Pubdate: Thu, 07 Dec 2017
Source: Cambridge Times (CN ON)
Copyright: 2017 Metroland
Author: Adam Jackson


While regional councillors have heard bits and pieces about the opioid
response in the region, they heard it from the horse's mouth on Tuesday.

Members from various regional and community groups spoke before
council in a public meeting to encourage a broad understanding of the
complex issue.

The public meeting was broken down into core areas, such as policing,
mental health services and public health services.

Bruce Lauckner, CEO of the Waterloo-Wellington Local Health
Integration Network (LHIN), said opioids have become similar to
cancer, where the general population is impacted by one or two degrees
of separation at most.

"Now unfortunately, the word opioid or opioid addictions is like that.
I don't think there is a person in this room who hasn't been affected."

While there are measures in place to deal with the crisis now, there
is a distinct sense of urgency in the region.

"The consequences of this crisis is that if you're a 22-year-old, you
can overdose before those solutions come in to effect," said Rebecca
Webb, manager of performance for the LHIN.

Waterloo Region has already hit a record high with 613 overdose calls
to paramedics and that number is expected to reach at least 700 by the
end of the year. In 2016 at this time, there were 461 calls and in
2015 at this time, there were 248.


Bryan Larkin, chief of Waterloo Regional Police Service, said the
opioid crisis puts them in a precarious position.

"We are heavily engaged in front line response and front line services
and secondly, we're tasked with enforcing federal law," said Larkin.

Larkin said previous to 2015, police never tracked overdose demand on
police services. When the epidemic of opioids came, they noticed more
stress on resources.

In 2015, there were 15 fatal overdoses requiring response from
Waterloo police. In 2016, there were 613 demands for service for
overdose-related calls. And as of Friday, there were 416 calls for
service in 2017.

But, police aren't always called to overdoses because of the fear from
those calling. There is the Good Samaritan Act, but many aren't aware
that they are essentially exempt if calling in an overdose.

Larkin added that mental health responses and drug addiction go hand
in hand oftentimes. Regional police receive an average of 2,400 mental
health service calls per year and so far this year, 45 police calls
per month for overdoses

Larkin said if the deaths were from other sources, it would be
received much differently.

"If we had seven deaths per month on our roadways, there would be
significant outcries," said Larkin.

It is estimated that 65 deaths have been caused by overdoses in
Waterloo Region so far this year. It breaks down into 29 in Kitchener,
27 in Cambridge and nine in Waterloo.

Larkin added that so far this year, 3,666 calls have been received for
unwanted persons in Waterloo Region and most are connected with drug

"The consistent theme from our front line is the correlation to
substance use and homelessness," said Larkin. "We will never arrest
our way out of this public health crisis."

Larkin said they've redesigned the way they approach prisoners with
health care in mind. They've also removed the word addict from the
organization and replaced it with the word use or user.

Coun. Tom Galloway said the demand on police may change the way police
operate and the level of service they provide.

"If your garden gnome is stolen off your front lawn, maybe a police
officer doesn't come and investigate," said Galloway. "That's
something the community may have to get used to."

Public health

Karen Quigley-Hobbs, director of infectious disease, dental and sexual
health for Waterloo Region Public Health, said in her 33 years, with
public health, she has yet to see anything like the current opioid
crisis, despite working through community-wide issues like crack
cocaine in the late 1990s and early 2000s and crystal methamphetamine
shortly after.

"I have yet to see something as complex as I have with this issue in
Waterloo Region," said Quigley-Hobbs.

Quigley-Hobbs said sometimes users seek fentanyl, but other times, it
is taken unwillingly, which is more dangerous.

Fentanyl, a synthetic opioid, is 1,000 times more toxic than heroin
and 50 to 100 times more potent than morphine. It is the leading cause
of a major increase in overdoses in Waterloo Region and across North


In Cambridge, Sanguen Health Centre, the City of Cambridge and Public
Health will soon launch a program where needle patrols will be
completed by "peer workers" or former users.

"Trails or areas where we may have residents living in tents, etc., we
may need to be a little more creative about how we approach needle
disposal," said Quigley-Hobbs.

Again in Cambridge, there has been an Overdose Awareness Day,
information events and the installation of 24/7 outdoor needle
disposal kiosks. Cambridge has also been a part of the feasibility
study for supervised injection services.

Cambridge is also expected to host a rapid access clinic, as part of
the LHIN funding, which is expected to make a significant difference.
Unlike the emergency room, rapid access clinics can start with
treatment immediately, ranging from referrals to addictions
counselling to prescription medication for withdrawal symptoms.

 From a policing perspective, Larkin said Cambridge there is a
"different clientele."

"You'll see it's fairly spread out throughout the region, but there
are challenges in one specific portion of Cambridge, as it is with
Kitchener," said Larkin.

Mayor Doug Craig, who originally requested the special meeting, said
the negative focus on Cambridge is unfair.

"We have community groups working with local government and regional
council and making things better."

Supervised injection services

Regional staff is currently working on a study on whether or not
supervised injection sites are feasible in Waterloo Region.

Regional council has given staff the go-ahead to start the study,
which is expected to come back to the community services committee in
early 2018.

Phase 1 of the study, determining the need and broad community input,
has been completed.

Phase 2 of the plan, with approval from regional council, would be
consideration of potential locations and council/community

If council is in agreement, staff would send an application to the
province to join the supervised injection program.

Coun. Helen Jowett questioned Larkin about how the enforcement around
safe injection sites will be approached.

"I think it's going to be a complex balancing act," said Larkin,
adding that the police service will have to look at how to balance
perception of enforcement with local safety.

"The person is going to get there and say they're not going because
I'm going to get stopped and questioned and arrested," said Larkin.

Public health is mandated by the Ministry of Health and Long-Term Care
to provide clean needles. All regions in Ontario have needle Syringe
Programs. None are "one-for-one" programs. Quigley-Hobbs said any
programs set up on the exchange basis are doomed to fail.

Individuals given clean needles are also provided with disposal
containers in various sizes. The sharps containers can be returned to
any needle syringe program location.
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