Toronto reports highest-ever daily opioid overdose count during August long weekend

There were almost 200 opioid-related overdose calls Toronto over the August long weekend, with 51 calls to 911 on July 30 alone — marking the highest number of emergency calls for overdoses on a single day since local paramedics began monitoring data in 2017.

Toronto Paramedic Services said in a news release that between July 30 and Aug. 3, there were also 30 overdose-related calls from July 31, as well as 31 calls on Aug. 1, and 30 calls each on Aug. 2 and 3.

Paramedics report there were no fatal calls for suspected opioid overdoses during those five days.

Officials say they believe the stark increase in calls is due to a range of substances found within the unregulated drug supply. The city's drug checking service has reported finding unexpected, highly potent drugs in samples collected in recent months.

Those include opioids like carfentanil, etonitazene, isotonitazene, and etizolam. These substances, which are being found mixed with more common opioids like fentanyl, are likely to contribute to higher incidents of overdoses, according to the news release.

Toronto paramedics say if someone is overdosing, the opioid antidote naloxone should be administered to reverse the effects and 911 should be called. While naloxone remains effective in countering overdoses, those who work in harm reduction programs — either independently or through the city — say more is needed to tackle the crisis.

The argument for decriminalizing opioids

Rhiannon Thomas is the program coordinator for CounterFIT Women's Harm Reduction at the South Riverdale Community Health Centre. She says the opioid crisis is an epidemic in the country, and while harm reduction programs continue to help clients, systemic change is needed to find a lasting solution.

Thomas says that she doesn't believe people who use drugs are valued in society, given societal response to the issue.

"I see a lack of political will and interest to invest resources and time into the lives of people who use drugs," Thomas said. "If we don't do things to change policy and practice very soon, those numbers are going to continue to climb."

When any level of government decides to tackle the problem, its consultations don't involve people who use drugs, she said.

"You need to involve people who are there, it's just a matter of whether you want to hear that or not," Thomas said.

Harm reduction workers 'burnt out'

While supervised injection sites and safe supply programs are helpful, she said, additional moves like decriminalizing drugs to regulate supply, reallocating resources from police to social programs to help clients, and accepting the "volumes and volumes of journal evidence" in support of harm reduction programs would all foster positive change.

"The way people working in harm reduction feel right now is tired and burnt out," Thomas said. "It's like we have a gushing arterial wound and what we're doing is holding up a little tiny Band-Aid."

"It's not even close to enough."

Toronto Public Health's associate medical officer Rita Shahin acknowledges the city is seeing a consistent rise in opioid overdoses and deaths.

"Ever since we started recording data in 2017 the numbers were increasing," Shahin said. 

In 2020, due to the COVID-19 pandemic, the city saw an 80 per cent increase in the number of deaths reported, she said.

In 2019 there were 300 reported deaths from opioid overdoses. In 2020, that number rose to 521. Like Thomas, Shahin and those at Toronto Public Health are concerned with the unregulated drug supply.

"The biggest concern we have is the toxic unregulated drug supply, there are a lot of contaminants and increased amounts of very potent opioids," Shahin said.

City also says unregulated drug supply a major problem

The city's overdose action plan involves increasing naloxone distribution, working with partner agencies and pharmacies, and expanding outreach and training around naloxone. The city has also increased the number of supervised injection sites.

Like Vancouver, the Toronto Board of Health has submitted an application to the federal government calling for the decriminalization of opioids, she said.

"If the drug supply can be regulated that would be helpful," Shahin said. "It helps deal with stigma and criminal prosecutions."

She cited Portugal as an example, where the decriminalization of all drugs has streamed people out of the criminal system and into harm reduction programs.

The city adds that in addition to the unregulated drug supply, higher numbers of people in the GTA are using drugs alone as a result of physical distancing requirements during the pandemic.

In response to rising overdose calls, the city of Toronto is hosting two virtual public meetings to discuss the crisis, its impact on shelters, and the work the city is conducting.

The first meeting is Monday, Aug. 9 at 7 p.m., while the second is Tuesday, Sept. 20 at 7 p.m.

Anyone seeking to attend the meetings can access them on the city's website.