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Public Health: With death rates climbing, it's clear Sudbury needs a permanent injection site

Nickel City has one of the highest rates in the province for opioid-related deaths, but a needs assessment study will take a year to complete
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Renee St-Onge, director, Knowledge and Strategic Services, Public Health Sudbury and Districts, left, and Dr. Ariella Zbar, associate medical officer of health and director of clinical services, provided an update on the opioid situation in Greater Sudbury during the health unit's board meeting on Thursday. (Arron Pickard/Sudbury.com)

Work on a feasibility study into whether Greater Sudbury needs a permanent safe injection site for drug users is set to get underway next week.

Renee St-Onge, director, Knowledge and Strategic Services, Public Health Sudbury and Districts, said it is clear there is a need for a safe injection site in Greater Sudbury, but the purpose of the study is to determine the degree of needs and potential structure and type of supervised consumption services required in the community.

Opioid-related deaths are starting to appear in the list of leading causes of deaths in the area served by Public Health Sudbury and Districts, and while lung cancer and ischaemic heart disease are still at the top of that list, opioid-related data is becoming much more prevalent.

“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 Ontario Provincial Police released a report recently that identified a 35-per-cent increase in overdose deaths across the province during the first quarter in 2019, compared to the first quarter of 2018.

The health unit reports there were an average of 34 opioid-related deaths per year from 2006 to 2015, on par with deaths related to influenza and pneumonia.

The health unit draws data from five sources, and soon, it will list all of the latest information on an online public dashboard, so the public will have it right at their fingertips.

For instance, in May 2019, the number of EMS calls for suspected opioid-related incidents was 79, the highest it has been since the start of 2018. This month, that number is at 33 to date.

Surveillance efforts also track the number of diagnosed accidental opioid overdoses in emergency departments across all hospitals within the jurisdiction of the health unit. Last month, there were 33 opioid overdoses diagnosed, which is much higher than the 19 diagnoses in April and the six in March.

Dr. Ariella Zbar, associate medical officer of health and director of clinical services at Public Health Sudbury and Districts, said there are many factors that contribute to the rising use of opioids and related overdoses.

“Prescribing opioids has long been entrenched in prescribing practices since the 1990s, when it started to be part of the World Health Organization's pain management ladder,” Zbar said. “Also, oxycodone has been delisted, making way for the stronger drugs, like fentanyl, that are killing people.”

The health unit is seeing a mixture of use of pharmaceutical-grade (prescribed) opioids, as well as what people are getting on the streets, which run the risk of being poisoned or tainted with other drugs, such as carfentanyl.

In order to curb the harm associated with overdosing, the health unit has been handing out naloxone kits. Last year, 1,964 kits were dispersed, with 601 refills. Each kit has two doses of naloxone. Pharmacies and Reseau Access Network also distribute naloxone kits, but their statistics are separate from the health unit.

Greater Sudbury Paramedic Services administered naloxone five times in March this year, 15 times in February and three times in January; however, with naloxone being given for free to through the various sources, those numbers are decreasing, Greater Sudbury Paramedic Services said in a report to council in April.

Recommendation from the feasibility study are expected in April 2020. Following that, the health unit would have to apply for federal exemption to set up a permanent site.




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Arron Pickard

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