Pubdate: Tue, 29 Aug 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Author: Karen Howlett
Page: 6


Province stops short of declaring public-health emergency, which more
than 700 health-care workers called for in an open letter

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

"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.
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