How Ottawa’s public health unit wants to fight the fentanyl crisis

Published Nov 05, 2023 • Last updated 3 hours ago • 3 minute read

Fentanyl pills. Photo by GAVIN YOUNG /Postmedia News files

In the fight to somehow curb the worsening fentanyl crisis, Ottawa’s public health unit is calling on the city for more funding aimed at prevention and response as part of a deeply-researched and wide strategy designed to try to help everyone they can.

In a report to be tabled at Monday night’s Ottawa Board of Health meeting, the health unit updates its plan and next steps — from improving timely surveillance of drug toxicity to grief and trauma support for users, their families and harm-reduction staff.

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The report, submitted by medical officer of health Dr. Vera Etches, makes many requests, including:

That the Board of Health’s Chair, Catherine Kitts, write a letter to the provincial government asking for more funding to support perinatal mental health, substance abuse health for infants and the prevention of adverse childhood events.Advance the coroner’s report recommendations to expand drug checking to ensure a safer supply.Expand options and access to health care, including supervised consumption sites in urban and rural neighbourhoods.More funding to scale up community outreach services and address concerns of neighbours.More funding for First Nations, Inuit and Métis Mental Health Teams, Inuit Family Health Teams, and the Ottawa Aboriginal Coalition Indigenous Mental Well-Being Strategy

Ottawa’s Board of Health first declared an overdose crisis in 2017.

Since then, the scourge of fentanyl has hit every neighbourhood, urban and rural. It’s now cut into most hard drugs and has killed unsuspecting users, young and old, rich and poor.

Most have survived fentanyl overdoses after quick-thinking friends, paramedics, hospital staff, bar staff, outreach workers, bystanders, jail guards and police administered Naloxone.

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Ottawa’s youngest overdose victim in the opioid crisis so far — a one-year-old girl — somehow ingested fentanyl at her Vanier family apartment in 2020. She was crawling on the living room floor, then stopped breathing. Her mom called 911 and paramedics said the baby was blue and limp with vital signs absent.

Paramedics rushed the baby to CHEO, and in another miracle on Smyth Road, staff saved the one-year-old girl with two doses of naloxone.

How the fentanyl residue came into the home is unclear, but after the baby was revived at hospital, tests showed she had not only fentanyl, but meth in her system too. (Her parents were later charged with criminal negligence causing bodily harm for failing to provide the necessaries of life, and administering a noxious substance.)

The 2023 State of Ottawa’s Health Report shows the rates of opioid-related emergency department visits tripled from 25 per 100,000 population (243 visits) in 2016 to 75 per 100,000 population (806 visits) in 2022.

Opioid-related emergency department visits also increased in the first half of 2023 with 644 visits from January to June 2023 compared to 429 in the same period last year.

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Death rates increased similarly from four deaths per 100,000 (41 deaths) in 2016 to 14 per 100,000 (145 deaths) in 2022, over a three-fold increase, according to this year’s state of health report.

Since the city first declared a crisis in 2017 and March 2023, most overdose deaths were from fentanyl, or its analogues. It accounted for 84 per cent of deaths in that period, and 93 per cent of opiod overdoses were accidental in nature, according to the state of health report.

The state of health report noted: “In Ottawa, 72 per cent of opioid overdose deaths from January 2018 to June of 2021 involved a stimulant like cocaine as a direct contributor to the death. In Ottawa, the proportion of accidental opioid deaths where there was evidence of inhalation as a mode of ingestion is increasing: deaths involving inhalation alone increased from 16 per cent in 2018 to 39 per cent in 2022.

In contrast, the proportion of accidental opioid-related deaths where there was evidence of injection decreased to 13% in 2022, compared to 22% in 2018. Not all deaths have evidence of only one mode of ingestion, but the trend to an increased number of deaths where there was evidence of inhalation persists. In Ottawa, 54% of deaths had evidence of inhalation alone or along with evidence of injection compared to 35 per cent in 2018.”

Incredibly, supervised consumption and treatment staff — stretched thin and working a high-stress job — managed to reverse more than 1,110 overdoses in 2022. That’s twice as many as were reversed in 2020.

Ottawa’s board of health will consider the report and its requests Monday night around 5 p.m. at Champlain Room at city hall.