Analysis: Deep in the opioid crisis in Southwestern Ontario
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The grip of the opioid crisis in Southwestern Ontario in 2019 remained strong, new data shows.
 
In Sarnia-Lambton, there were 155 emergency department visits on the year, a rate of about 119 for every 100,000 people.
 
In Ontario, by comparison, the average emergency department visit rate for people who’d taken fentanyl or other opioids – powerful and addictive painkillers – was about three-fifths of Sarnia-Lambton’s, at 68.7 per 100,000 people.
 
The deadly drug class meanwhile was linked to 15 deaths in Sarnia-Lambton in the first six months of 2019.
 
There were 13 in Sarnia-Lambton in all of 2018.
 
In London, again through January to June 2019, there were 37 deaths counted, compared to 62 for the entire previous year, and there were 45 in Windsor.
 
Huron-Perth saw one death in the six months of information available for 2019 (eight in all of 2018) while Chatham-Kent had one in six months of 2019, compared to four in all of 2018. Southwestern public health – which includes Elgin and Oxford counties – counted 11 in six months in 2019, compared to 23 in all of 2018.
 
Some of the data – released recently via monthly opioid surveillance reporting by local health units, and tracked via the Public Health Ontario Interactive Opioid Tool – is considered preliminary and is subject to change.
 
The annual toll of the drug-use crisis – a public health problem gripping all of North America – has surged since 2016, said Southwestern health unit epidemiologist Melissa MacLeod.
 
Increased attention to the issue could partially explain the sharp jump in emergency visit cases and hospitalizations since four years ago, she said.
“From 2017 to 2019, it’s been slowly increasing.”
 
Increased distribution of life-saving naloxone kits publicly via health units and pharmacies – in Lambton more than 5,100 were distributed in 2019 – and equipping front-line responders like paramedics and police with the overdose-counteracting drug has been part of the strategy to save lives.
 
Provincial funding to health units for monthly tracking of emergency department visits and other indicators, as well as more naloxone distribution, has also backed health unit-specific action plans to address the root causes of drug and alcohol addiction.
 
A plan was rolled out in Oxford in late 2018 – focused on things like securing a drug court, raising awareness about needle exchange programs and boosting naloxone availability – MacLeod said, and Lambton has one in development. The hope is to launch it in April, Lambton’s Michael Gorgey said.
 
Strategies like making harm reduction supplies, including naloxone kits, more available to people in rural areas has been important in the fight, said Rhonda Galler, a family health supervisor with the Lambton unit.
 
Seeing spikes in hospitalizations and emergency department visits isn’t necessarily a bad thing, she said.
“It’s far better than seeing the number of deaths go up.”
 
Sarnia recently approved passing to Lambton County a choice on whether to make naloxone available alongside defibrillators in public buildings.
 
London started a one-year pilot program in April 2019 to put naloxone nasal spray kits in 29 city facilities. Data is expected back after the pilot period ends, but there was just one opioid-related medical emergency at a city-owned facility with a public-access defibrillator between 2015 and 2019 in Sarnia, the recent report to council from Sarnia fire Chief Brian Arnold says.
 
More information is needed, the report suggested, before committing to stocking the City of Sarnia’s nine facilities with public-access defibrillators with naloxone, at an up-front cost of about $2,000, and restocking costs of about $1,000 every two years for expired medication.
 
The costing doesn’t include training and spare inventory.
 
The majority – 76.4 per cent – of Ontario’s 1,337 confirmed opioid-related deaths in Ontario between July 2017 and June 2018 occurred in private homes, the report noted, citing the Opioid Mortality Surveillance Report from Public Health Ontario, the Office of the Chief Coroner of Ontario, and the Ontario Drug Policy Research Network.
 
It’s impossible to predict what will happen in 2020, but opioids don’t appear to be going away, Galler said. She hopes the drug and alcohol strategy Lambton has in development will make a difference.
 
The opioid crisis is “a problem that crosses socioeconomic boundaries and it’s universal. People of all ages – people from all kinds of backgrounds – are facing this problem,” she said, urging “de-stigmatization” of the opioid-dependent, many of whom developed an addiction after taking prescribed medicine for pain.
Trying to get off the drug causes painful withdrawal symptoms.
 
“Most of these people who are taking these drugs, they’re not even getting high anymore,” Galler said. “They’re just trying not to get sick.”
 
More needs to be done to help people ready to fight their addictions, she said, pointing to the long-standing calls for a residential withdrawal management hub in Sarnia.
 
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