Ontario's Opioid task force a 'step in the right direction' says Sudbury addictions doctor

Dr. David Marsh, an addictions researcher at the Northern Ontario School of Medicine, says an opioid emergency task force for the province is a step in the right direction.

The province announced Wednesday plans to establish the force, which will operate out of the health ministry's emergency operations centre.

It will include front-line harm reduction workers, emergency responders, mental health and addiction professionals, public health experts, other provincial ministries and municipal representatives, health-care groups and people who live with addiction.

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There's been a growing demand for treatment because of the increase in the number of people dependent on opioids Marsh said. He also hopes the task force's approach is multi-layered, which may address some of the root causes of opioid addiction.

"Keeping [addicts] alive and creating opportunities for them to get connected to treatment is the first good step," Marsh said.

"The reasons why people become addicted are common in many parts of North America," he added. "A combination of a wide availability of opioids and the risk factors for developing dependence, like history of childhood trauma, genetic risk factors, mental health issues, unemployment, lack of hope for the future."

Marsh said a focus on the treatment may also prevent drug-induced fatalities.

"A drug user is never going to come to treatment if they die of an overdose." 

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In August, Ontario's chief coroner released updated figures on opioid-related deaths. Dr. Dirk Huyer said there were a total of 865 opioid deaths in the province in 2016, a 19 per cent increase from the previous year.

Marsh said he has some suggestions of things he's like the task for address.

"First of all, things like Naloxone distribution, supervised injection sites and overdose prevention sites that help keep people alive and refer them to treatment," Marsh said.

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"Secondly making treatment much more readily available, including getting people started on treatment in the emergency room."

"Thirdly when they are in treatment making sure the treatment is as effective as possible, including integrating the treatment of their addiction with public health primary care, mental health care and other services," he said.

Marsh added that the specific opioid doesn't influence the treatment, as the drug of choice changes every year.  

"A few years back the drug of choice in Sudbury was Oxycodone or Oxycontin pills, but that has decreased," he said. "Now they see people dependent on hydromorphone, or morphine or Fentanyl."

Northern voices must be included on task force

Dr. Mike Franklyn, an addictions specialist in Sudbury, says the province's idea to establish the task force must include members from northern Ontario. This part of the province has different challenges than those in the south.

"As bad as things are in Toronto, it's not the worst area in the province," Franklyn said. "Northeastern and northwestern Ontario have a far greater problem on a per capita basis"

Earlier in 2017, Franklyn called northern Ontario the "epicentre" of opioid addictions in Ontario.

• Northern Ontario at 'epicentre' of opioid crisis, says Sudbury addiction specialist

"In the north there is very little Fentanyl or heroin," he said. "It is mostly prescription opioids."

The challenges of dealing with addictions on First Nations should also be addressed in the task force, Franklyn said. Poverty, especially in more remote communities, is a driving factor in addiction rates.

"First Nations need health programs to address addictions," he said. "[heath providers] are currently holding wellness clinics, [which are] culturally based."

And if the province comes calling on his input for the task force, Franklyn said it would be hard to say no.

"I think you have to get involved and you have to be a change agent, so I'm always willing," he said. "I've served on a Minister's Task Force on methadone and sit on something now called Health Quality Ontario, trying to set standards for opioids, but if asked I would serve, because I think we have to do that, and I bring a northern experience."