Toronto Public Health issues alert after 10 people die of suspected opioid overdoses in 5 days

Toronto Public Health has issued its first drug alert this year after 10 people died of suspected opioid overdoses in five days.

Preliminary data from Toronto Paramedics suggests the overdoses happened from July 17 to 21, out of a total of 21 suspected fatal opioid overdoses reported this month.

Public health officials point to fentanyl, which they say continues to show up in the local drug supply with "unpredictable potency and contamination," as the main culprit. Toronto's Drug Checking Service has found higher amounts of the lethal drug contaminating other substances such as crack cocaine.

"We're very alarmed because the drug supply is what is harming people — particularly the opioid supply," said Hayley Thompson, the project manager for the service, which provides people who use drugs with "timely and detailed information" on the contents of the substances they're taking.

Thompson told CBC News the higher levels of fentanyl in street drugs are "what's driving the overdose crisis."

The alert comes after updated figures from the Office of the Chief Coroner revealed an estimated 511 people in Toronto died of opioid-related overdoses in 2021 (on top of an additional 54 probable deaths) and 539 died in 2020 — a 71 per cent and 80 per cent increase respectively over 2019, according to a status report on the city's overdose action plan last month.

Lack of supervised smoking sites

In an email to CBC News, the city states overdose deaths are preventable and are largely due to the unregulated drug supply, where the use of highly potent opioids combined with unexpected and concerning substances significantly increase the risk.

Public health states while there's a range of drugs involved in the overdose fatalities, there appears to be a potential increase in deaths from smoking opioids and stimulants. According to emergency service reports, pipes and other objects used to inhale drugs were present in a number of overdose cases.

Jolene Eeuwes, the manager of the safer opioid supply program for the South Riverdale Community Health Centre, said even though demand for safer supply options is high, there are only so many people the programs can take on.

"We only have sites presently that offer services for folks that are injecting, not smoking," said Eeuwes, who called the loss of 10 people from the community "devastating."

"This is something that we've been advocating for a long time: having safer inhalation spaces for people to consume the substances, because we know that the [illicit street] supply across the board is toxic."

The last time the city released an alert on the increase in deaths from smoking opioids was October last year. These types of deaths accounted for 30 per cent of all 164 accidental opioid fatalities from Apr. 1, 2020 to Mar. 31, 2021 in Toronto.

Non-fatal overdoses on the rise

The report states there were 71 opioid deaths in the shelter system in 2021. It adds during the first quarter of 2022, there were 10 fatal opioid or suspected drug-related overdose deaths in homelessness service settings. 

The report also states non-fatal suspected overdoses within the city's shelter system have escalated "rapidly" since May 2021.

It says TPS attended 1,496 non-fatal calls in the city's shelter system for suspected opioid overdoses last year, representing an 85 per cent increase compared to the previous year. 

Nick Boyce, the director of the Ontario Harm Reduction Network, said in a statement to CBC News that non-fatal calls strain the health-care system and cause trauma in the community.

"Until the federal government decriminalizes and regulates drugs, and other levels of government support safer alternatives, such as [better] pharmaceutical quality options, we will keep seeing alerts and people will continue to die unnecessary deaths," Boyce said..

When using drugs, the city advises people to:

• Try not to use alone. Use with someone else and take turns spotting for each other, and consider physical distancing and wearing a mask when doing so. 
• If you must use alone, get someone to check on you either by phone or in person.
• Before you use alone, call the National Overdose Prevention Line at 1-888-688-NORS (6677). You can connect to community members via the Brave app.
• Use a supervised consumption service, if possible. A list can be found here.
• Vet your supply. Ask others about what they are experiencing with the same drug or batch.
• Check what's in your drugs at local drug checking services.
• Get naloxone. Kits are available at a wide range of agencies throughout the city. Free kits are available at some pharmacies. Visit www.ontario.ca/page/get-naloxone-kits-free or call 1-800-565-8603.