Opioid-related deaths spike as toxic supply filters into smaller cities

A mostly rural public health unit in eastern Ontario is seeing a significant spike in opioid-related deaths as an especially potent drug supply first reported in Toronto and other major cities filters into smaller communities.

The Leeds, Grenville and Lanark District Health Unit reported four opioid-related deaths between July 16 and July 26.

"We've never had anything like this in such a short period of time," said Jes Besharah, a harm reduction support worker with Change Health Care in Brockville, Ont.

"We keep getting more batches of unregulated toxic drugs in, and we're just going to see more and more people going down."

The health unit identified the deaths through its Overdose Early Warning System, which compiles overdose information from local hospitals, emergency services and an online reporting tool.

Between 2005 and 2019, the health unit never recorded more than two opioid-related deaths in a single month.

Even though numbers increased in 2020, the health unit has still recorded more opioid-related deaths in the first six months of 2021 than it did all of last year.

'More and more toxic'

"It's not that the use has changed. It's that the drug supply is getting worse. It's getting more and more toxic," said Besharah.

"Every time a new batch comes in, it's cut with something different, and people have a different reaction to it. It's the drug supply that's really the problem."

It's like fentanyl on steroids.- Jes Besharah

A recent report by Toronto's drug-checking service found the emergence of more potent opioids is making the city's drug supply stronger and harder to predict.

That supply is now making its way into smaller cities.

Besharah said it usually takes around a month for the supply in places like Toronto and Montreal to trickle down to Brockville.

"We just had another [batch] come in this morning," she said. "People are saying it's like fentanyl on steroids."

Besharah said she'd like to see Brockville replicate the approach taken in larger cities, and while local advocates are pushing for a supervised consumption site, they don't have the space or resources to meet federal qualifications.

Pandemic a factor

The toxic drug supply comes at a time when pandemic safety measures may also be causing people to use drugs alone.

"We've got feedback from people who are using substances, and there's a number of factors repeated," said Sgt. Tom Fournier, who's in charge of support services with the Brockville Police Service.

Fournier said those factors include capacity limits in treatment facilities and difficulty running virtual counselling and support programs during the pandemic.

"There's not a one-size-fits-all treatment," he said. "Many persons prefer the harm reduction method. Some prefer to go to support groups [or use] an abstinence method to seek help. And those facilities in many cases aren't available, especially in rural communities."

Besharah urged anyone who is using not to do in isolation.

"These people are my friends. I love them like they're my family," she said. "It's a sin to watch them just fall through the cracks."