Opioids now rival pneumonia and flu, as well as several types of cancer, in terms of their deadly impact in the Sudbury area.
On Thursday members of the Public Health Sudbury and Districts board heard some alarming statistics concerning the toll of drugs like fentanyl and purple heroin — a dangerous street narcotic sometimes cut with a substance strong enough to knock out an elephant.
Heart disease and lung cancer still top the list for leading causes of death in the health unit’s catchment area, but opioids are quickly climbing the rungs.
In 2017, for instance, they accounted for 34 deaths, as many as die per year, on average, from flu and pneumonia. And last year’s 29 overdose fatalities were more than the yearly average for breast or prostate cancer deaths.
“These data demonstrate that opioid-related deaths are now so prevalent that opioids on their own, even when we separate these out from all other causes of overdose deaths, show up on this table and ultimately contribute to the plateauing or decrease in life-expectancy estimates,” said Ariella Zbar, associate medical officer of health.
The health unit has been responding to the crisis on a variety of fronts, including more awareness on the dangers of opioids and how to prevent tragedies.
“One of the initiatives we are doing is around harm reduction messaging, for instance where to get naloxone, which is the reversal agent, and understanding safer opioid use, such as not using alone and using smaller amounts,” said Zbar.
The health unit has also been distributing naloxone kits since 2017 to agencies that “provide service to vulnerable populations and those most at risk for an overdose,” she said.
Nearly 2,000 of these kits, each containing two doses of the OD antidote, have been dispensed to the public, board members heard. “This is in parallel to the local pharmacies that have access to naloxone distribution,” said Zbar.
Simultaneously, the health unit is participating with Greater Sudbury Police, through their collaborative Community Drug Strategy, on a study for a supervised consumption site in the city.
“The study is to understand the degree of need and feasibility of this kind of service in our community,” said Zbar.
An exemption through the federal government is required to operate a facility of this nature, she noted, because it is governed by the Controlled Drugs and Substances Act.
“The study will help gather the information necessary for the application but does not guarantee we will get that exemption,” she noted.
People who inject drugs, focus groups and stakeholders are all being consulted for the study.
Researchers affiliated with the Northern Ontario School of Medicine will also be involved in analyzing data, Zbar noted, with the collection of information to commence next week.
The expectation is the study will be completed by the spring of next year.
Supervised consumption sites have proven effective in other locations by “providing safer drug supplies,” said Zbar, as well as a safer environment, with health-care providers on hand “to make sure they are using safely and are there to respond to an overdose.”
Drugs are not provided but clean equipment for injection or inhalation is available, as well as advice on safe usage — “for example injecting in the arm as opposed to the neck, which is very risky,” said Zbar.
Apart from reducing harm among people who use drugs, a supervised site also has broader societal benefits, she noted, including fewer ER visits and discarded syringes, as well as an increased perception of safety among community members.
Zbar stressed, however, that approval for a supervised consumption service in Sudbury is far from a given, nor would it be imminent, so the health unit must continue to make information and naloxone available in the meantime.
Board member Jeff Huska wondered if there is an opportunity for more education in local schools, given victims of overdose fatalities tend to be younger than those who succumb to other leading causes of death in the area.
“Would that be a tool you can use when you are talking to young people in schools?” he asked. “That this is something that is hitting you young and early, and you need to understand the ramifications of what can happen?”
Renee St-Onge, director of knowledge and strategic services with PHSD, said the agency doesn’t have precise data on the age of those who have died locally in recent years from overdoses, but there is research showing young men tend to be disproportionately impacted.
“Tragically you are right in regard to the youthfulness in general of the deaths,” said Dr. Penny Sutcliffe, chief medical officer of health. “And of course that’s what is reflected in the life expectancy either plateauing or diminishing in Canada — because of the number of deaths, but also the ages of the victims.”
According to a chart shared with the board, opioids now rank 10th, alongside flu and pneumonia, as a leading cause of death.
That should make people very worried, said board member Mark Signoretti, and inspire more effort to combat the problem.
“The opioid crisis is lower than (several types of) cancer and some of the other diseases, but the trend is showing that it’s picking up steam,” he said. “So as much as we’re not at the cancer level, we still need to be cognizant that we don’t get it to that level.”