Pubdate: Fri, 04 Aug 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Justin Giovannetti

TORONTO CRAFTS OPIOID STRATEGY AMID CONCERNS THAT CRISIS HAS REACHED CITY

Toronto is considering fast-tracking the opening of three supervised
drug-use sites and will ask some police officers to carry a
life-saving antidote to fentanyl after a spate of deaths linked to
tainted street drugs over the past week.

Public-health officials across the country have warned for months that
authorities in Toronto should be prepared for the appearance of
powerful illicit painkillers that led to the deaths of thousands of
Canadians over the past two years.

The deaths, starting in Alberta and British Columbia, have moved east
across the Prairies as potent opioids have been inexpertly mixed with
street drugs, yielding lethal cocktails.

Six people have died from suspected overdose and dozens more have had
non-fatal incidents since July 27, leading Toronto Mayor John Tory to
call public-safety and health officials to his office Thursday for a
meeting about the fatalities nearly a week after the city's police
issued a public-safety alert about the deaths) Mr. Tory said officials
in Toronto will be asking some police officers to carry naloxone,
which can reverse an overdose within minutes. Most major police forces
in Western Canada decided to equip their officers with the antidote
last fall. The city also wants all firefighters in areas with higher
rates of overdose to be trained on administering naloxone by the end
of September. Mr. Tory said he is considering an emergency bulk
purchase of the antidote.

"There is no magic answer but I think we can at least sit down and try
to prevent deaths," the mayor told reporters after the meeting with
officials from the city's police and fire departments, paramedics and
some city councillors.

British Columbia, which has been in a state of emergency for more than
a year because of opioid deaths, is on pace for nearly 1,500 overdose
fatalities this year. Officials in Alberta have made kits with the
antidote naloxone available to everyone in the province, citing the
scope of the province's drug crisis.

Councillor Joe Mihevc, the chair of Toronto's board of health, said on
Thursday that he is now looking at ways to speed up construction of
the city's supervised drug-use sites. Three of the sites have been
approved and granted construction permits, but the first is not
expected to open before November.

"That last hurdle is getting construction under way and hiring and
training the staff," he told The Globe and Mail. "We had originally
thought a November opening, now we're saying that even if it costs
more money let's do what we can to open earlier. A week earlier is
still a week."

On Thursday, Health Canada approved a supervised drug-use site in
Victoria, granting an exemption from Canada's drug laws in an effort
to reduce overdose deaths in the city.

The councillor also wants Toronto to work at increasing its collection
of data, which will help it identify hot spots for overdoses and react
more quickly.

Within a matter of weeks, the city will know whether the recent deaths
are linked to a permanent increase in lethal drugs, like what has been
seen across Western Canada, or whether this was the result of a single
bad batch of street drugs poorly mixed with inexpensive opioids.

"Time will tell whether this is a bad batch of too much fentanyl in
heroin, but we won't know for a while. If this is the leading edge of
a surge in opioid-related deaths, I'm surprised it's taken this long.
We've been expecting this for a long time," said David Juurlink, head
of clinical pharmacology and toxicology at Sunnybrook Health Sciences
Centre in Toronto.

The number of deaths related to fentanyl has risen in Toronto over
recent years, increasing from zero in 2008 to 42 in 2015. Toronto
Public Health's most recent data indicate there were 87 opioid-related
deaths in the city in the first six months of 2016, and there were 135
opioid-related deaths in 2015. Earlier this year, the city released an
Overdose Action Plan that called for a series of steps to respond to
overdoses.

Toronto's response will be crucial to determining how many Canadians
are killed by drug overdoses this year. Dr. Juurlink expects 3,000
Canadians could be killed by drug overdoses this year.

- - With files from The Canadian Press
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