Inhaling drugs surpasses injections in Ottawa, and experts want new tools to fight it
Ottawa Public Health recommending expanding programs to help drug users, families, first responders
As drug use continues to change, Ottawa Public Health (OPH) is looking for more money and resources to help tackle the city's ongoing opioid crisis.
On Monday, the health agency presented an update on its overdose response strategy at a board of health meeting, outlining some old and newer ideas to address addiction and reduce deaths.
Some of the recommendations are already well-known, including adding more mental health support, more affordable housing and better co-ordination between first responders.
But there are a number of other proposals, including creating a Mental Health, Addictions and Substance Use Health Urgent Care Centre; implementing grief counselling and trauma support for those who use drugs, their families, and those who work with them; and expanding a pilot project that allows members of the homeless community take the lead in helping each other.
Many of the recommendations would rely on Ontario government funding, and the report requests that the board of health's chair write a letter to the Minister of Health and the Minister of Children, Community and Social Services to ask for it.
"We know that this is a complex challenge that we're facing," said Dr. Vera Etches, Ottawa's medical officer of health, at Monday's meeting.
"And so what you'll see today is a strategy in progress ... you'll see new data as the community requested."
Inhalation surpassing injection
According to OPH data in the report, there's been a shift in how people are consuming drugs in recent years.
Community health experts say that's a factor of the drugs themselves; they're more poisonous and often need to be taken more frequently to obtain the same high, leading to collapsed veins.
The OPH report asks the board to urge the province to work on reducing deaths caused by inhalation and for sustainable funding for safer inhalation services.
The percentage of accidental opioid deaths from inhalation more than doubled from 16 per cent in 2018 to 39 per cent in 2022, according to the report.
That corresponded with a proportional decrease in accidental overdose deaths from injections.
"It used to be we thought that encouraging people to smoke rather than inject was a safer way to use drugs, and that's no longer the case," said Wendy Muckle, past executive director of Ottawa Inner City Health.
"Currently in Ottawa, more people are dying from inhalation than they are from injection for the first time in our history."
She said while those on the street do tend to congregate near supervised injection sites where they can get help if they overdose, the situation is far more dangerous for anyone who smokes at home.
The report also urges for more funding for outreach services like peer-based programs.
It gives the example of Ottawa Inner City Health's 'block leaders' pilot program, which trained about 120 people who have experience living on the street and using drugs to become leaders themselves, ready to interact with their fellow community members in the ByWard Market and Lowertown neighbourhoods.
Since the Canada Day long weekend, many of them venture out for two-hour shifts, six hours a day, seven days a week, providing fellow community members with snacks and water on hot days and handing out naloxone and needle disposal containers.
"Those very simple measures are very effective in reducing overdoses," she said, adding they're often the first to administer naloxone.
But most of all, the program also provides hope to those leaders, said Tabitha Morris, program and case management team lead with Ottawa Inner City Health.
"If you're staying in a shelter and you don't have a steady place to be where can you get a job?" she said. But with the two-hour shifts, "it really opens the door to be able to do something for your community, feel a bit better about yourself and have some sort of schedule where time seems very lost and the only ability to cope is through drugs."
So far, the organization has spent about $50,000 over the past five months, but only has enough funds to continue the pilot until the end of the year.
Grief counselling
Another of the recommendations revolves around implementing grief and trauma support for drug users, their families and those on the front lines who are witnessing dozens of overdoses each month.
In the last three months, alone, the Sandy Hill Community Health Centre saw approximately 80 overdoses each month.
"So if you can imagine frontline staff are not only providing harm reduction services and supports, they have relationships with these people," said Wendy Stewart, director of the health centre's OAISIS program.
More engagement needed, say residents
Several residents from Sandy Hill, Lowertown and Vanier presented their response to the report and shared their experience living in areas where overdoses are on the rise.
Some recommended adding more public toilets and designated green space with seating in their neighbourhoods, and asked for provisions to reduce the over-concentration of service providers in their neighbourhoods.
Others shared they felt the report didn't go far enough to address community safety, and felt OPH didn't consult residents enough. They said the term "community" in the report is misleading and lacking definition.
"I'm disappointed and frustrated and angry by the report," said Calla Barnett, a resident and vice-chair of Action Sandy Hill. "We can't keep fighting each other. It's not us versus them. But the report sets it up to be dichotomous ... Please, let us help."
"There are some common themes here that inspire me that we can get to a better place, about sadness and concern about safety and lots of people willing to work together and wanting to be part of the solution," Etches said in her concluding remarks.
"... We can work with that. We'll be able to make progress as a community."
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With files from Priscilla Ki Sun Hwang