Spike in opioid overdoses, deaths in 2018
By Chad Ingram
There was a surge of opioid-related overdoses and deaths in the area served by the Haliburton Kawartha Pine Ridge District Health Unit in 2018.
During an Oct. 23 meeting, Haliburton County councillors received a presentation on the Haliburton, Kawartha Lakes, Northumberland Drug Strategy from Megan Deyman, the project’s co-ordinator, and Cathy MacDonald of the health unit.
“For HKPR, there were 222 suspected drug overdose-related emergency department visits, which includes opioids and other drugs, among HKPR residents in 2018,” MacDonald said, adding there were 145 opioid-related visits. “This rate is higher than it was reported for 2017.”
In 2018, there were 29 hospitalizations related to opioid use, and 20 deaths from January through September.
“That’s almost two and a half times higher for the same time period in 2017,” MacDonald said.
The health unit does not have statistics specific to Haliburton County available.
The drug strategy received Ontario Trillium Foundation funding in 2016, that funding coming to a close at the end of 2019. Research and consultation with service providers and residents took place throughout 2016 and 2017, with a number of priority concerns identified, including impaired driving, lack of resources and ability to access resources as the primary ones. The project has involved more than 50 partner organizations and has operated on a “four pillar” approach, those pillars being harm reduction, prevention and education, treatment, and justice and enforcement.
MacDonald cited a provincial report showed there were 1,337 confirmed opioid-related deaths in Ontario from July of 2017 to June of 2018, saying that the vast majority of those deaths were accidental overdoses, and that Fentanyl and Fentanyl analogs contributed to nearly three quarters of those deaths.
Three quarters of the deaths occurred in males, 74 per cent of overdoses occurred in private residences, more than half were individuals between the ages of 25 and 44. Forty-seven per cent of those who died were unemployed, 18 per cent were employed and 31 per cent of those who were employed were in the construction industry. MacDonald said nearly half of those who died were alone at the time of incident, and that almost half involved a resuscitation attempt. “Three out of five incidents [occurred] in the person’s own home, and over one fifth Naloxone administered,” she said. Naloxone is a drug that can act as a temporary counter to the effects of opioid drugs.
Deyman said an increasing number of poisoned drugs has also contributed to the increase in ER visits in the region.
MacDonald said another report that had very recently been released indicated there may be a decline in the prescribing of opioids.
“They did change the prescribing recommendations for physicians,” she said.
As far as a municipal response, Deyman said there are a series of recommendations from the Association of Municipalities of Ontario that councils could adopt, and that some councils within the region already have. Those recommendations deal mostly with lobbying upper levels of government.
County councillors wondered what they were to do with the information at a local level.
“So, what happens with these priorities, and what happens with you guys and this report?” asked Algonquin Highlands Mayor Carol Moffatt. “Interesting, sobering information that’s fabulous to have. And now? What do we do with it? What do we, eight people sitting here today, decision-makers, what are we supposed to do with this?”
While there is a Central East Local Health Integration Network opioid strategy in place, there is not a local one, and MacDonald said that a HKPR District opioid task force had recently been established.
“We’ve only had an initial meeting . . . part of which is, we are developing a local opioid response plan, and that plan does involve the three counties, for now.”
MacDonald said the task force would be looking for feedback from the community and service providers, as well as people with lived experience with substance use.
Minden Hills Mayor Brent Devolin said he would have liked to have seen the county involved earlier in the process.
“This is a three-year project and we’re within a couple of months of the end of it in 2019, I would say . . . in things that will go forward, we would like to be engaged much earlier in the process rather than at the end of a three-year strategy that affects our area,” Devolin said.
Dysart et al Deputy Mayor Pat Kennedy said councillors needed local information, specific to the county, to take effective action, noting the day before, Dysart et al council had received a report on the needle exchange program within the HKPR District.
“I was disappointed yesterday, and I’m a little disappointed again today, that you’re not getting your data down deep enough,” Kennedy said. “ . . . If you want us to be able to drill down in our geographic area, we need local data, and I’d just encourage you, if there’s a possible way to break that out.”
MacDonald said the health unit gets data through limited sources. While information from hospitals is received daily, she said data from other sources can come one, two, even six months after the fact. “So, one of our struggles has been having real-time data,” she said.
Recently, a data-sharing agreement was established between the health unit and Haliburton County’s EMS department.
“So we’re looking forward to starting to get that data in a more real-time fashion, and we are working with the police and the hospitals in all of the districts to also get their data in a more timely fashion,” MacDonald said.
She also noted that data doesn’t capture the full picture.
“We have a lot of overdose events that are not reported,” MacDonald said. “We have a lot people who are refusing to go to hospital once EMS is called.”