Town councillor outlines new approach against addictions crisis in Fort Frances

As communities across northwestern Ontario continue their struggle against opioid addiction, homelessness and a growing mental health crisis, a town councillor in Fort Frances is trying to spur fellow officials in her community to take action. 

Mandi Olson is calling for more resources from upper levels of government, and better collaboration between regional stakeholders, to come up with community-driven solutions.

Fort Frances is roughly 350 kilometres west of Thunder Bay and has a population of about 7,400 people. 

According to two recent reports — the Northwestern Health Unit's 2022 opioid report and supervised consumption services needs assessment — statistics show the opioid crisis is hitting Fort Frances hard. 

• Fort Frances saw the highest rate of opioid-related ER visits between 2017 and 2021 in the health unit's catchment area.
• Opioid-related ER visits in Fort Frances are 58.8 per cent higher than the rest of the health unit's catchment area and 78 per cent higher than the provincial average.
• Hepatitis C rates in Fort Frances are much higher than in the rest of Ontario.

"I think a lot of people were surprised and perhaps confused as to why our numbers would be so much greater than the rest of the district," said Olson, who works in the mental health and addictions field as vice-chief executive officer of the Binesiwag Center For Wellness. "We're substantially under-resourced compared to other locations."

Olson's calls for action come at a time when many communities in northwestern Ontario, such as Dryden, Kenora and Thunder Bay, are grappling with how to ease the crisis. Northern Ontario's five largest cities have a per capita opioid overdose rate of 60.1 per 100,000 people. That's three times higher than the provincial average of 17.6 per 100,000. 

Dr. Kit Young Hoon, medical officer of health for the Northwestern Health Unit, said opioid-related ER visits are an interesting statistic. One might assume the community with the highest rates is seeing the worst of the crisis, which may be true, she said – but that's not necessarily the case. 

There are many reasons why opioid-related ER visits could be higher in Fort Frances, she explained, saying those numbers could be the results of people being exposed to more lethal substances than other communities, naloxone kits are not as widely available, or that a lack of safe spaces means users have nowhere to go but the ER.

While there are high death rates in Fort Frances, the numbers are too small to tell whether there are significantly more deaths there than in neighbouring communities. Other rates like Hepatitis C and HIV cases, albeit high, are similar to the rest of the health unit, she said.

Urgent action, collaboration needed

Olson drafted two council motions last month, which include several measures:

• Requesting letters of support for more resources to address the opioid crisis.
• Recommending the health unit creates a regional coalition of stakeholders to amplify regional concerns and investigate strategies and resources.
• Supporting the health unit in creating an opioid task force.
• Recognizing National Opioid Awareness Day on Sept. 21.
• Designating a public space for those grieving the loss of loved ones to addiction. 

The notices of motions were passed unanimously in May, and the the final motions are expected to be adopted later in June. 

Young Hoon said the health unit's primary role in Fort Frances is providing harm reduction services, like naloxone kits and the needle exchange program, and support for rapid access addiction medicine clinics.

The health unit keeps municipalities up to date with the latest data to help leaders make evidence-based decisions, she said.

Regional conversations are happening, particularly around supervised consumption services, and Young Hoon said these discussions must include multiple stakeholders – from businesses to the broader community, health care providers and social service workers, Indigenous leaders and municipalities.

The burdens of care, communal grief

Olson sees the impact of the opioid crisis first hand, not only in her line of work but in her personal life.

"Most of us are exhausted in the work that we're doing. We're sort of battling two fights: resources and support … on the funding side of things, and then on the front end of things, too, where we're losing our community members at such an astronomical rate," she said.

"These are our families, these are our friends."

One problem she sees is organizations providing mental health, addictions and other social services are competing for the same funding.

"None of that funding recognizes that this is a complex issue and that we all need to be on the same page, on the same table and potentially utilizing the same resources," she said.

That's why her motions discuss the need for an inclusive and diverse approach, she said.

"I think every day that we continue to lose people, that we're doing a disservice – and it's hard and it's painful," said Olson. "I've lost my own family members, too, to addiction, and I don't know how much longer the community as a whole can continue to do this, burying our families."

Social challenges, geography create barriers

Dr. Charles Bonham-Carter is the chief medical director of Canadian Addiction Treatment Centres, owned by Texas-based BayMark Health Services.

These centres primarily offer opioid agonist therapy, such as methadone or suboxone, which provides a steady opioid alternative that helps people manage opioid withdrawals. Fort Frances has an associated Ontario Addiction Treatment Centres clinic on Scott Street. 

In a small town with such a vast geography, Bonham-Carter said people often have to travel far distances to access treatment. That, compounded with social issues like precarious housing or homelessness, can make it difficult to get consistent services. 

"You can imagine if other things are not going well in their life, to have the wherewithal to get to a program every single day and get your medication and what you need, it can be really quite hard," he said.

"Sometimes, people find it easier just to try and access the drugs that are at hand, and therefore the problem continues."

Supervised consumption services recommended

Earlier this year, the Northwestern Health Unit recommended four communities in the region should have safe consumption services: Fort Frances, Kenora, Dryden and Sioux Lookout.

The only supervised consumption site in northwestern Ontario is Path 525 in Thunder Bay.

Out of 50 people who use drugs surveyed in Fort Frances, three out of four respondents said they would use supervised consumption services if they were available, though 43 per cent did say the number one reason they would not use those services was fear of being seen. 

As for the broader public's perceptions, 68 per cent said they agree or strongly agree there is a need for drug consumption and treatment services in Fort Frances.

Medical Officer of Health Young Hoon said the health unit's opioid report and supervised consumption services report have been sent to the Rainy River District Ontario Health Team's mental health and addictions subcommittee. Discussions are underway regarding supervised consumption services, and what agency or agencies may apply to offer those services in each community.

While the health unit will play a role in this process, Young Hoon said the development of these services will come from communities, like Fort Frances, directly.

"From my end, I wouldn't want to be too directive and say this is the path it has to go through," she said. "It's very much dependent on the local committee to figure [out] the best way because they would have the best understanding of all the stakeholders in Fort Frances."