Opioid overdoses keep rising — but Ottawa finally gets moving on the crisis

Emergency-room visits for opioid overdoses increased 76 per cent in a year, according to new figures the Ontario government released Tuesday.

The figures compare the first half of 2016 to the first half of 2017. The number of trips to hospital for overdoses from drugs like heroin, morphine and fentanyl increased from 1,078 to 1,898, the government says.

Our numbers are a bit less alarming than the provincewide trend but still headed the wrong way. In the first half of 2016, local hospitals saw 109 opioid-overdose cases. In the first half of 2017, they saw 157.

Over a year ago, with the crisis brewing and knowing worse was to come, Ottawa’s board of health voted 9-2 in favour of the general idea of helping someone else open a supervised drug-injection site, a place where addicts shooting drugs like heroin can be treated by nurses if they accidentally overdose.

The Sandy Hill Community Health Centre is due to open a fuller site around the end of October, working as quickly as it can to get all the approvals and money it needs, but in the meantime the body count is growing.

So far, the only such site in Ottawa is a tent in Lowertown, staffed part-time by volunteers, whose rough disregard for bureaucratic niceties changed the discussion from “Can we do this?” to “We’re doing this — are you going to stop us?”

The health board voted Monday night to have its staff open a temporary site of their own in an Ottawa Public Health clinic on Clarence Street nearby, and to explore the possibility of running one (or more) themselves permanently. The city’s medical officer of health, Dr. Isra Levy, was already working on these things and just asked his bosses to let him continue.

So no, we won’t stop you, the health board decided. We’ll help.

The whole thing has been a study in winding a politically touchy health service around politicians — pushing here, pulling there, and never forcing straightforward decisions if they could be avoided. The process has been slow. People have died because it’s been slow. The figure skating wouldn’t have been necessary if we had better, braver politicians. But it’s worked.

The point of creating an independent board of health back in 2010 was to try to depoliticize decisions that should be driven by science. In the previous council term, city councillors had voted to defund a $7,000 program that gave out clean crack pipes to try to contain the spread of sickness from one addict’s cracked and burned lips to another’s.

The program was cheap, the health unit was adamant that it saved lives, and the politicians collectively didn’t care. They worried about the message it sent. They allowed themselves to be guided by urban legends — ones nobody could back up — of dealers selling crack rocks preloaded into fresh pipes with the city logo on them, as if the health unit’s pipes were swag like fridge magnets and mini hockey sticks. They voted the program down.

The health unit found money from the province instead and kept the pipe program going.

Having people with credentials and experience with scientific rigour on the board (they’re a narrow minority now, with five civilian appointees and six city councillors) was supposed to lead to fewer embarrassing decisions and it has. If nothing else, it gives politicians cover, allowing them to be publicly uncomfortable with things but defer to experts when the time comes to vote.

This time, the vote to open a temporary no-frills site on Clarence was unanimous, including skeptical politicians Shad Qadri and Michael Qaqish, who represent suburban wards and opposed supervised injection sites in principle back in 2016. They explained themselves to the Citizen’s Jon Willing afterward.

Qadri, who’s also the board chair, said he’s against supervised injection sites that don’t include drug treatment of some sort, sort of.

“I’m still in opposition to SIS sites,” he said. And then, a few seconds later: “I’m still in favour of SIS with treatment attached to it.”

Injection-site supporters say that such a site is treatment, of the most basic kind: keeping drug users from overdosing and dying, buying them time. It’s contact with health workers who can help with infections and illnesses and let users know somebody cares about them. Not every addict is ready for detox and rehab. A supervised injection site can keep people alive until they are.

The temporary site won’t include much more than keep-users-alive treatment, though, it’s true. But Qadri voted for it, so make of that whatever you can. There’ll be a report on how the site works and whether the health unit’s people think it helps after a couple of months. The health board can take the question up again then.

Qaqish said circumstances have changed: Health Canada has approved the Sandy Hill Community Health Centre’s site and the Overdose Prevention Ottawa people set up their tent.

“Now they’re doing them anyways, so let’s at least put some structure in the framework,” Qaqish said. Having a site overseen by the health unit in a government building is preferable to one in a park, he said, and those appear to be the choices.

The guerrilla tent operation, that means, was key. It worked. And now fewer drug addicts will die needlessly.

New opioid-overdose numbers

Emergency-room visits for opioid overdoses, January-June 2016, all Ontario: 1,078
Emergency-room visits for opioid overdoses, January-June 2017, all Ontario: 1,898
Emergency-room visits for opioid overdoses, January-June 2016, Ottawa: 109
Emergency-room visits for opioid overdoses, January-June 2017, Ottawa: 157

By David Reevely
Source: Ottawa Citizen