Ontario’s response to the opioid crisis? Offer less help, and fewer answers

Posted on April 1, 2019 in Health Delivery System

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TheGlobeandMail.com – Opinion

There’s a journalistic axiom that holds that the more untenable a political announcement is, the closer its release will be to the weekend.

The Friday afternoon announcement the Ontario government made about supervised-consumption sites only lends credibility to that belief.

“Ontario’s Government for the People is putting patients at the centre of our integrated health care system,” the press release reads. “As part of this commitment the Government of Ontario is ensuring those struggling with drug addiction can connect with full wrap-round supports for treatment and rehabilitation services, by approving 15 Consumption and Treatment Services sites in communities with high need and will continue to accept applications from interested organizations.”

Using Orwellian doublespeak – plus a dash of Trumpian random capitalization – the government was not announcing that it was “continuing to build a connected mental health and addictions treatment system”, but rather that it was cutting the legs from under four badly-needed overdose prevention sites, rejecting two others, and continuing to drag its feet on funding of additional sites.

In the midst of the worst public health crisis the country has experienced in decades, the “Government for the People” has decided to alternately twiddle its thumbs and chop at the knees of those working to solve it.

How we got to this absurd public policy position requires a little background.

Doug Ford, during the election campaign, said he was “dead against” supervised consumption sites and vowed to shut them down, despite the fact that about 1,200 people a year in Ontario – most of them young adults – are dying of opioid overdoses.

Once in office, the newly-elected Premier backed off a bit, deciding instead to launch a “review”. The new approach included having existing supervised consumption sites reapply for approval and funding, capping the number of sites in the province at 21, and re-upping the rhetoric about treatment being the be-all-end-all.

In other words, the cut-the-bureaucracy Conservatives decided to choke supervised consumption programs to death slowly with red tape instead of just killing them outright.

The decision to the restrict the number of sites to 21 was never explained, nor does it seem rooted in any science. Friday’s explanation-free announcement that Ontario would fund only 15 sites somehow makes even less sense. Of the remaining six applications, three sites had their funding cut effective April 1 – one business day after the announcement – while two proposed new sites were rejected, and one was put on hold.

The site that’s in limbo, known as the Works, is operated by Toronto Public Health. It is one of the busiest supervised consumption sites in the country; according to Toronto’s medical officer of health, there have been more than 40,000 visits and 748 overdoses reversed since it started offering supervised consumption in 2017. Closing it makes no sense, especially since other nearby facilities are already overwhelmed.

Of course, no government has an obligation to simply give advocates and the opposition everything they ask for. But the least they can do is justify their policies.

What seems clear is there is some partisan jiggery-pokery at play. The three sites that lost their funding all have federal exemptions, meaning they can remain open – at least theoretically. Mr. Ford’s government is essentially forcing the federal government to step up and provide funding. And since Mr. Ford wears his disdain for the provincial capital on his sleeve, the fact that he would dump a Toronto-based provincial responsibility is hardly a surprise at this point.

There is also some clever media manipulation at work with these targeted cuts. So much attention is being focused on the handful of supervised consumption sites losing their funding that virtually no attention is being paid to the larger issues.

Chief among them: having only six sites in Toronto, three in Ottawa and one each in London, Guelph, Hamilton, St. Catharines and Thunder Bay is clearly inadequate.There are vast swaths of the province where the opioid epidemic is running rampant – places such as North Bay and Windsor – in which desperately needed supervised consumption sites are not available.

Further, for all of the government’s talk of emphasizing treatment and rehabilitation, there is no obvious commitment to either.

The reasons people use drugs are complex; addiction, even more so. You can’t just snap your fingers and make them “clean.”

If your goal is to get them into treatment, the starting point has to be keeping them alive. That’s what harm reduction programs do.

And make no mistake: Shrinking rather than expanding access to supervised consumption sites, as Ontario has chosen to do, will result in more deaths – preventable deaths of young people.


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