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On today’s show we will be discussing some potential policy responses to combat the ongoing opioid crisis. As strategies to tackle the opioid crisis have been a focal point of all levels of government, various stakeholders have proposed taking a public health response to address the ongoing national epidemic. In the first half of 2018, there were 2,066 apparent opioid-related deaths, which means that more than 9,000 lives were lost between January 2016 and June 2018 related to opioids. Experts have attributed this ongoing crisis due to the rates of high-dose opioid dispensing which began in the mid-2000s and have significantly increased since then. Canadians are the 2nd highest per capita consumers of opioids in the world, after the United States.

In response, the Government of Canada has embraced and is committed to taking action against the opioid crisis through a targeted public health emergency response which includes: prevention, treatment, harm reduction and enforcement which is supported by evidence-based research. The federal government has also restricted the marketing and advertising of opioids the healthcare professionals. A key focal point of the shared intergovernmental response to the crisis is the the Government of Canada’s financial commitment of $5 billion dollars to the provinces and territories over ten years to improve access to mental health and addiction services.

At the provincial level, the Ford government recently signed onto a bilateral agreement with the federal government to access its share of the $150 million fund earmarked for the opioid crisis in order to expand access to treatment and rehabilitation services at supervised consumption sites. Yet in order to renew permits and receive funding under the new Consumption and Treatment Services (CTS) model, sites must complete an application that demonstrates:

  • A need,
  • Its proximity to other sites and services, and community support
  • There is ongoing community consultation
  • Integration with primary care, treatment and other health services
  • “Defined pathways” to addictions treatment, rehabilitation, mental health, housing, employment
  • Pick up of used harm reduction supplies

Importantly, the federal government still remains responsible for granting exemptions to Section 56.1 of the Controlled Drugs and Substances Act to operate a Supervised Consumption Site.  Advocates of safe injection sites fear that the new guidelines set up by the provincial government are overly restrictive and create unnecessary roadblocks that may result in lives lost to overdoses.

In 2017 Toronto developed the Overdose Action Plan which outlined key prevention and response strategies including expediting the opening of supervised injection sites and addressing social factors that lead to substance abuse and overdose such as expanding the supply of affordable housing, implementing basic income and increasing the social assistance benefits and employment opportunities.More recently, the Toronto Board of Health called upon the federal government to decriminalize drug use and possession as there is “evidence on the health and social harms of the current criminalization approach to illegal drugs.”

With the assistance of today’s guests, we are going to dive head first into this issue as we now know how nuanced and interconnected the policy responses that are required to tackle the opioid crisis.

Gillian Kolla is a PhD candidate in Social and Behavioural Health Sciences at the Dalla Lana School of Public Health, University of Toronto. She holds a Master of Public Health degree from the University of Toronto, as well as a Bachelor of Arts in Religious Studies and a Bachelor of Social Work, both from McGill University. Her career to date, both academically and professionally, has focused on the barriers to healthcare and social services confronted by marginalized populations. Using ethnographic methods, Gillian’s PhD research examines a peer-based program that aims to address the barriers that limit access to hepatitis C prevention services and healthcare among people who use drugs. By exploring how risk and harm are experienced, embodied and mitigated by people who use drugs within the environments where they use drugs, her research aims to examine whether interventions in the spaces where people use drugs increase awareness and uptake of prevention interventions, and improve pathways into treatment and care.

Matt Johnson is the Coordinator of the Overdose Prevention Site at Parkdale Queen West Community Health Centre. He is a long time Harm Reduction worker, advocate and was involved in setting up the unsanctioned Overdose Prevention Sites in Moss Park and Parkdale as an activist response to inaction around the overdose epidemic and the ongoing drug war. He has been asked to speak as an expert on substance use, Harm Reduction and Overdose response to Social Service agencies, Universities, a Coroner’s inquest and media. He continues to push for greater and meaningful involvement of people who use drugs in the development and implementation of services as well as policies affecting drug users. He works for an end to the drug war, and a humane system based in respect, human rights and greater health and stability for all.

Credits:
Robert Giannetta, Host & Producer
Tony Yin, Host & Producer
Vienna Vendittelli, Technical Producer
Nuri Kim, Executive Director

Music Credits:
99 by Barnes Courtney
High Hopes by Panic! At The Disco