Pubdate: Sat, 20 Jan 2018
Source: Windsor Star (CN ON)
Copyright: 2018 The Windsor Star
Author: Brian Cross
Page: A3


A four-pillared strategy to combat the region's opioid crisis was
unveiled Friday by local officials.

They zeroed in on improving treatment options, public awareness,
physician and patient education, availability of the anti-overdose
drug naloxone and harm reduction measures like needle disposal boxes
and investigating a safe-injection site.

"We can call it a crisis because it is affecting our community hard
and our average rate of opioid-related death is way higher than the
provincial average," acting medical officer of health Dr. Wajid Ahmed
said at a morning news conference to announce the strategy that's been
a year in the making.

He displayed a graph comparing the steadily climbing provincial death
rate - peaking recently at 6.2 per 100,000 population - to
Windsor-Essex's 9.1 death rate, which is 46 per cent higher.

Ahmed called the comparison, taken from the province's opioid tracker,
"alarming enough" to draw up a plan to prevent what are largely
preventable deaths. In Ontario, 14 per cent of the population filled
an opioid prescription in 2015-16, and the Erie St. Clair health
region (Windsor-Essex, Chatham-Kent and Sarnia-Lambton) had the
highest rate of opioid prescriptions in the province at 18 per cent.

The impact is being felt everywhere. In the last several months, the
strain on first responders like paramedics has become severe, said
Tecumseh Mayor McNamara, who chairs the region's board of health. He
noted that the budget for local land ambulance is rising 19 per cent
this year, driven at least partly by the increasing demands wrought by
the opioid epidemic. The number of opioid-related emergency department
visits have more than tripled since 2003.

"And certainly the despair within our families," he added. "This is
something that is embedded in our region."

The strategy identifies a number of problems that need to be

Comments to surveys included: complaints that doctors and dentists
were giving out huge doses of painkillers; a lack of public
information to help identify when a family member is in trouble; the
stigmatization of drug users that prevents them from seeking help; the
lack of treatment facilities unless you have money to pay for them;
and the shortage of non-abstinence treatment programs (opioid
substitution therapies like methadone and suboxone).

Mayor Drew Dilkens stressed that while municipalities like Windsor can
tackle the issue - the city's 2018 budget includes money for needle
disposal boxes and an outreach worker - the Ontario government needs
to provide funding to help lift the strategy off the ground.

He also expressed unease about a safe-injection site. As part of the
strategy, the health unit plans to do a feasibility study on one for
the region. Dilkens said his impression of Vancouver's experience with
a safe injection site is there are many problems associated with it.

"Maybe the answer is yes, but I think we have to think through what
that looks like to make sure we're not solving one problem but
creating a whole host of problems in the community, as well," he said.

The four pillars identified in the strategy are: prevention and
education; harm reduction; treatment and recovery and enforcement and
justice. Officials warned that there was still more work to be done to
identify specific actions. "We just need to be patient and we need to
make sure that what we are doing is working," Ahmed said.

Byron Klingbyle, the harm reduction co-ordinator with the AIDS
Committee of Windsor, expressed frustration over the time it was taking.

"All these pillars they're talking about, they're all important, but
to do the biggest impact to the number of fatalities, you have to
address that issue first and then work on the others," he said,
explaining that providing as many people as possible with naloxone and
training them how to use it will immediately save lives.

Since July, the AIDS Committee has trained people and dispensed 618
naloxone kits (they're available free from the province), and they
were used successfully 137 times. On 96 of those overdoses, the
situation was bad enough that a second dose was administered. That's
137 saved lives, Klingbyle said.

"If makes logical sense to me, I would put all my resources into that
to reduce the fatalities."

Naloxone kits have been provided to many agencies and first
responders, but Windsor Police have been wary about issuing them to
officers because of Ontario rules requiring the province's Special
Investigations Unit to investigate instances of death or serious
injury involving an officer.

"For me, that's a game changer," Windsor Police Chief Al Frederick

"I don't want to subject my officers to further investigation when
they're out there trying to help people."

He said while crime rates in Windsor and the rest of the province are
flat, the number of calls for service are increasing dramatically. And
its largely due to more calls involving complex issues such as drug
overdose and mental health.

"It's a very complex issue," he said of the opioid crisis. "I can't
say we're on the winning edge of this fight just yet."
- ---
MAP posted-by: Matt