Opioid-related drug-harm cases are sharply on the rise this year with potential opioid overdoses reaching record highs in the first six months of 2020 according to data from Winnipeg Regional Health Authority, Population and Public Health and Winnipeg Fire and Paramedic Services.
More than 550 cases required Winnipeg Fire and Paramedic Services to administer naloxone — a drug administered to block the effects of an opioid overdose — between Jan. 1 and June 27 this year, the highest on record according to the August 2020 report. Apparent opioid overdoses reached all-time highs in May and June with more than 150 cases recorded each month.
More than 90 per cent of opioid overdoses were reportedly attributed to non-pharmaceutical opioids such as fentanyl, heroin and "down."
By contrast, the first six months of 2019 saw 212 opioid-related drug-harm calls, according to annual WFPS data, already a sharp increase from 64 calls in the first half of 2018.
WFPS reports administering naloxone to 909 patients thus far in 2020, already above the full-year total of 789 patients in 2019.
Cory Guest, public education co-ordinator with the Winnipeg Fire Paramedic Service told the Free Press earlier this month the WFPS has seen significant increases in drugs such as fentanyl since the beginning of this year.
Guest stopped short of connecting the 2020 opioid spike to the COVID-19 pandemic, though acknowledged it would be naive to think the crisis has not made an impact.
"The opioid use really across the board has increased dramatically, really from about April-ish, April, May, to about now," Guest said. "And the lethality of the drugs that we’re seeing is something that we’ve never seen before."
Guest noted while the drugs WFPS are encountering are not new, polysubstance use — when people use more than one drug at once — has been on the rise as well. The increased drug use and increased lethality has posed a challenge for paramedics, who have had to increase the starting dosage of naloxone to 10 times the level that would have been administered just two years ago.
Guest said drug use fluctuates over the years, with "high highs and low lows," so he isn’t surprised by the surge in fentanyl cases.
Healthy Sexuality and Harm Reduction (HSHR), who track community-reported opioid overdoses, indicated in the report that 169 apparent overdoses were treated with take-home naloxone kits between Jan. 1 and Aug. 6. More than 60 per cent of apparent overdoses recorded this year involved men, the WRHA said, and over 90 per cent took place in private residences.
The release noted in nearly half of all overdose events reported by community members, 911 was not called, something the city’s health officials cautions against.
The WHRA recommends drug users and those who support them call 911 if witnessing or experiencing a drug overdose. The Good Samaritan Overdose Protection Act protects those involved from drug possession charges and breach of probation charges.
Health authorities also recommend having a take-home naloxone kit and getting overdose and naloxone training.
After losing her son to a fentanyl overdose in 2014, Arlene Last-Kolb of Overdose Awareness Manitoba has been advocating for supports for drug users, including a push to have naloxone designated as an unscheduled substance, which would make the drug readily accessible over-the-counter for those who need it.
"We need to unschedule naloxone so that people don’t have to worry about only getting one or two kits," Last-Kolb said Saturday.
"It has to be much, much easier for peers (of drug users) to get it. So when I look at this paper, what I see is I see a lot of people that aren’t using alone because obviously somebody’s been able to phone for help. But what we don’t see is the fatalities, and those people could be people that are using alone."
As the drugs get more fatal, Last-Kolb worries the dosage in a take-home naloxone kit may not be enough to stop an overdose, which is part of why she’s advocating for the drug to be more widely available.
"It is not good enough to tell us that there is an increase in overdoses and then not do anything about it. So what you need to do is you need to say, OK, we have a lot of overdoses. We need naloxone. It needs to be everywhere," she said.
"If you’re not going to offer a safer supply or something safer, or deal with it in some way, then you have to give people the life-saving antidote. And it has to be out and around for everybody to see."
Last-Kolb notes the uptick in overdoses is likely connected to the COVID-19 pandemic and availability of CERB, and said families of drug users have been "going through a lot of hell" as the drugs get more unpredictable.
"(The report) is just telling us about how many people use drugs and overdose, but we really don’t care enough to give them the antidote or to give them as much as they need," Last-Kolb said.
"So why are you telling us? What is the point? We know that CERB has something to do with it, obviously, right. We know all of that. So again, nobody’s blaming anybody. All we’re saying is just make the antidote unscheduled and you know, it’s easy peasy."
The WRHA recommends those who use drugs do not do so alone, and to start with the most unpredictable substance at reduced dosages if using more than one.
—with files from Katie May
Julia-Simone Rutgers is a general-assignment reporter.