In the past five years, drug overdose numbers for Sudbury show a definite spike in the number of opioid-related deaths that occurred in 2020, the first year of the COVID-19 pandemic.
But while there was a spike in 2020, the "crisis" was building a years earlier. A recent compilation of statistics provided by the Office of the Chief Coroner in Ontario allows for a bigger picture look at the substance abuse problem in Greater Sudbury in the past four-and-a-half to five years.
It was in 2018 that it became apparent that opioid use in the Sudbury area was a serious enough problem to warrant monthly statistics for fatal opioid overdoses (confirmed and probable according to the Coroner's Office).
In 2018 there were 34 overdose deaths recorded in the jurisdiction of Public Health Sudbury and Districts (PHSD).
For undefined reasons, most of the deaths occurred during good weather months (six deaths in May, nine deaths in August). One theory that has been put forward on an anecdotal basis only is that when people are together, perhaps during winter months, their drug use is safer because they're with friends who can help them if an overdose occurs. Drug users who are alone during times of mild weather are at greater risk of overdose if no one is nearby to get help.
It was the same year that PHSD created YouTube videos about safe needle disposal and reducing the stigma connected to drug use, according to the health unit’s annual report that year.
"Three drug alerts were issued over the year to help prevent overdoses and raise awareness. These alerts were triggered by reports about street drugs potentially containing deadly substances such as fentanyl or carfentanil," said PHSD's report.
Also in 2018, PHSD worked with community partners in Sudbury, Espanola, Manitoulin, and Sudbury East to develop community drug strategies.
This eventually led to the creation of a 78-page study that explored the need for a supervised drug consumption site in Sudbury.
The executive summary of that report revealed that in 2018 Sudbury ranked 12th in the province for opioid-related emergency department visits, seventh in the province for confirmed opioid-related deaths, and 10th for hospitalizations, based on rates per 1,000 population.
While the 34 drug deaths in 2018 got people talking, the situation got worse in 2019 in Sudbury. That's when 55 opioid overdose deaths occurred in the local health jurisdiction. It was a significant increase over the previous year.
Renee St-Onge, director, Knowledge and Strategic Services at PHSD, told the board of health that year that the opioid death rate was climbing and action was needed. She said opioid deaths would soon be outpacing heart disease and cancer as the leading cause of death in the Sudbury health unit area.
“That's an important consideration in our surveillance,” St-Onge said. “Our area has one of the higher rates in Ontario for opioid-related deaths.”
The number of opioid overdoses climbed steadily in 2019, with the worst month being April with 11 deaths followed by November with 10 deaths.
In the 2019 annual health report, PHSD stated, "Five drug alerts were issued over the year to help prevent overdoses and raise awareness."
On the awareness effort, PHSD said it was stepping up communications online.
"An online Opioid Surveillance Dashboard was launched to provide a monthly, publicly available report on the opioid community response. Five drug alerts were issued over the year to help prevent overdoses and raise awareness," said the report.
Things got even worse during the year 2020, now infamous as the pandemic year. The opioid death rate that year was 107, almost double the 2019 number and more than three times the number of opioid deaths in 2018. The death count began with five in January, 12 in February, along with 10 deaths in August and 15 deaths in September.
By December, it was revealed that Sudbury's death rate was outpacing that national average.
In the annual report that year it was noted that the biggest public health effort was directed toward coping with the rise of the COVID-19 pandemic, but just as quickly it was reported that COVID was not the only urgent health issue locally. PHSD called it the opioid crisis.
"To further draw attention to increasing opioid-related harms across our region, three drug warnings and two drug alerts were issued, and over 30 media interviews were conducted. The Those People are Us and We Are Jeff campaigns were promoted through television ads, social media posts, newspapers ads, and on billboards to help reduce the stigma of substance use and to foster empathy and compassion, and highlight how we all can be part of the solutions," said the report.
This was also the year that the Community Drug Strategy in Sudbury created the Needs Assessment and Feasibility Study (NAFS) which showed that Greater Sudbury would benefit from a supervised consumption site. This would eventually see PHSD and other community partners establish the new consumption site located at Energy Court, on the edge of Sudbury's downtown area.
While 2020 would prove to be the worst year so far for local opioid overdoses, the following year was almost as bad. The coroner’s statistics revealed that in 2021, there were 100 opioid-related overdose deaths in the Sudbury jurisdiction.
The year began with 12 deaths in January, 12 more in February, 11 deaths in May and 11 deaths again in December.
Public health responded by noting that while COVID-19 was still placing a huge demand on health services, the opioid issue was still a crisis not only in Sudbury but across Northern Ontario.
The 2021 PHSD Annual Report noted that harm reduction would be the focus of dealing with opioids locally, but also noted that a pan-Northern approach was being worked on by public health units across the North.
"This is in addition to an application for funding to the Provincial Government. In response to the opioid crisis in the North, seven Northern Ontario health units created a Northern Public Health Opioid Response Community of Practice to share knowledge and explore innovative approaches to address the effects of opioids," said the report.
"We know there is not just one quick solution, and in the presence of an ongoing toxic drug supply, Public Health remains focused on preventing the harms associated with substance use by offering education and awareness-raising activities, working to build resilient communities, and strengthening local partnerships and policies as part of immediate, medium, and long-term collective strategies to address this crisis," the report continued.
The opioid crisis continued into 2022, and although complete numbers for the year are not yet available, the numbers so far are still high.
Preliminary data provided by PHSD on the opioid surveillance web page showed the following figures from January 2022 to June 2022 (preliminary data):
- 56 residents of the Sudbury and Manitoulin districts died from an opioid-related overdose.
- This represents a local annualized mortality rate of 54.2 deaths per 100,000 population per year, significantly higher than the comparable rate in Ontario overall, 17.0 deaths per 100,000 population per year.”
It was in May that the PHSD board of health was given another summary of the status of the opioid crisis locally as this city continued to have the highest overdose death count in the province.
Shana Calixte, manager of mental health and substance use in the health promotion division at Public Health Sudbury and Districts (PHSD) presented the information as part of a formal briefing to the board that month.
"The opioid poisoning crisis continues to take the lives of many, including citizens in Sudbury," Calixte said. "Both pre-pandemic and during the pandemic, Sudbury had the highest per capita rate of overdose deaths in the province."
Len Gillis covers health care and mining for Sudbury.com.