The fentanyl-fuelled opioid crisis that has wreaked havoc in British Columbia is moving east, and the mayor of Toronto hopes a united and rapid response will help save lives in Canada’s most populous city.
Part of that effort begins Monday, with the first meeting of the Toronto Overdose Early Warning and Alert Partnership, which will bring together politicians, public health officials, first-responders, the coroner’s office, community groups and other stakeholders.
“I don’t think that we can sit back and be complacent for one moment,” Toronto Mayor John Tory said in an interview. “The first thing you have to do is to form a partnership that sort of says everybody is going to be at the table, exchanging information, exchanging knowledge.”
While the full scope of fentanyl-related problems in the city isn’t known at this point, Dr. Barbara Yaffe, Toronto’s acting medical officer of health, said there are already troubling figures indicating an uptick.
In 2015, there were 45 fentanyl-related overdose deaths recorded, up from 23 deaths in 2014, Yaffe said. Figures for 2016 are not yet available.
“It’s pretty much doubled,” Yaffe said. “It’s obviously a growing issue, it’s preventable and we need to act now to make sure it doesn’t get worse.”
Fentanyl – a drug prescribed for chronic pain management – is roughly 100 times more potent than morphine and about 40 times stronger than heroin. It produces a drug high but also depresses the body’s rate of respiration, which can cause breathing to stop.
A dose of just two milligrams of pure fentanyl – the weight of seven poppy seeds – can be lethal. Police have said many people are ingesting it unknowingly as the drug, which cannot be seen, smelled or tasted, is difficult to detect when laced into other drugs.
Tory said he decided to take action after a brief correspondence last fall with Vancouver, a city that’s dealing with a spike in fentanyl-related overdoses. Tory had reached out to his counterpart, Mayor Gregor Robertson, to see if there was any way Toronto could help.
“He wrote back and said there wasn’t anything necessarily of that kind that I could do, but he did say ‘my advice to you would be to get ready,'” Tory recounted.
“The second request from Mayor Robertson was to simply be an advocate – get attention of other governments and the public so that everybody gets behind saving lives.”
On that note, Tory said he will also be raising the issue of fentanyl at an upcoming meeting of big-city mayors later this year.
“If this was some other kind of illness that was entering Canada and killing hundreds of people … I think you’d have more focused attention being paid to it by everybody,” he said. “I just think I have to join together in common cause with people like Mayor Robertson and say this is a national crisis.”
Yaffe said Monday’s meeting will hopefully be the first in a series of monthly gatherings that aim to provide a better understanding of drug overdoses and related trends in Toronto.
“We need to know the bigger picture and what’s happening in the community with overdose, where it’s happening and who it’s happening to,” she said. “We’ll look at a different way of communicating the data, sharing the data and deciding, based on the data, what different strategies could be taken.”
Such a meeting could indicate, for instance, a particular part of the city where more overdoses were taking place, allowing for a targeted distribution for naloxone, an emergency medication that reverses the effect of an opioid overdose.
Yaffe noted that an overdose prevention action plan is also being developed for the city – with a final report due in March – and public consultations about preventing overdoses are set to be held in the coming weeks.
The federal government has also been paying attention to the increasing number of deaths linked to fentanyl, and the health minister has promised to look at legislative changes to address the growing opioid crisis.
Health experts and ministers gathered for a two-day event in November to examine a national approach to addiction, overdose and deaths related to opioid use. A report on Health Canada’s Opioid Action Plan is due in February.
South of the border, public health officials have called the current opioid epidemic the worst drug crisis in American history. More than 33,000 people died in the U.S. from opioid-related overdoses in 2015.