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Our region has a 'staggering' opioid problem. What can be done?

Simcoe-Muskoka's death rate far exceeds provincial rate, panel hears; 'The constant grief and loss that’s happening is big,' says outreach worker
2021-10-19 Drug symposium
Experts from across Simcoe-Muskoka took part in the region’s first-ever public health dialogue on the overdose crisis and policy solutions to the mounting drug toxicity deaths in the community on Tuesday, Oct. 19.

Community leaders came together virtually this week to take part in Getting to Tomorrow Barrie, the region’s first public health dialogue to address the overdose crisis and discuss policy solutions to the city’s increasing drug toxicity deaths.

Last year, Simcoe-Muskoka saw 134 opioid poisoning deaths (equalling a rate of 22.2 deaths per 100,000)  a number significantly higher than the provincial rate of 16.4 deaths per 100,000. 

Participants included a combination of individuals with past and current lived experience of drug use and harm reduction to leaders from health care, government, First Nations, and law enforcement, with a goal of creating a “shared understanding and common purpose that will trigger collaboration and catalyze policy changes needed to save lives."

Through the various discussions, the event also aimed to “accelerate the adoption of public health and human rights-based drug policies in Canada," including safe supply and decriminalization; empower decision makers and the public to take evidence-based actions by providing the latest research on policies that could end the overdose/drug poisoning crisis; and engage the public in dialogue on issues related to substance use and drug policy in an effort to reduce stigma.

“The rate at which we are seeing overdoses is staggering,” said Suzanna McCarthy, executive director of the John Howard Society Simcoe Muskoka. 

Barrie Coun. Keenan Aylwin agreed, pointing out that the city has an overdose rate eight times the provincial average.

“Barrie has been hit pretty hard by this toxic, dark supply crisis. I think it’s been exacerbated by the intense housing crisis that we’re facing. We have a lot of people who are unhoused in this community… and it’s causing a lot of issues where people are just surviving day-to-day on the streets, living rough in encampments and coping with life the best they can,” he said.

“I think we also have a cultural problem in the city around drug use, where we have a lot of stigma and look down on people who use drugs," Aylwin added. "We have a lot of work to do to eliminate that stigma and ensure people who use drugs are treated as human beings.”

Sarah Tilley, who is a harm reduction co-ordinator with The Gilbert Centre, said along with the criminalization of drug use has come the apparent criminalization of poverty. 

“Those two directly go hand-in-hand. There’s a lot of people who use substances and a lot of people who use drugs, (but) because they have a place to go and do them, they’re not targeted the same way as people who are living on the streets,” she said. “Their homes are often very public places, so their drug use is surveilled in a very different way.

"I think it’s the criminalization of that poverty, as well, that ties into a lot of these harms.”

The city as a whole is experiencing a profound amount of grief because of the high number of fatal overdoses that are occurring. 

“A piece we have to remember is these are people and they’re part of a community. They have friends, they have family and the number of people dying in Barrie because of the toxic drug supply is just unfathomable really, when you look at the rates. For me that’s really pressing.”

The scarcity of services in the city likely also plays a role, added Denise Baldwin, co-founder of the Indigenous Harm Reduction Network.

“The constant grief and loss that’s happening is big. You hear it out there doing outreach,” she said.

Trauma and a lack of hope are two other factors that often play a big role in why some individuals turn to drug use, acknowledged the panel on Tuesday. 

“It’s unresolved trauma and trauma that is perpetual. There isn’t a space for people to deal with this grief and loss and it’s successive,” said McCarthy, adding people working "on the front line can barely catch our breath and we get to go home to very privileged places every single night.

"We have access to counselling, to resources to take care of ourselves and we are struggling. I couldn’t imagine what it’s like for our clients who are sitting unsheltered, unhoused and unsupported," she said. 

Add to that the prejudice around drug use and it just perpetuates that trauma and pushes people further into their use because they can’t catch a break, McCarthy added.

“As we come into... 18 months of being in hotel shelters or being outside for a lot of our friends and rents keep going up, there doesn’t seem to be an obvious light at the end of the tunnel. Some of what we are seeing is a lack of hope,” added Jennifer van Gennip from Redwood Park Communities.

Van Gennip says she believes a shift is needed on how we as a society offer help to those in need. She said what needs to begin to happen is centring people as the experts in their own lives and to begin treating people like adults and hearing from them what they need. 

Prior to starting her career in social work and harm reduction, Tilley shared her own history of trauma and substance abuse, adding she was “very privileged” in her substance use in that she had family she could call on for help.

“I don’t want to sugar-coat it because it was very messy… but I had family and I had the ability to take time off of work to go to a treatment centre," she said. 

Even with those supports, Tilley admits it was still extremely difficult to begin to understand what her trauma was, let alone address it in a meaningful way that allowed her to make different choices in her life.

“I could not imagine what that would be like if I was not privileged in those ways that I could go home to my mom when I needed to,” she said. “The amount of people and the resilience I see every day of people simply surviving  having that experience in my background  I am in awe and shocked that we as a society can’t see the harm we are continuing to do by not changing policy.

"When will people wake up? There’s a beauty in that resilience, but... we need to do better by our community.”

The group also discussed the topic of decriminalization and the difference that change could make. 

Canadian Drug Policy Coalition executive director Donald MacPherson said the difference that change in policy would make in every city would be huge.

“You hear so much about stigma. It’s very real and it’s crushing,” he said. “We don’t recognize that the primary historical cause of stigma is criminalization of people who use substances.

"There’s mountains of evidence globally that shows criminalization is harmful. It pushes people into the shadows, it destroys relationships and it increases risks of contracting infectious blood-borne diseases and infections,” MacPherson added. “Politicians, what are you waiting for? There’s consensus across civil society, public health, law enforcement.

"It's mind boggling to see us so stuck on removing one of the primary causes of stigma… and to wonder how long it will take. This new government in Canada has a golden opportunity to move things forward at this time."