Jury examining opioid overdose calls on Ontario to declare public health emergency

A jury investigating the fatal overdose of a homeless man in Toronto has recommended that Ontario declare a public health emergency over the ongoing opioid crisis.

The call was among dozens of recommendations submitted by a jury at the conclusion of a coroner's inquest into the death of Bradley Chapman.

The 43-year-old died in August 2015 after he was discovered unconscious and with drug paraphernalia around his body near a downtown Toronto hotel. He died seven days later in hospital.

The inquest examined the circumstances and emergency response to his death, which the jury ruled an accident due to "acute opiate toxicity."

Before the recommendations were revealed, a member of the jury implored the various levels of government, law enforcement and health-care providers to "recognize the urgent nature of the opioid overdose crisis" and take immediate action.

A lawyer representing the Chapman family said they were "very, very happy" with the 55 recommendations, the vast majority of which mirrored the family's suggestions.

"The jury has realized what the severity of this problem is, that it's the defining health crisis of our time," said family representative Suzan Fraser. 

The coroner's office revealed during the inquest that three to four Ontarians die of opioid overdoses daily, and that the number of deaths increased by 16 per cent in 2018 over 2017.

New strategy 

The recommendations are designed to prevent similar deaths, and mainly focus on the province, Toronto and its police.

The jury is also calling on Ontario to develop a comprehensive opioid and overdose prevention strategy, and to assign a provincial co-ordinator to oversee the overdose crisis.

Harm-reduction workers who attended the inquest said there has been a dangerous lack of co-ordination between various government agencies since the opioid crisis began around 2015. They are also concerned that the province's existing opioid task force has not met since the Progressive Conservatives took office in the summer. 

"We're in one of the biggest public health emergencies in the last decades and we need co-ordination and we need people in charge to help us get out of this," said Zoe Dodd, who runs Toronto's Moss Park safe injection site.

"We cannot ignore that we are in a crisis and this crisis has been escalating," she said.

'The way forward'

The jury is also calling on Ontario to suspend any changes to existing safe injection sites and reconsider the decision to limit the number of sites to 21 around Ontario.

The recommendations also contain calls to address the risks of stigma, discrimination and "NIMBYism" in properly tackling the opioid crisis.

"Ordinary people who arrived from a variety of different places brought their common sense and said 'this is the way forward,'" said Fraser. 

Ontario announced earlier this year it would review safe injection sites, though Premier Doug Ford has said he is "dead against" them and instead favours rehabilitation. 

While coroner's inquest recommendations are not binding, the named governments and agencies must acknowledge the findings.

"I think that is something that governments have to listen to," Fraser said.

More recommendations are below, listed by the named government or organization.

The province of Ontario:

• Assign a provincial co-ordinator for the opioid crisis.
• Resume regular meetings of Ontario's opioid task force.
• Re-evaluate the existing 21 site limit on overdose prevention sites.
• Declare a public emergency in relation to the opioid overdose crisis.
• Engage in discussions with the federal government to make a clean, legal and non-toxic supply of opiates available at safe injection sites.

The city of Toronto:

• Appoint a dedicated lead focused on overdose-related efforts.
• Establish, fund and co-ordinate an overdose committee.
• Launch a sticker campaign allowing establishments to advertise that they carry naloxone, which is used to treat opioid overdoses.

Toronto Police Service:

• Equip all frontline officers with naloxone.
• Ensure that officer first aid training includes opioid overdose training.
• Develop officer training programs that cover discrimination against drug users and the homeless.