Opioid crisis 'getting worse': Algoma Public Health doctor

Algoma’s rates of opioid-related hospitalizations and deaths remain three times higher than the rest of Ontario.

Algoma Public Health officials and board of health members were reminded of that alarming fact during Wednesday’s board meeting.

The use of naloxone kits is key in helping people who experience an overdose from substances such as fentanyl, heroin, morphine or codeine, said APH staff members Jennifer Miller and Karen Hooey in a harm reduction presentation to the board.

The report shows there were over 3,000 naloxone doses distributed in the District of Algoma through the Ontario Naloxone Program for Pharmacies Program in the second quarter of 2024.

Ontario pharmacies offer both injectable and nasal spray naloxone kits. The kits are free and a prescription is not needed. Pharmacists train people in recognizing signs of an opioid overdose and explain how to use naloxone kits.

“Who are becoming users? Is this something that can be defined? Is there something we can do to prevent people from becoming users? Is it growing or getting smaller?” board member Don McConnell asked at Wednesday’s meeting.

“It’s getting worse,” replied Dr. John Tuinema, APH acting medical officer of health.

“The rate of opioid-related hospitalizations and deaths is three times higher here than the rest of Ontario, which is staggering. Do we have any idea why?” board member Sonia Tassone asked.

While the opioid crisis can be traced to a number of causes, Tuinema said some addictions to painkillers can be linked to injuries suffered in northern Ontario’s heavy industries.

“Some more unique factors may be that in some industries such as construction, for example, people are more likely to have injuries and chronic pain as a result and that can have an impact," Tuinema said. "We have a higher proportion of things like that. Another one is the mining sector. We would have a much higher proportion of that in northern Ontario as well."

Because the opioid crisis has been attributed in part to overprescribing of opioids by some doctors, board member Jody Wildman asked if that is still the case. 

“Five to 10 years ago there was a lot more prescribing than there is now,” Tuinema said.

“There’s a lot of information out there you can see about how different pharmaceutical companies sort of pushed that, that it looked like a certain type of drug would be very helpful for a lot of people but it led to a lot of misery and to where we are now. Now physicians are aware and they have changed their prescribing practices as a result. There is some higher level monitoring. A while back there was a look at all the prescribing practices of all the physicians in Ontario to see who the high prescribers were.”

However, Tuinema noted that cutting down on prescribing of opioids by doctors has caused suffering for those who used the painkillers. 

“With less prescription drugs out there being used somewhat inappropriately that means people turn to illicit sources which aren’t regulated and very likely toxic. It’s difficult to win in that situation I suppose.”

Tuinema said proactive medicine — such as ensuring people have a better quality of life — can often be the best way to keep people from turning to opioids in the first place.

“We know that things like access to employment and housing are protective factors for any type of substance use or difficulties people might run into," Tuinema said.

The provincial government recently decided to close 10 supervised consumption sites across the province and invited communities to apply to be host locations for 10 Homelessness and Addiction Recovery Treatment (HART) Hubs.    

Tuinema’s written report to the board for Wednesday’s meeting stated that APH supports the recent HART Hub application submitted to the Ontario government by several agencies in Sault Ste. Marie.