Fears a potent new street drug and lack of naloxone will mean a 'crisis within a crisis'

Doctors who work with Hamilton's street population warn a lack of naloxone caused by COVID-19, combined with a new potent drug on Hamilton's streets, is causing a perfect storm for opioid deaths.

And they are already seeing an increase in fatal overdoses that will only continue if the problem isn't solved.

Jill Wiwcharuk of the Hamilton Social Medicine Response Team (Hamsmart) says she knows of three people who have died from overdoses in the last week, and worries she'll only see more. In one case, a woman overdosed near one of Wiwcharuk's clinics and needed six doses of naloxone to start breathing again. The woman recovered, then used drugs a week later and died.

"The street supply is more contaminated than it has been in the past," said Wiwcharuk.

"Once COVI9-19 kind of shut down the city, it was shortly after that, that something new came on the streets. That there was something really, really dangerous out there."

Meanwhile, several programs that provide naloxone to drug users have either scaled back or temporarily stopped.​ Wiwcharuk says this is costing lives, and "it's awful."

Michelle Baird, director of epidemiology, wellness and communicable disease control with Hamilton Public Health, says the number of overdose-related calls to paramedics is creeping upward.

"We don't want to have a crisis within a crisis," she said.

In April, paramedics answered 50 opioid-related overdose calls. and answered 37 in March. That's far below this time last year, when there were 83 calls in March and 67 in April. But last year was exceptional because of a supply of bad street drugs, Baird said. She worries the numbers are trending that way again. 

The drug circulating on the streets now appears to be a potent mix of fentanyl and benzodiazepines, she said. 

This comes as drop-in centres that used to distribute naloxone, such as the AIDS Network and the public health clinic within the Wesley Day Centre, have scaled back their operations to prevent the spread of COVID-19. 

People are also using drugs more alone, Baird said. While people are encouraged to keep a physical distance from others, she said, opioid users should use with someone who can help if they overdose.

There are still options to get naloxone. The street health van offered by the AIDS Network and the city has expanded its hours, Baird said. It used to only operate in the evening, and now it's available during the day. 

Hamilton Urban Core Community Health Centre is still running its supervised consumption site. The city is also striking up memorandums of agreement with other agencies to distribute naloxone.

Three pharmacies have donated naloxone, and a Hamsmart and Keeping Six street outreach team is distributing it. People can also get naloxone three times a week at FirstOntario Centre, where the city has set up a temporary shelter.

"We have enough supply," Baird said. "If you need naloxone, absolutely reach out."