Public Health Nurse Rhonda Lovell said COVID-19 is “absolutely” a contributing factor to the rise of overdoses in the Kingston, Frontenac, Lennox & Addington (KFL&A) public health region this year.
For the past three years, Lovell has worked on the opioid overdose portfolio at KFL&A.
“We are at an intersection right now between an [opioid] epidemic and a pandemic,” she said, “and it’s really just a challenging time.”
Jurisdictions across Canada, including Vancouver, Toronto and Ottawa have all made headlines in recent weeks, connecting the dots between the COVID-19 lock-down and a nationwide spike in overdoses.
Preliminary results from the Ontario coroners office indicate a 25 per cent increase in overdose deaths between March and May of this year, compared to 2019.
“It’s not just people in Canada that are overdosing,” Lovell said, “not just people in Ontario, but people right here in the KFL&A area at risk from a highly toxic, unregulated drug supply.”
Supply chain disruption
On Monday, May 25, 2020, KFL&A Public Health warned that local emergency room departments, harm reduction centres and first responders were fielding an increased number of drug-related overdoses, attributed to a “bad batch” of street drugs circulating in the area.
Street drugs are often contaminated with other very harmful substances, Lovell said. Now, disruptions in international travel due to COVID-19 have made an unregulated drug supply even more unpredictable, and potentially more toxic.
“We’re hearing about disruptions in the drug supply chain itself,” she said. “There are lots of restrictions on movement right now, moving the drugs themselves, or the precursors, or ingredients.”
Substances that might have been coming from overseas may not be crossing borders as easily as they once were, she said, pushing dealers and users to work with whatever is available.
Those changes in drug supplies can also force users to make “challenging decisions” she said, about what they can do — or take — to avoid a period of withdrawal.
“I don’t even know how to accurately describe it. Its just a situation that you don’t want to find yourself in, going through an opioid withdrawal without adequate support,” she said.
“When someone is using drugs from an unregulated market, they might believe that they’re using one thing, but can’t say with certainty what’s in there. It’s not just drugs. Other contaminants that might be in there as well.”
Crystal methamphetamine and cocaine for example, she said, can both be contaminated with fentanyl, an opioid responsible for many overdose fatalities.
Other factors: stress, isolation
Public health advocates and social workers in Ottawa and Toronto have suggested that easy access to cash through the Canadian Emergency Response Benefit (CERB) could also be a factor in rising overdoses.
“I see that it could be,” Lovell said. “It makes logical sense… The theory applies quite widely and we’re hearing this speculation across the country.”
She said that general feelings of stress and uncertainty, social isolation, and loss of access to services also contribute .
“Job loss or just the general sense of fear and uncertainty from this can be very triggering on a lot of levels,” she said.
People actively using drugs at the start of the pandemic might increase their consumption, she said, while people in recovery risk using again, “particularly if they’ve experienced some of the losses related to the pandemic, or they’ve lost access to supports that they’ve had.”
With many social spaces shuttered during the COVID-19 pandemic, the public has been encouraged to practice social distancing for safety reasons. This presents risks of its own for people with drug addiction, Lovell said.
“Its a loaded statement right now to tell people: ‘Don’t use alone,’” she explained of a harm-reduction strategy often advised by social service workers. “But certainly if people are going to use alone, they need to make sure that someone is available to at least check in on them, make sure they’re okay, or call 911.”
She said that the local social service network has responded well to the crisis.
“One of the things that I’m so proud of in our community… is that we’ve seen just a great modification of services to try to keep as much access as we possibly can, so people are not going without those supports,” Lovell said.
She said KFL&A public health has taken on the issue of overdose risk and awareness more actively in the past few years, and has had a “much more active role in letting the community know that this risk is out there.”
Lovell said she will be watching the outcomes of harm-reduction strategies in British Columbia, where the provincial health authority has recently enabled access to a “safe supplies” of regulated opioids on the street.
“They’re certainly ahead of us in that regard,” Lovell said. “Hopefully we’ll get some attention on that here in Ontario, to see if it might be a solution to help mitigate some of these impacts.”
KFL&A Public Health advice
KFL&A Public Health is urging all those who use drugs not to mix them, to do test amounts, and to never use alone. Public Health is also reminding residents that the Public Consumption and Treatment Service at Kingston’s Street Health Centre is open seven days a week from 9 a.m. to 4 p.m., providing a safe place for anyone who wants to use drugs to do so under the supervision of people who are trained in how to respond to an overdose. Additionally, the Rapid Access Addictions Medicine Clinic at the Street Health Centre is open Monday through Friday from 9 a.m. to 12 p.m. and 1 p.m. to 4 p.m. by appointment. That clinic can provide individuals with support in getting help for a substance use disorder.
KFL&A Public Health is encouraging all residents to be aware of the signs of an opioid overdose and pick up a free naloxone kit. Free kits are available at the following locations:
- KFL&A Public Health (Kingston office): Monday to Friday from 8:30 a.m. to 4:30 p.m.
- Street Health Centre: Monday to Sunday 9 a.m. to 12 p.m. and 1 to 4 p.m.
- HIV/AIDS Regional Services: Contactless drop off available Monday to Friday (call 613-329-6932). Mobile outreach unit is located at Street Health Centre from 4 to 8 p.m. on Mondays, Tuesdays, Thursdays, and Saturdays.
- St. Vincent de Paul Society of Kingston: Monday to Friday from 9 a.m. to 1 p.m.
- Martha’s Table: Monday to Sunday 11 a.m. to 1 p.m.
- Home Base Housing Street Outreach Team: Monday to Friday at Lunch By George from 11 a.m. to 11:30 a.m. and Street Health Centre from 12 to 1 p.m.
- Change Health Care: Monday to Friday 6:30 a.m. to 4 p.m.; Saturday to Sunday 8 a.m. to 12 p.m.
- Napanee and Area Community Health Centre: Monday to Friday 9:30 to 11:30 a.m. and 1 to 3 p.m.
For more locations, visit https://www.ontario.ca/page/where-get-free-naloxone-kit.
It is also important for residents to remember that an overdose is a medical emergency. Anyone who suspects or witnesses an overdose should call 911, and the Good Samaritan Drug Overdose Act provides some legal protection against simple drug possession charges for anyone who experiences, witnesses or responds to an overdose and calls authorities.