By james art 
There is no one-size-fits-all solution to the opioid crisis plaguing Oshawa and other Ontario cities, but using “evidence-based strategies” to develop a local opioid response plan with an early warning and monitoring system and access to life-saving naloxone is putting more groups in the hands for support is the next step in getting the help addicts need.
“Substance use is complex,” said a spokesman for Durham Region Health, adding that there was no single method to prevent or reduce harm from it. “Substance use exists on a wide spectrum with varying stages of benefit and harm. Substance use varies from person to person, and an individual’s pattern of use may change over time.
The sheer numbers were at their worst in the middle of the pandemic in 2021, with support services in Durham stretched to the limit and a humanitarian crisis on the streets, with addicts facing reduced access to services, lockdown measures and social distancing – which increased the likelihood of engaging in drug use alone – as well as the “negative impact” the pandemic may have had on an individual’s mental health.
“This is also something that is being seen in other health unit jurisdictions across the province,” the department said.
There were almost a thousand calls to Durham Paramedics for suspected opioid overdoses this year, with 878 emergency room visits for opioid poisoning and 128 deaths from opioid toxicity.
The peak was in September with 129 overdose calls, 97 suspected emergency room visits and a dozen deaths. Nearly three-quarters of those numbers occurred in Oshawa, the epicenter of the Durham crisis with most shelters and services located in the region’s largest city.
The previous month was actually Oshawa’s worst, with 95 overdose calls and 69 emergency room visits.
Oshawa councilor Derek Giberson, who is the former director of the downtown Back Door Mission, cautioned that while the availability of support services in the city has something to do with the numbers, economic factors play a much bigger role.
“The existence of services is not the main predicate for overdose, although that narrative has certainly taken hold in some circles in recent years,” he explained. “The main connection is found in the socio-economic profiles of the neighbourhoods. We know that areas with factors such as lower incomes, higher rates of single-parent households, housing poverty, and other public health data challenges will also have higher overdose rates, among other attendant challenges.
The region agreed, noting that the opioid crisis is a complex public health problem and is the result of “multiple complex factors,” including:
- Misunderstanding the addiction risk of prescription opioids.
- Psychological, social and biological risk factors such as genetics, mental health, early life experiences, trauma, poverty, lack of secure housing and other social determinants of health.
- Stigma of substance use disorders.
- Frequent prescription of opioids and large amounts prescribed for pain relief.
- Lack of awareness or access to alternative pain treatments.
- Use of prescription opioids by non-prescribed individuals such as friends and family members.
- Lack of access to prescription opioids, leading to illicit opiate use.
- Illegal drugs that contain fentanyl and its analogues.
- Lack of comprehensive care to meet all of an individual’s mental and physical health needs
“The opioid crisis can affect anyone,” the health department spokesperson noted, citing a statement from the Canadian Mental Health Association, which said addiction “disproportionately affects people living in low-income situations, people who are unemployed, people with disabilities and local communities grappling with systemic racism, trauma and intergenerational trauma.”
From the worst times in the fall of 2021, the numbers continued to decline, dropping to 32 calls for paramedics, 29 suspected opioid poisonings and five deaths by February 2023, but have since increased, climbing back to 98 calls for paramedics (65 from Oshawa), 65 suspected opiate overdoses (44 from Oshawa) and seven deaths through December.
It’s also worth noting that paramedic calls and emergency room visits underestimate the true number of overdoses in Durham because emergency services are not sought for all opiate poisonings.
Results were mixed this year, with the number of overdoses falling in June (54 calls to paramedics across the region) before rising again in August to 84 911 calls and 25 suspected overdoses. September’s numbers dropped slightly to 61 paramedic calls and 18 suspected opioid poisonings, but whether that bodes well for the future is unknown.
Of those 54 paramedic calls in June, 34 were from Oshawa and ten were from Ajax. Clarington reported four calls and Whitby three, with Pickering, Scugogue and Brock reporting one each.
Durham Health also reported a 34% year-on-year increase in paramedic calls from January to August this year.
“It is too early to know the reason for this increase and whether it is temporary. With that said, September saw a drop in the number of paramedic calls compared to August,” the health department said. “It’s important to note that while there are fluctuations in hospital emergency department visits, the preliminary data is decreasing over time. We also see fluctuations with deaths, but overall the preliminary figures are still lower than what we saw in 2021.”
Getting naloxone into the hands of more support groups is critical to reducing the number of overdoses, the department added, with the Region serving as a leading distributor and training provider for community organizations such as community health centers, outreach organizations, shelters, Aboriginal health access centres, HIV/AIDS service organizations and abstinence management programs.
An early warning and monitoring system is also an important future goal. The Durham Region Opioid Dashboard currently focuses on trends over time, but more demographic information will be added in 2025.
The opioid response plan being worked on by the region and other communities around Ontario, which will integrate important areas of focus across the system (health and social care systems, the criminal justice system and law enforcement and border enforcement), is receiving support from municipalities across the province , since the Solve the crisis the campaign is making its way through the municipal and regional councils.
The city of Whitby passed a resolution earlier this month calling on the provincial government to commit to “immediate action” as the number of homeless people and those suffering from mental health and addictions is growing “exponentially”.
More than 3,200 people died of overdoses in Ontario in 2023.
The resolution acknowledges the additional funding recently provided for mental health, addictions and homelessness programs, but says it does not adequately address the growing crisis and the financial and social impact on municipalities and regions across the province.
“Municipalities and regions are stepping up and working with community partners to implement community-specific solutions to address this crisis, but lack the expertise, capacity and resources to tackle these increasingly complex health and housing challenges on their own problems.”
The council wants the province to formally make homelessness a health priority by appointing a minister “with appropriate funding and authority” as a single point of contact to address “the full range of housing needs, as well as mental health, addictions and support.” and form a task force to develop a Made in Ontario action plan to try to resolve the crisis.
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