A naloxone anti-overdose kit is shown in Vancouver on Feb. 10, 2017.Jonathan Hayward/The Globe and Mail
Armed with new data that show an increasing number of opioid-related deaths, the Ontario government is offering police and fire departments kits that contain a drug that can reverse an overdose.
In an announcement at Queen's Park on Thursday, Health Minister Eric Hoskins said the government has also obtained federal permission to approve and fund what are known as overdose-prevention sites, which can be pop-up or mobile operations that have not received approval from Health Canada as supervised drug-consumption sites. The move will protect the front-line workers from criminal prosecution.
The measures coincide with the release of new data from the Office of the Chief Coroner that found the province had 336 opioid-related deaths from May to July, a 68-per-cent increase over the same period in 2016. More than half of the deaths were among those aged 25 to 44. Fentanyl was a factor in 67 per cent – up from 41 per cent in 2016, and 19 per cent in 2015.
"The data demonstrates the urgent need for continued and heightened action to address this growing public-health emergency," Dr. Hoskins said, noting that emergency-department visits for opioid overdoses from July to September increased 115 per cent from the previous year. "We're dealing with a grave situation. … The status quo is no longer acceptable."
The government will offer naloxone kits to all 61 police services and 447 fire departments in the province, but the uptake will be voluntary. Community Safety Minister Marie-France Lalonde said the police and fire departments can decide whether to apply to their local public-health agencies to obtain the kits, which are offered for free in some pharmacies and through community-based organizations.
Some police forces in the province have already been using naloxone and paying for it out of their own budgets.
Ms. Lalonde cited a recent survey by the Ontario Association of Chiefs of Police survey of 35 police services that found that since January, staff used naloxone kits 45 times and successfully revived 43 people from overdoses.
The president of the Police Association of Ontario (PAO), which represents 18,000 police and civilians across the province, said he has been lobbying for the province to provide naloxone kits to officers for months. Bruce Chapman said officers in Brantford have saved several lives with naloxone in the year since they began carrying the antidote, and now officers across the province can start doing the same.
Mr. Chapman said budget considerations held up the push to equip officers with naloxone until the provincial announcement on Thursday. The kits cost upwards of $120 an officer, several groups told The Globe and Mail, and need to be replaced frequently. The shelf-life for naloxone is two years and it degrades more rapidly if stored below 15 C or above 25 C.
There have also been questions about legal liability. Last year in B.C., an officer who provided naloxone to someone who later died came under investigation by the Independent Investigations Office, the province's police watchdog.
The agency found the officer did nothing wrong and changed its policy so that officers will not be scrutinized if someone dies during the course of life-saving measures.
In Ontario, the equivalent agency is the Special Investigations Unit (SIU). Asked whether the agency would investigate an officer who administered naloxone in the case of an overdose fatality, an SIU spokeswoman responded with a sentence taken directly from the group's mandate: "The SIU is mandated to investigate any incident involving police where there has been serious injury, death or an allegation of sexual assault."
The Toronto Police Service has no immediate plans to distribute naloxone to officers, but that could change with Thursday's announcement. "We will look at this very, very closely," spokesman Mark Pugash said.
Zoe Dodd, one of the activists behind an illegal overdose-prevention site in Toronto's east-end Moss Park, said equipping police and firefighters with naloxone would do little to reduce overdoses. "I mean, you can't even get people to call 911; people still don't call because they are afraid of the criminalization of what they are doing," she said, arguing that drugs need to be decriminalized to solve the problem.
Ms. Dodd said she did not yet know how Thursday's announcement would affect the proliferation of government-run facilities or, more specifically, the Moss Park site. Plans to hook up the site's trailer to electricity recently fell through, she said, but she vowed to keep it operating through December.
Ms. Dodd said she was angry that the new numbers show a 68 per cent increase in opioid-related deaths and blamed governments for not acting sooner.
The data released on Thursday are the first to come under a new approach the Office of the Chief Coroner has adopted. Coroners are filling out a questionnaire that asks for specific information for each opioid death, collectively providing a clearer picture of the crisis and, indirectly, of the impact of harm-reduction measures. Of the accidental fentanyl-related deaths that occurred during the three-month window, 55 per cent also involved cocaine. That is an increase of 9 per cent over the same period last year. Chief Coroner Dirk Huyer said it is unclear whether people mixed the drugs or used a contaminated supply.
Federal Health Minister Ginette Petitpas-Taylor released a statement on Thursday afternoon saying the new numbers confirm that the epidemic is worsening, despite ongoing efforts. She said she discussed the situation with Dr. Hoskins earlier in the day, and noted that Health Canada has officially granted the province's request for overdose-prevention facilities. "This crisis," she said, "is unlike any other public health crisis we have experienced in recent years."
With a report from Jeff Gray