The opioid crisis in Canada: Is Ottawa a path for solving the crisis?

Written by By Mary Young, Ph.D.

Ottawa has serious drug issues.

Where drugs and alcohol are concerned, we have a credibility problem. Our reputation, their health, and the safety of people’s lives in the city are at stake.

Earlier this year, I had the great fortune to travel through the Great White North with two other researchers from the University of Calgary and colleague Dr. Matt Wing. Our aim was to investigate the acute effects of drugs, and particularly fentanyl, on people with mental health issues in the city of Toronto. One of the authors of this article, Nick Bolatko, is the lead author of a study recently published in Health and Aging where he describes many of the negative consequences of the opioid crisis on the North American population.

These researchers traveled through three different Canadian cities, Ottawa being our final destination. Along the way, they visited a number of support groups for people who were living with the opioid crisis, holding an online survey to better understand the opioid crisis on the Canadian population.

Some highlights from the online survey:

In Toronto, we saw a sharp increase in overdoses in the last two years. In Ottawa, we saw six heroin overdoses within 24 hours of each other on the same day.

In Ottawa, over 50% of opiate users previously found acceptable opiate levels in their drug of choice. After a two-year period, our survey revealed that 41% of respondents using heroin use heroin with no primary dependence on opiates. Others have switched to less dangerous alternatives, such as a lower purity form of heroin, compounded with buprenorphine. However, the stigma attached to heroin —the stigma usually associated with drug use — is sometimes too heavy, for these individuals and for society as a whole.

As a doctor, I have the fortune to provide medication to treat opiate-using opiate-dependent individuals. Ottawa patients were diagnosed with opiate-related disorders and to treat them, clinicians need medication. Over 90% of people who are undergoing treatment in Ottawa need something other than only opioids. This means our city has a problem with widespread opiate use. Indeed, Ottawa, Toronto, and several other Canadian cities have a serious problem. But, where do we go from here?

First, community organizations such as crisis service providers, treatment centers, and organizers of drug use cessation programs, as well as policymakers, need to recognize the extent of the issue. If we want to approach this epidemic from the bottom up, it is essential that community organizations take the lead.

Organizations like the Drug Users’ Advocacy Network are at the forefront of research, education, and the community-building that is needed to address these problems.

We must open doors for people in recovery and at risk for opioid use disorders to access life-saving medications that can be effective in preventing overdose deaths and to address the common, underlying cause of use: a relapse into opiate dependence. The opioid crisis involves not only the most harmful drug use, but also problems associated with the majority of actual drug users. This encompasses a wide range of behaviors, beginning with impaired driving, misuse of prescription drugs, and problematic interpersonal use.

The community organizations of Toronto have started the conversation with an on-the-ground approach to helping reduce opioid deaths. These organizations have implemented harm reduction policies that have been effective in reducing the number of opioid-related deaths, but they have only been at the center of this work because key players recognize the need.

We must also recognize the need for more state-of-the-art treatment services, for treatment needs to be no longer treated like it is a stigma.

For organizations like the Drug Users’ Advocacy Network, however, being the voice of the community rather than a voice for its limitations can be a daunting and important responsibility. The consequences of the opioid crisis for community and community members are many and far-reaching.

Leaders can learn from the good work of community organizations, and this can put Ottawa on the forefront in their response to this opioid crisis.

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