What's the Plan? Ontario's Addiction Plan
- gandhirh89
- Jun 20, 2018
- 5 min read
Updated: Jul 24, 2018
In 2017 the plan by the Ontario provincial Liberal government was to invest $222 million over 3 years to address opioid addiction (Draasima, 2017). The goal was to improve access to harm-reduction services and addiction treatment.
In 2016, the Ontario Chief Coroner, Dr. Dirk Huyer said there were 865 opioid addiction related deaths. Toronto Fire Services now carry anti-overdose drug kids, which include Nalaxone for the first responders. This is part of the Toronto Overdose Action Plan (Janus, 2017; Yaffe, 2017).
The introduction of pop-up supervised injection sites such as the one at Moss Park, reversed more than 30 overdoses after less than just 50 days of operation (Toronto City Council, 2016; Yaffe, 2017). They continue that they have reversed 200 overdoses so far (as of 2018). There are 3 more safe injection sites approved by the city of Toronto.
It is interesting because the new PC led provincial government in Ontario says he is “dead against” supervised injection sites and would rather focus on drug rehabilitation. He states “I don’t believe in safe-injection areas, as I call them. I believe in supporting getting them help,: Doug Ford (The Canadian Press, 2018).
He is focused on fighting the ongoing opioid crisis and believes in the route of rehabilitation which has believed to contain sustaining effects. However, at this time Ford doesn’t believe to have specifics on his plan. The HIV Treatment Network (2016), insists that safe injection site reduces rates of HIV, Hepatitis C, Injection related wounds and Infections, fatal and non-fatal overdoses. It doesn’t resolve the long-standing problems but they address addiction by reducing risk (Ontario HIV Treatment Network, 2016).
Francisco Sapp, co-direction of Ontario HIV and Substance Use Training program, suggests that harm reduction strategies such as supervised safe injection sites are best to ensure safety, until drugs are decriminalized (Janus, 2017).
Funding towards opioid crisis (The Ontario Drug Policy Research Network, 2016)
- More than $15 million to support health-care providers in appropriate prescribing and management
- More than $7.6 million to increaser addictions treatment in primary care
- $70 Million in long term support for people with addiction disorders
- $9 Million to add more front line harm reduction workers in the community, across the province.
- And in 2018-2019, #20 million over 2 years for specialized support for indigenous communities and youth groups.
(Draaisma, 2017).
Benefits of Supervised Injection Sites
Studies have shown that supervised injection services have positive impacts on the communities where they are located. Supervised injection services have been shown to:
- reduce the risk of HIV transmission and overdose deaths
- increase the use of addiction treatment services
- reduce the extent of injection drug use in public places
- reduce the amount of injection-related litter in public places.
(Ontario HIV Treatment Network, 2016)
Funding by
Ministry of Health and Long-Term Care
Toronto Central LHIN
The major point of emphasis in Ontario are harm reduction/safe practices such as safe injection sites and for housing services.
Strategies for Mental Health and Addictions Ontario include:
-Strategic goals of MHLTC:
-System design
-System management
-Service delivery
-Supportive care
-Improved outcomes
-Promotion, prevention, early identification and intervention
-Reduce stigma
Current treatments are based on:
-Bed access
-Assessment- use of screening tools
-Crisis Response- follow protocols for symptom management
-Minimize environmental stimuli- e.g.; noisy emergency departments
-Provide knowledge development tools for primary care professionals to assist in early diagnosis.
-Interdisciplinary primary care models should include mental health and addiction treatment components (e..g., social worker, mental health worker)
Moving forward recommendation:
Promote, prevent and intervene early
Close critical service gaps
Build foundations for system transformation
Ontario faces parallels in regards to opioid and addictions epidemic. My classmate and I compared the issue between Ontario and British Columbia (B.C). My classmate interestingly alluded to the Biopsychosocial Model for addiction as we agreed it is the most appropriate method of assessment and treatment, while remaining person c
entered. The information on B.C was similar in their initiatives to that of Ontario. Both provinces have heavily promoted harm reduction and promote safe practice. The harm reduction initiatives have prevented many overdoses and deaths in individuals suffering from substance abuse.
The commonalities between Ontario and B.C;
-supervised safe injection sites (Supervised Injection Services Working Group, 2013)
-provided housing and employment opportunities
-providing street Nalaxalone kits
-training front-line service workers (i.e.: fire fighters) (Medical Officer of Health, 2016)
-offering education about addictions and overdoses.
(Ghosh, 2018)
The Biopsychosocial model applies to individuals with addictions a multi-level health approach that uses overlapping layers support a generalized caring initiative to people of all races and populations. Much like the BC stance, health outcomes are proportional to socioeconomic position. Individuals struggling with addiction in our society do encounter challenges and feel marginalized as a result of their socioeconomic status. The challenges also suggest that they are unable to meet the social determinants of health. Housing assistance is a step in fulfilling those determinants of health and facilitate change in their external influences.
Personally, I do see the benefits for safe injection sites. I think that the strategy is extremely useful in risk reduction, as mentioned above. The idea of taking the drugs away would only cause a revolt and is absolutely Utopian to consider. The practicality of the safe injection sites is the most realistic option to help the individuals ensure safety and hygienic personal practices.
In addition to my original thought, the need for appropriate screening and identification of problems and 'at-risk' individuals requires health professionals to make a considerable effort to mediate problems for the individuals. As mentioned, housing and assistance with acquiring resources to fulfill their social determinants of health and live in a reasonably healthy manner. The new provincial leader in Ontario bids to minimize the problem and lacks consideration for those troubled by the addiction currently. In my opinion, safe injection sites do not minimize the problem, however, bring attention to it and safety around it. It is an appropriate step in minimizing risk and harm, while other interventions are introduced to change behaviors.
Resources
Draaisma, M. (2017). Ontario health minister says province to invest $222M over 3 years on opioid crisis. CBC. Retrieved from http://www.cbc.ca/news/canada/toronto/eric-hoskins-opioid-crisis-1.4266578
Ghosh, I., (2018). Moss Park overdose prevention site is moving indoors in June. CBC News. Retrieved from https://www.cbc.ca/news/canada/toronto/moss-park-ops-indoors-1.4658552
Medical Officer of Health (2016). Staff Report: Implementing Supervised Injection Services in Toronto. Toronto: Author, June 16. http://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-94548.pdf
Ontario HIV Treatment Network (2016). FAQ: The Ontario Supervised Injection Services Feasibility Study. Retrieved from http://www.ohtn.on.ca/wp-content/uploads/2016/02/SIS-FAQ1.pdf
Janus, A. (2017). Ontario forms opioid emergency task force to address ongoing crisis. CBC. Retrieved from https://www.cbc.ca/news/canada/toronto/opioid-task-force-1.4391417
Ontario’s Mental Health and Addictions Leadership Advisory Council. (2016). Mental health and addictions: Moving forward. Retrieved from http://www.health.gov.on.ca/en/common/ministry/publications/reports/bmhmbh_2016/moving_forward_2016.pdf
Supervised Injection Services Working Group (2013). Supervised Injection Services Toolkit. Toronto: Toronto Drug Strategy. http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-59914.pdf
The Canadian Press. (2018). Doug Ford says he's 'dead against' supervised injection sites. CBC. Retrieved from http://www.cbc.ca/news/canada/windsor/doug-ford-says-he-s-dead-against-supervised-injection-sites-1.4628547
The Ontario Drug Policy Research Network (2016). Opioid Use and Related Adverse Events in Ontario. Toronto: Author, 8. http://odprn.ca/wp-content/uploads/2016/11/ODPRN-Opioid-Use-and-Related-Adverse-Events-Nov-2016.pdf
Toronto City Council. (2016). HL 13.2 Implementing Supervised Injection Services in Toronto. Retrieved from https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-94548.pdf
Yaffe, B. (2017). Toronto Overdose Action Plan Update. Report for Action to Toronto Board of Health. Retrieved from http://www.toronto.ca/legdocs/mmis/2017/hl/bgrd/backgroundfile-99792.pdf
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