Hamilton has seen an 'exponential rise' in opioid deaths. Is it a 'state of emergency'?

Following a year that saw Hamilton paramedics respond to 827 suspected opioid overdoses, city councillors are weighing whether to declare a state of emergency — and are hoping such a declaration could bring additional provincial resources to address the issue.

It's a step being praised by some front-line workers as one among many needed to address a crisis that is hitting people who live in shelters — some of the city's most vulnerable residents — the hardest.

Councillors voted in favour of a motion Thursday to have the city's medical officer of health look into whether the latest data on opioid deaths and overdoses meets the threshold for declaring a state of emergency.

Kim Ritchie, who spent 15 years living on the streets and is now a social worker serving marginalized residents, says that declaration could force Hamilton to better support what she says are underfunded and understaffed shelters. Many of their workers are students or recent graduates who barely make enough money to support themselves, she says, and aren't always trained to handle the frequent overdoses they are seeing. 

"If we declared it a state of emergency we could secure funding to properly fund these facilities," she told CBC Hamilton on Friday, adding that monitoring residents for overdoses is taking staff away from essential tasks such as helping them find housing.

According to city statistics, Hamilton saw 100 deaths linked to opioid use in the first half of 2022. There were 170 deaths in 2021 — an "exponential rise" from 26 in 2005, according to a report coming to the city's Board of Health when it meets Monday morning.

The report, called Population Health Assessment and Public Health Priorities, says more than 65 per cent of opioid deaths are among men between the ages of 25 to 65, and that Hamilton's opioid-related death rate is 45 per cent greater than Ontario as a whole.

City data shows paramedics are being called to dozens of overdose calls every month, with 87 such calls in August, the worst month last year.

'Every single ward' has had overdoses: councillor

Coun. Brad Clark (Ward 9 — Upper Stoney Creek) cited some of those statistics at Thursday's general issues committee meeting while discussing the motion he put forward, which directs Medical Officer of Health Elizabeth Richardson to investigate the "threshold of opioid deaths and overdoses that would enable the declaration of a state of emergency and report back to the Board of Health."

The motion, which received unanimous support from those present, also directs staff to lay out the response required to address such an emergency. 

"What was striking to me is ... every single ward in the City of Hamilton has had overdoses," he said, suggesting that an "all hands on deck" approach may be warranted. "People seem to think it's a downtown issue.

"I think the motion itself will help us create a more holistic approach to it rather than just dealing with it as one-offs every time there's a call… If it is a state of emergency, we may be opening the doors to [provincial] funding."

Dundas councillor Alex Wilson described a surge of overdoses in the shelter system, and indicated their plans to bring forward a motion in the future asking staff to look at whether it would help to have spaces within shelters where users could consume drugs in a safer way.

'Safer use' spaces reduce burden on health-care system: advocate

Olivia Mancini, a Hamilton social worker who worked in the men's shelter system for several years, would support such a move.

Mancini, founder of Hamilton's Student Overdose Prevention and Education Network, says she knows of five overdose deaths related to drug poisoning in one Hamilton shelter alone in the last three months of 2022. She says that number would have been unfathomable during a whole year just a few years ago.

Mancini says "safer use spaces" within shelters face hurdles that include funding and reluctance from shelter operators, which she says are often religious organizations with "abstinence-based values" when it comes to drug use.

However, she notes that adoption of safer use spaces, where users are supervised and helped if anything goes wrong, would reduce 911 calls and lessen the burden on other over-taxed systems, such as paramedics and emergency rooms.

"Most importantly, it would be saving lives," she said. 

Ritchie, who used opiates during her time on the streets but has been sober for 12 years, says there needs to be enough support available so that someone who decides they are ready for help can access it right away.

"Rock bottom is when desperation for change meets resources," she said. "If you don't have that nexus point, it just turns into despair."

'These are human beings. They matter'

Ritchie says an emergency declaration could push Hamilton to expand access to supplies of safe drugs, an intervention known to save lives. "I'd rather have more safe drugs on the street than what's out there now ... so people don't have to bury their loved ones."

She says the city is currently re-assessing its shelter standards, which, combined with a state of emergency declaration, could be an opportunity to radically change how the municipality treats drug users.

"It would be an opportunity to co-create what shelters need to be now, in our current state of society where resource scarcity is so prevalent," she said. 

"These are human beings. They matter."

HOW THEY VOTED

In favour of the city's medical officer of health investigating a state of emergency declaration

Tom Jackson, Maureen Wilson, Matt Francis, Craig Cassar, Tammy Hwang, Mark Tadeson, John-Paul Danko, Brad Clark, Nrinder Nann, Mike Spadafora, Jeff Beattie, Alex Wilson

Absent 

Cameron Kroetsch, Esther Pauls, Ted McMeekin, Andrea Horwath