Opioid overdoses on the rise in homeless shelters despite Toronto’s harm reduction program

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Jennifer Jewell has lived in one of the shelters in Toronto for the past year.

While there, the 51-year-old says she regularly saw overdoses among other residents, some of the 610 suspected overdoses in urban shelters in the first six months of 2021, according to a set of City of Toronto data which can be found on its open portal. Of these, 26 were fatal.

“There are far too many deaths,” Jewell said.

“At least one death per week in the past month … And there is no [enough] mental health support services. People lose their friends to death all the time and there is nothing for them. “

This is a staggering increase from the same period in 2020, when the city documented less than 10 fatal overdoses in its shelters.

The peak comes despite the city’s efforts to strengthen overdose prevention strategies in its shelters. In December, the city launched the Integrated Harm Reduction and Prevention Initiative (iPHARE). The program provided $ 7 million to partner organizations to implement a range of harm reduction supports, such as increased mental health efforts and a limited number of supervised consumption sites.

And yet, the number of overdoses in shelters has continued to climb.

Distancing can be deadly for drug addicts, warn advocates

Some frontline advocates say moving people from camps to hotel shelters may have worsened the overdose crisis.

Lorraine Lam, an outreach worker at Sanctuary Toronto, a nonprofit that works with the homeless, said the settlements provide community and safety for residents.

“A lot of the people who live outside are the first responders. They are there long before the paramedics,” she said. “If one person breaks down, others can be there… literally saving lives.”

However, in city-run hotel shelters, many residents live in relative isolation due to physical distancing measures. Lam said it can be extremely dangerous for drug addicts.

“It’s like the golden rule: never use alone,” Lam said. She also highlighted the need for safer consumption sites in urban shelters.

Diana Chan McNally, training and engagement coordinator at the Toronto Drop-In Network, says more safe drinking sites in shelters and peer testimony programs are needed to help fight overdoses in shelters. (Tyler cheese / CBC)

Diana Chan McNally, Training and Engagement Coordinator at the Toronto Drop-In Network, agrees.

“We have advocated for supervised consumption sites to be placed in every hotel refuge,” she said.

Currently, only three of the city’s 26 temporary shelters have safe consumption sites, operated by Toronto Public Health. However, the opening of more sites does not depend solely on the city. He must seek an exemption from the province, McNally said.

The city says it has requested urgent provincial aid.

In an emailed response to CBC News, the Ontario Ministry of Health said it would continue to work with its municipal partners to tackle the opioid crisis and highlighted the $ 30 million in funding it it supplied to operate 21 consumption and processing sites across the province.

In addition to safer consumption sites, Lam and McNally also identified peer testimony programs as a way to discourage isolated drug use.

“When you use drugs, you don’t necessarily want to go into a semi-clinical environment,” McNally said.

“Allowing people to support each other in their rooms, not necessarily in a dedicated site, would go a long way in reducing the level of overdose we see in hotel shelters. “

Lorraine Lam, an outreach worker at Sanctuary Toronto, says the recent increase in overdoses at Toronto homeless shelters is concerning. (Craig Chivers / CBC)

Too many residents, too few staff

Staffing has also been an issue contributing to the increase in the number of overdoses, according to Lam.

“I don’t think there are enough sufficiently trained staff,” she said. She attributes this to the speed at which temporary shelters must have opened in response to COVID-19.

“We know it takes many years to do this to really be able to respond adequately,” Lam said. “People have told me that they have witnessed overdoses and that the staff take a step back because they don’t know what to do or refuse to respond.”

She suggested hiring the residents of the shelters themselves to respond to overdoses.

“These will be the most effective people at understanding how harm reduction works,” Lam said.

In an emailed statement to CBC News, the city said its shelter directive said “all program staff on each shift will be trained in overdose prevention, recognition and response, including the administration of naloxone ”, a drug that can block the effects of opioids and help reverse overdoses.

“All clients will be offered a naloxone kit and training upon admission. Shelter providers will ensure that naloxone kits… are available at all sites for staff and residents,” the statement said.

Additional calls for secure supply

Dr Andrew Bond, medical director of Inner City Health Associates, said one of the top priorities should be ensuring a safer supply of drugs.

“We currently have a huge amount of contaminated drugs,” he said. “When the scale is so important, it’s not that people are using it inappropriately or in a dangerous way. It’s just that they’re using substances that happen to be so toxic that almost any dose can kill them. . “

With overdoses still on the rise, Jewell said more needs to be done faster.

“They need to do something about it now, because… a lot of these deaths are completely preventable,” she said.

“And we can’t wait any longer because too many of us are dying.”


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