The opioid crisis is hitting Northern Ontario communities harder because there is less access to most of the medical and social services that Southern Ontario residents take for granted.
That was one of the key conclusions of a half-hour examination of the opioid crisis in Northern Ontario featured on the TVO Agenda program Oct. 22. TVO is a provincially funded public broadcast agency with The Agenda being the flagship news and current affairs program broadcast every weeknight.
The participants included Marc Lionello, program manager for the Cochrane Temiskaming Canadian Mental Health Association Cochrane Timiskaming Branch, Anne Marie Thibault, clinical director for the Gwekwaadziwin Miikan Youth Mental Health & Addiction Program on Manitoulin Island, Joel Boivin, a registered nurse and outreach worker with the Sudbury Action Centre for Youth (SACY) and Marion Maar, professor and co-chair of Northern and rural health at the Northern Ontario School of Medicine (NOSM).
Agenda host Steve Paiken told the panel that Ontario had more than 1,500 opioid-related deaths in 2019. Paiken said the trend so far in 2020 indicates things are getting worse.
"Early reports from March to May show that opioids deaths are up 25 per cent compared to last year," he said, adding that opioid death rates have been on the rise in Ontario since 2011.
Paiken also revealed a startling statistic comparing the north and the south.
"Last year in 2019, death rates were more than doubled in Northern Ontario compared to southern Ontario," he said.
Maar said one of the reasons for that could be the inability to connect patients with the continuum of care that is available in large urban centres.
"A lot of time, you know, if you are in southern Ontario, the services might be a few blocks away or maybe just in the next town. A lot of times here (in Northern Ontario) they might be hundreds of kilometres away," she said.
Maar added that people wanting to get into treatment may not have the support systems available for example if they wanted to check themselves in to get treatment. She said this is especially true for women with children who find they cannot get any care for their children while they get treatment.
In Timmins, Lionello said the CMHA has seen the program getting worse in the past five years, not only more people becoming addicted, but also with the complexity of those addictions.
"I can say strongly with a lot of confidence, especially in the last five years, the difficulty in terms of the cases we're looking at supporting has increased not only with the numbers, but the complexity of the cases, with the addition of not only opiates but with things like speed (amphetamine) and meth (methamphetamine). It is increasingly difficult to be able to support these individuals," said Lionello.
Change has also been happening in Sudbury according to Boivin, who said things began to change around 2016 when it was noticed more people were using Fentanyl. Boivin said users also began mixing substances, such as amphetamines and carfentanil.
"The other thing I've really noticed over the last four years, too, has been a definite increase in the amount of suffering people are going through.”
Boivin said this referred to not only physical pain and suffering, but also emotional pain and psychological trauma. He said the COVID-19 pandemic has made things worse by cutting off access to such things as soup kitchens, food banks and even a place where people can gather to get out of the weather.
Thibault said the opioid treatment program has seen an increase in wait times, partly because of pandemic quarantine rules. She said the program on Manitoulin Island accepts clients from across Ontario, but they had to set up quarantine and withdrawal-management camps to ensure that the people in treatment would not become infected.
Thibault said this also meant protecting the people who run the treatment programs as well as the general public who live on the Island.
She said the concern from addicts is that the pandemic forced many people to stay at home, trying to cope with their feelings, and in many cases this only reinforced the sense of need and urgency to take drugs.
Thibault added that the pandemic has not taken a severe toll on Island residents and that there were only a handful of active cases since March.
"We've still had to mitigate that and make sure that we're safe and I think the reason we don't have the cases is the safety precautions that all of the communities on Manitoulin have put into place," said Thibault.
She added that there is a growing need for funding to accommodate the increase in addicts seeking treatment. She said one of the positive aspects of the Gwekwaadziwin Miikan program is that part of the treatment takes place outdoors in the wilderness and that makes it appealing because it is easier for the program to carry on despite the pandemic.
Regardless, said Thibault, they're not able to provide treatment to as many addicts as they would like.
"I think there needs to be more beds across Ontario for people to access treatment programs."
She said the program which began in 2018 has had more than 280 applicants but they have only been able to accept 102 for treatment because of limits on funding and bed allocations.
"The hardest part of our job is not in working with people with addictions," she said.
"The hardest part is when we have 50 people on our waiting list right now and we have 10 beds to offer them come Jan. 15, and having to pick up the phone to tell somebody who is trying to save their life that unfortunately they're going to have to stay on the waiting list for another three months — (that) is absolutely devastating," said Thibault.