Toronto Overdose Action Plan: Status Report 2020

During the first four months of 2020, paramedics responded to 1,307 suspected opioid overdose calls, including 71 calls involving deaths. In April 2020, paramedics responded to the highest number of suspected opioid overdose deaths (25) since September 2017. This staff report highlights actions taken to implement the Toronto Overdose Action Plan since the last status report in June 2019 and includes issues related to the COVID-19 pandemic. The report also recommends additional urgent actions that are needed to address the opioid poisoning crisis, especially in the context of the pandemic and the increasingly toxic unregulated drug supply. The need for a fundamental change toward a public health approach remains critical to improving the health outcomes of people who use drugs. Toronto Public Health remains committed to working with our community and institutional partners to improve our collective overdose prevention and response efforts, and to improving the health and well-being of people who use drugs, which is even more of an imperative during this time of dual public health crises.

support evidence-based knowledge exchange and capacity-building responses that reduce the harms of benzodiazepines and opioids. 2. The Board of Health reiterate its request urging the federal Minister of Health to increase funding for a spectrum of safer supply initiatives, including enhanced and flexible injectable and oral hydromorphone programs. 3. The Board of Health urge the provincial Minister of Health to: a. convene a multi-sectoral opioid overdose task force comprised of public health officials, community-based service providers, people with lived and living experience of drug use, and family members; b. expand the criteria for naloxone distribution to allow any organization that has clients who use drugs to distribute naloxone; c. provide funding to pilot and evaluate virtual and/or phone-based supervised consumption services to complement the current in-person service options; d. remove the current cap of 21 Consumption and Treatment Services permitted for Ontario and utilize the federal class exemption granted to provinces during the COVID-19 pandemic to increase the availability of these lifesaving services in a variety of settings; e. provide funding to treatment and harm reduction services to enable them to adapt their services to adhere to COVID-19 public health requirements; f. support the increased use of virtual care for substance use treatment services for the duration of the COVID-19 pandemic; g. dedicate funding for grief and trauma supports specifically for overdoses; and h. consult with harm reduction services, health care providers, first responders, treatment providers, police, and people with lived and living experience of drug use to develop responses to benzodiazepine and opioid-related issues. 4. The Board of Health reiterate its request urging the provincial Minister of Health to support the implementation of managed opioid/safer supply programs, including by adding the required formulation of hydromorphone (i.e., 50 milligrams/milliliters and 100 milligrams/milliliters hydromorphone) to the Ontario Drug Benefit Formulary to enable injectable hydromorphone programs to operate. 5. The Board of Health urge the Office of the Chief Coroner for Ontario to report on the role of COVID-19 as a possible contributing factor in opioid toxicity deaths. 6. The Board of Health urge the Toronto Central Local Health Integration Network to increase funding for comprehensive crisis services for people who use drugs in Toronto.