Week 6: Opioid crisis and safe consumption sights

Question 1

Opioids

Answer 1

prescribed pain relief medications such as codeine (in Tylenol 3), fentanyl (duragesic), Morphine (doloral), oxycodone (oxycontin, percocet), hydromorphone (Dilaudid), and medical heroin. Opioids can also be produced or obtained illegally.

Question 2

Approximately what fraction of people in Ontario filled an opioid prescription in 2015/2016 and what percent of the population is this

Answer 2

1/7, 14%

Question 3

How many apparent opioid toxicity deaths between January 2016 and March 2023 and how many hospitalizations

Answer 3

deaths 38514, hospitalizations, 37697

Question 4

How many deaths/day in Canada in 2023

Answer 4

21

Question 5

Of all accidental opioid deaths from jan-march in 2023 what percent were fentanyl

Answer 5

81%

Question 6

True or false: this crisis is bad in british columbia and alberta, middle in ontario and getting better as we go east

Answer 6

true

Question 7

What year was the peak of opioid morbidity and mortality and what year did it decrease

Answer 7

2021, 2022

Question 8

True or False: Disproportionally men dying from opioids

Answer 8

True

Question 9

Causes of opioid deaths

Answer 9

High rates of opioid prescribing
Emergence of strong synthetic opioids (e.g., fentanyl) in the illegal drug supply (fentanyl is a cheap way to make street drugs more powerful)

Question 10

Policy responses to this crisis

Answer 10

Provide help, in whatever form, to those taking opioids
Provide support to individuals to help stop taking opioids
Provides services to ensure opioid use is as safe as possible
Provide resources to the public to prevent opioid-related overdoses
reduce/change opioid prescribing practices
Change pharmaceutical marketing practices
Reduce the illegal production, supply, and trafficking of opioids
Eliminate/ abolish/ prohibit unhealthy or harmful practices of behaviors
‘Prevalence reduction’, often via criminalization
Harm reduction: a set of strategies to reduce the negative consequences associated with unhealthy or harmful practices of behaviors.

Question 11

Examples of things to target individuals taking opioids

Answer 11

Wellness together canada (help line)
National overdose response service (NORS hotline)
Drug rehab services
Narcotics anonymous
Overdose intervention app
Harm reduction supplies (e.g., sterile needles)
Supervised consumption sites and services

Question 12

How to target the general public

Answer 12

Raise awareness about opioids, overdoses, and other policies directed at reducing opioid-related harms
Opioid response training (e.g., st. john’s ambulance)
Free naloxone kits and training

Question 13

Target health practitioners

Answer 13

Effectively allows healthcare practitioners to track opioid prescription practices
Will receive primary care reports
How many you’ve provided vs how many other prescriptions
Creating a registry, resources for healthcare providers to reduce opioid abuse

Question 14

What are the substances strategies

Answer 14

Prevention strategies, e.g., opioid prescribing guidelines, handouts for patients
Treatment strategies, e.g., promoting evidence based approaches to treatment
Enforcement strategies, e.g., reduce controlled substances being diverted from otherwise legal activities, like pharmacies
Harm reduction strategies, e.g., safe consumption sites
Evidence strategies, e.g., systematically collect information about opioids and their harms
Funding strategies, e.g., provide grants to community-led organizations to respond to drug issues
Consultation strategies, e.g., to gather input from impacted communities

Question 15

Good samaritan drug overdoes act

Answer 15

federal law that came into force in 2017 that provides some legal protection for people who experience or witness an overdose and call 911 or their local emergency number for help.

Question 16

What does the good samaritan drug overdoes act protect individuals from

Answer 16

Charges for possession of a controlled substance
Breach of conditions in probation orders, parole, etc

Question 17

Who does the act apply to

Answer 17

anyone seeking emergency support during an overdoes, including the person experiencing an overdoes

Question 18

What section do you have to seek exemption from to operate a supervised consumption site

Answer 18

section 56.1 of the federal controlled drug and substances act

Question 19

Safe consumption sites

Answer 19

designated sites where people can use their own drugs under the safety and support of trained personnel
AKA safe injection sites, supervised injection sites, overdose prevention sites, etc
Commonly offer a range of evidence-based harm reduction services, such as drug checking, and provide access to important health and social services, including substance use treatment

Question 20

Primary objective of safe consumption sites

Answer 20

Help prevent overdose deaths (via drug checking and emergency medical care, and because people are not rushing or using alone)
Provide health care (e.g., wound care)
Facilitate entry into addiction treatment programs and other health and social services (e.g., housing, employment assistance, and food banks)
Reduce the spread of bloodborne infections (e.g., HIV, hepatitis C) by providing access to clean drug use equipment and safe disposal, as well as testing/screening
Reducing the strain on emergency medical service

Question 21

How many sites are currently offering services in canada

Answer 21

39

Question 22

How many visits take place everyday

Answer 22

2700

Question 23

How many visits take place at the busiest safe consumption site

Answer 23

400

Question 24

Between 2017-June 2023
How many visits
How many unique visitors
How many overdoses and drug related medical emergencies, with no reported on site fatalities
What percent of substances consumed were opioids

Answer 24

4.3 mil visits
361000 unique visitors
49000 overdoeses
70% substances

Question 25

Urgent public health need sites

Answer 25

Similar to supervised consumption sites, but established on a temporary basis to respond to urgent needs tin a specific region or community
AKA ‘overdose prevention sites’
Class exemptions under the controlled drugs and substances act authorize the minister of health in each province and territory to establish urgent public health need sites as required
It is the minister of health’s discretion if they wish to to implement the class exemption or not