How Thunder Bay, Ont.'s increasingly toxic street drugs are driving overdose and death rates

It's a record they never hoped to break, and it's setting the tone for another turbulent year of fighting the opioid crisis in Thunder Bay, Ont.

Last month, Path 525 — the only safe consumption site in northwestern Ontario — responded to 38 overdoses. It's the most the site has ever handled in a single month since it opened in November 2018.

"It was a very difficult month for the community," said Jennifer Lawrance, director of health services for NorWest Community Health Centres, which runs Path 525.

At safe consumption sites, people can use illicit drugs they've purchased on the streets, in the presence of health-care professionals who can help address and reverse any overdoses. 

In the four years Path 525 has been open, no one has died of an overdose on site.

But Path 525 responded to 67 per cent more overdoses in 2022 compared to the previous year.

In the Thunder Bay District Health Unit, 114 suspected drug-related deaths were reported in 2022. While that's down from the year before, overdoses are on an upward trajectory.

"I think the reality right now is that we're in a crisis, so resources are needed to address what's going on currently," said Lawrance.

More unknowns in street drugs

The rising overdose rate is attributed largely to the unknown nature of what's in substances these days. In October, the site ramped up drug testing with a new piece of equipment that uses a laser to scan traces of substances.

Last month's testing yielded shocking results: Only 11 per cent of cocaine samples contained purely cocaine, and more than half of the samples had no cocaine at all.

Many clients thought they had bought drugs from a reliable dealer, said Keesha Bauer, Path 525's consumption, treatment and services co-ordinator.

"If you don't have a tolerance to opiates and you use this cocaine, you will die," Bauer said. 

A lot of samples also contained a cutting agent called phenacetin, a pain and fever reliever that's been banned in Canada since 1973, after it was found to cause kidney and liver damage, and cancer.

People who use cocaine recreationally on weekends may be less wary of the unknowns in what they're purchasing, putting them at greater risk of an overdose. Bauer said bars should ensure they have naloxone —  a fast-acting drug used to temporarily reverse the effects of opioid overdoses — at the ready.

"You may get a batch [of street drugs] one time that is OK. The next day, you go to get a batch, it might not be OK, and that's just the reality of the unpredictable drug supply that's out there in Thunder Bay right now," Bauer said.

The most common substances people are bringing for testing are fentanyl, cocaine and methamphetamines. While drug testing is available for anyone — and people can also come on Thursdays from 6 p.m. to 8 p.m. when Path 525 itself is closed — there hasn't been much uptick from the broader community.

Lawrance said the stigma attached to drug use is largely to blame.

Making the supply safer

Beyond checking street drugs, health-care workers are looking at how to provide safer alternatives. 

Path 525's safer supply pilot program, funded by Health Canada through its Substance Use and Addictions Program, has been underway for several months. A dozen clients are filling safer supply prescriptions at Path 525, with 45 others receiving wraparound services.

But the province doesn't cover drug substitutes that are as potent as what people buy on the street, Lawrance said, which means they are less effective.

The pilot runs until the end of September.

While Lawrance would like to see that extended, she said it may be more effective for primary-care facilities to deliver safer supply programs. Many people who use drugs have broader health concerns that could be better addressed by primary health-care professionals, she said. 

Originally, there were plans to operate Path 525 safe consumption sites in two areas of Thunder Bay, but that hasn't happened yet, said Lawrance.

While she believes there's an appeal for this in the city, she isn't sure what it would take to get there.

"I think that provincially and federally, there needs to be an appetite to look at the opioid crisis and what needs to happen in the short and long term, and provide the resources required in communities to help address what's going on," she said.

– With files from Logan Turner