Why Ontario won't declare the opioid crisis a provincial emergency

A day after receiving an open letter from 700 health-care workers calling for more action to address the opioid crisis, Ontario Health Minister Eric Hoskins announced that the provincial government will invest $222 million over three years into harm-reduction services for opioid users.  

• Ontario health minister says province to invest $222M over 3 years on opioid crisis
• Harm reduction workers call on Ontario to declare emergency over opioid crisis

The letter, sent Monday, also called on Premier Kathleen Wynne to declare the opioid crisis a provincial emergency — something Hoskins says the province will not do.  

In an appearance on Metro Morning Wednesday, he explained the rationale behind not using the term "emergency," and what the provincial government is doing to address the growing problem.

Questions and answers have been edited for clarity and length.

Metro Morning: Why did it reach the stage where these 700 health-care workers felt they had to speak out publicly before we heard from your government about its plans to further address the problem?

Eric Hoskins: I want to commend the health-care workers who have been advocating passionately and capably for a long time for additional support. This is a public health crisis — I've been saying that for well over a year. We need to do everything we can to diminish this crisis and prevent the overdoses we're seeing unfortunately with increased frequency. It's a complex situation. Yesterday was my fourth funding announcement with regards to the opioid crisis. It brings the level of new funding by this government to well over a quarter of a billion dollars over the next two-and-a-half years. I doubt it will be my last announcement. We rely on our frontline health-care workers, I have been relying on them for upwards of two years to get their best advice in terms of the measures that we need to take to tackle this crisis in an effective manner. 

MM: This may be your fourth announcement, but there were 700 people [in that letter] almost begging you to act.

EH: We have been acting. Obviously yesterday was an additional investment. But a year ago, for example, we made naloxone available free of charge through pharmacies. It's now available in 1,500 pharmacies across the province, as well as public health units. Here in Toronto we are funding 100 per cent of the costs, both capital and operating, of three safe injection sites, as well as other programs like needle exchange. Every single public health unit in the province — there are 36 of them — has received funding to hire more staff that will be on the frontline, involved in harm reduction. We provided $20 million additionally to pain management clinics across the province, and added to the number of pain management clinics. We're developing standards for physicians and nurse practitioners for prescribing. There are so many touch points, if I can call them that. Yesterday's announcement provides $70 million for early treatment, things like rapid access addiction management clinics. 

MM: And yet, you're not calling this an emergency. Why?

EH: There's no doubt that this is a public health crisis. We're looking to provide national leadership, as well — this year, it's likely that 3,000 individuals across the country will die of opioid overdose and that is 3,000 too many. This is entirely preventable. With a provincial emergency declaration, the legislation that that is drawn from, it refers to events that are expected to be of a time limited or finite nature. In fact, the initial declaration of an emergency, which is typically used for floods or fires, is for a 14-day period. It can be renewed for another 14 days. We all know that the opioid crisis has been with us for quite some time and will be with us for a long time.

MM: In British Columbia they declared an emergency at least a year ago, and they are still in that state — were they wrong to make that decision?

EH: No, they were absolutely correct to do it. Those were powers that the minister of health applied to enable certain measures to be taken. We have the ability, because the legislation is different, [that] a number of the measures that BC was looking to improve upon, we're able to do without having to make a declaration or pass any particular legislation. So yesterday's announcement for example — the $222 million over the next two-and-a-half years, was one of the major asks of the frontline health-care workers. We were able to do that without any such declaration.

We all know this isn't going to be solved overnight or in a short period of time. The commitment I made yesterday includes not just funding for early treatment, but here in Toronto the support to the safe injection sites. We know there will be other [safe injection sites] right across the province. We have invested specific funds for First Nations communities.

MM: But these frontline workers, they want this declared an emergency. That was part of their ask — it sends a message.

EH: I spoke with some of them yesterday, I'll be meeting with the group next week. The premier earlier this week met with them and explained her rationale for not using the emergency legislation as I mentioned, because it has that particular requirement that it be a time-limited or finite nature. I've been calling it a public health crisis. And I think actions speak louder than words. The unprecedented investment that we're making responding to the letter from the 700 but even moreso from what we've heard over the past more than a year from frontline healt-care workers, we are responding to what they've identified as priorities. So we've included a significant funding boost so that at the community level, more harm-reduction workers can be hired, we're [also] further expanding the supply of naloxone.