both fatal and non-fatal drug poisonings across the city.
Preliminary data for 2021 from the Office of the Chief Coroner for Ontario (OCC) shows that there were 560 confirmed opioid toxicity deaths in Toronto representing the greatest number of drug poisoning deaths in Toronto in one year and an 87 per cent increase compared to 2019. In 2021, more than one in four deaths (28 per cent) reported by the OCC due to accidental opioid toxicity in Toronto was in people experiencing homelessness. This has increased from one in ten deaths (11 per cent) in 2018. The data is available through the Toronto Overdose Information System: https://public.tableau.com/app
Recent Toronto Public Health data shows that during the first seven months of 2022, Toronto Paramedic Services responded to 172 fatal suspected opioid overdose calls. Tragically, the vast majority of these deaths are preventable. Friends, family members, neighbours and colleagues mourn for the loved people who have tragically lost their lives to this public health crisis. The tragic and substantial losses that people face from the drug poisoning crisis, and the grief experienced, are immeasurable.
The unregulated drug supply is increasingly toxic and unpredictable. The unregulated opioid supply is now dominated by fentanyl, which has replaced heroin/morphine as the most commonly present opioid in accidental drug toxicity deaths in Toronto. In addition, the unregulated fentanyl supply contains varying concentrations and may contain unexpected drugs.
Drug checking services in Toronto continue to find unexpected, highly potent drugs in samples. The increased involvement of drugs such as xylazine (a veterinary drug not meant for use in humans), benzodiazepines and stimulants, alongside opioids, is directly contributing to drug toxicity deaths in Toronto.
Drug toxicity remains the leading cause of death of people experiencing homelessness. New data released today for January to June 2022, shows that Toronto Public Health (TPH) received 92 reports of deaths among people experiencing homelessness. More than half (54 per cent) of deaths so far in 2022 were due to drug toxicity. This is similar to what was observed in 2020 and 2021. The data is available on the City’s Deaths of People Experiencing Homelessness webpage: www.toronto.ca/community-peopl
Data for overdoses in homeless service settings show that in Q2 of 2022, there were 224 calls to Toronto Paramedic Services for non-fatal suspected opioid overdoses. This represents a decrease from Q1 and previous quarters in 2021, but remains higher than pre-pandemic incidents. There were 14 suspected drug-related deaths of shelter residents in Q2 of 2022. This is down from previous recent quarters that have seen as many as 23 in Q4 of 2021 and more than 20 in Q3 of 2021 and Q4 of 2020. More information is available on the City’s Overdoses in Homelessness Services Settings webpage: www.toronto.ca/city-government
Every shelter program in the city offers harm reduction services to clients, which may include wellness checks, peer witnessing programs and supervised consumption services. Staff are trained on drug use, harm reduction, and overdose prevention and response, including administration of naloxone. It is a testament to the policies in place and the quick action of trained staff, clients and City first responders that more than 224 non-fatal overdose interventions occurred.
The City remains committed to addressing the drug poisoning crisis through the implementation of the Toronto Overdose Action Plan and supporting collective actions to save lives and improve the health and well-being of people who use drugs and the whole community. The City provides harm reduction and treatment services through TPH’s The Works, which supports more than 60 agencies across Toronto to offer harm reduction supplies and services at more than 100 locations and access points.
The Integrated Prevention and Harm Reduction Initiative, or iPHARE (www.toronto.ca/iPHARE), was established in December 2020 and is a multi-pronged effort by the City and community agencies to address opioid-related deaths in Toronto’s shelter system. In 2022, iPHARE provided more than $9 million in funding for a range of harm reduction supports, including embedded harm reduction workers or visiting harm reduction outreach workers at 23 shelters, respites and shelter hotel locations identified as priority sites (based on overdose data) and a mobile program to provide harm reduction support to clients required to self-isolate in shelters experiencing a COVID-19 outbreak, support services for enhanced intensive mental health case management supports and Urgent Public Health Needs Sites embedded into selected shelters across the city.
The City has been using data to inform decisions to improve the health of people experiencing homelessness over time, including:
* Working with Inner City Health Associates (ICHA) on a collaborative initiative to increase our understanding about the health status of people who are experiencing homelessness and accessing Toronto’s shelter system, as well as their use of current health services to improve service planning
* Working with Ontario Health Toronto Region and other partners to review and update the Homelessness Health Services Framework to provide a consistent approach to health services in all shelters, as well as to map harm reduction, mental health and primary care resources to shelter locations in order to identify resource needs and gaps
TPH and the Toronto Board of Health continue to advocate for the expansion of all critical services that support people who use drugs, including harm reduction and evidence-based treatment. Decriminalization of the simple possession of drugs and the expansion of safer supply programs that provide alternatives to the city’s unregulated drug supply, along with health and social supports for people who use drugs, are urgently needed. Further action from all levels of government are needed more than ever to address the drug poisoning public health emergency and to save lives.
Today, placed in participating City buildings including the lobby areas of City Hall and Metro Hall, are empty purple chairs that symbolize a space held for those lost due to drug poisoning. At City Hall, a flag is raised on the courtesy pole to raise awareness of overdose and reduce the stigma of drug-related death and the CN Tower and Toronto Sign will be lit in purple tonight in recognition of International Overdose Awareness Day. More information on International Overdose Awareness Day is available at www.overdoseday.com/.
SOURCE City of Toronto