Fatal opioid overdoses on the rise in Ontario shelters, report finds

Researchers from the Ontario Drug Policy Research Network (ODPRN) at St. Michael’s Hospital and Public Health Ontario analyzed health data from the Office of the Chief Coroner of Ontario and ICES and found that 210 accidental deaths from opioid-related toxicity occurred in shelters. between January 2018 and May 2022, with deaths more than tripling during the study period (48 before the pandemic vs. 162 during the pandemic).

Statistics Canada data shows that the annual number of emergency beds in Ontario grew by only 15% (6,764 to 7,767) between 2018 and 2022.

The report ‘Opioid-related toxic deaths in Ontario shelters: circumstances of death and prior drug and health care use’ was published on the website ODPRN website.

“People using Ontario’s shelter system not only face housing instability, but also have complex health care needs and unique barriers to accessing treatment and harm reduction programs,” said lead author Bisola Hamzat, an epidemiologist with the ODPRN . “This report underscores the disproportionate impact of the opioid crisis on this population.”

Shelter trends differed from the rest of Ontario

When examining the circumstances surrounding the overdose and death, data showed that only 1 in 10 opioid-related toxicity deaths in shelters had someone present and able to intervene, which is lower than Ontario overall (about 1 in 4 ). However, naloxone was usually administered if someone was able to intervene in shelters.

In the week before death, almost half of people who died in a shelter had contact with the health care system, and in the five years before death, almost 80% had a hospital visit related to a mental health diagnosis healthcare. higher than 56% of people in Ontario overall.

Several factors remained consistent with the rest of Ontario, including the emergence of multiple substances that contribute to death (such as benzodiazepines and stimulants), an increased tendency to smoke and inhale drugs, and fentanyl from the unregulated drug supply which is the most common cause of death. deaths.

In a secondary analysis of hotels and motels, researchers found that opioid-related overdose deaths followed similar patterns to those in shelters, but began to decline toward the end of the study period in 2022. The researchers say the increase in deaths was likely. influenced by the rapid expansion of temporary hotel shelters early in the COVID-19 pandemic.

There is an urgent need for a better response to crises

“Our report highlights the need for improved and more comprehensive approaches to harm reduction, overdose response, as well as training and support for shelter staff,” said co-lead author Tara Gomes, a scientist at the Li Ka Shing Knowledge Institute at St. Michael’s Hospital . and ICES, and a principal investigator from the ODPRN.

“In addition, better connections to community-based health care, treatment programs, and mental health supports are needed for people experiencing homelessness and housing instability, along with efforts to address upstream factors such as more accessible housing , income and employment support, and community support. -based social support across the province.”

“The report highlights what we have seen in Timmins in recent years. It demonstrates the need for comprehensive support across the spectrum of care for unhoused community members, and the importance of shelter design and management to ensure services are accessible and safe for people. An increase in deaths in the Timmins shelter system over the past two years is a stark reminder of this importance,” said Jason Sereda, chairman of the DIY Community Health Timmins board of directors.