The number of ER visits due to an opioid overdose is down in Haliburton County from peak COVID-19 numbers, while the Highlands was the only region within Haliburton, Kawartha Lakes, Pine Ridge district (HKPR) not to record a drug-related death last year.
A new situational assessment report, compiled by the Haliburton Kawartha Lakes Northumberland Drug Strategy (HKLN) and the HKPR health unit, was released Oct. 29, analyzing the impacts of the drug poisoning crisis in the region. It looks at localized trends in drug use and poisonings, while breaking down the four-pillar approach used to address the crisis in HKLN.
Dane Record, HKLN chair, said the four localized pillars focus on prevention and education, treatment, harm reduction, and community safety.
“The drug poisoning crisis is both an urban and rural crisis that exists everywhere and affects all of us,” said Dr. Natalie Bocking, HKPR medical officer of health. “Our response needs to be collaborative; we must recognize there is not one strategy that will solve this, and we must work together at multiple levels to address the drug crisis.”
In the report, co-authors Record, and HKPR staffers Kate Hall and Vidya Sunil note the drug crisis is fueled by the distribution of unregulated opioids – a class of drug commonly used to reduce pain. Synthetic opioids, such as fentanyl, methadone, oxycodone, and hydromorphone are being mass produced illegally and sold on the street for non-medical consumption, they state.
Since 2016, Health Canada has been tracking opioid-related deaths nationwide – posting stats annually on a virtual public dashboard. Between January 2016 and March 2024, there have been 47,162 apparent opioid toxicity deaths.
The authors note data from early 2023 suggests most overdoses occur in British Columbia, Alberta, and Ontario – predominantly affecting males aged 20 to 59. Fentanyl was involved in over 80 per cent of cases.
Last year, there were 221 opioid-related emergency department visits in HKPR – with nine in Haliburton County.
It was pointed out the region’s ER visitation rate has increased 12 per cent over the last five years for drug-related emergencies. Per 100,000 people in the region, the report found 136.5 required urgent medical attention following opioid use – this is higher than the provincial average of 81.8.
For the County, rates trended up from 2019 to 2021 but saw a significant drop in 2022. The incidence rate increased from 36.1 in 2019 to 192.7 in 2021, before significantly decreasing in 2022 to 31.6. The number jumped to 40.1 in 2023.
There were 35 hospitalizations across the region in 2023, including two in Haliburton County. Between 2018 and 2022, there were 173 opioid-related deaths in HKPR, with a further 36 deaths confirmed in 2023. In Haliburton, there was one death in 2019, three in 2020, eight in 2021, three in 2022, and none in 2023.
Record, Hall and Sunil suggest the epidemic is at least partially due to an increased demand for opioids to treat injuries. The report states one out of five Canadians are seeking health care for chronic pain. In 2023 there were 1,332,482 individuals in Ontario using opioids for pain management.
They say one way to reduce harms associated with substance use is through education and interventions in early childhood and adolescence. Record noted adverse experiences while growing up can have long-lasting impacts on developing brains and can increase the likelihood of substance use in later life.
The team said there’s no “one size fits all” approach to treatment, but noted there are opioid substitution therapies and supports provided by organizations like the John Howard Society, Fourcast, and the Canadian Mental Health Association. There’s no publicly funded residential withdrawal management or treatment programs in the region.
It was suggested engaging people with lived experience of substance use is the best way of reaching those struggling and forms an important part of the Drug Strategy’s solution.
“Co-design harm reduction and treatment programs, pathways of care… resource local drug strategy groups to develop proper engagement strategies… we need to address the urgency for support,” the report reads.
“Advocate for the creation of a provincial drug strategy task force; standardize drug poisoning alerts and response protocols to bring them in line with alerts about foodborne illnesses and infectious diseases; call for access to real-time data on drug poisonings.”
