Coronavirus versus opioid deaths: a tale of two crises

The ambitious efforts to contain a potential coronavirus outbreak in Canada make the lagging response to the opioid crisis all the more striking



The rapid spread of coronavirus (aka COVID-19) has captured the entire world’s attention. The virus has infected a striking 76,000 people worldwide, with three cases confirmed in Ontario.

Canadian government officials and public health agencies have responded immediately to the potential crisis.

In the last 40 days, there has been a nationwide education and awareness campaign on coronavirus, its symptoms, transmission and prevention and treatment options. Considerable resources have been put into routine screening at airports and placing individuals in quarantine. Prevention and treatment strategies have been made widely available, and coordinated communication has been put in place to closely monitor the virus.

The ambitious efforts to contain and manage a coronavirus outbreak in Canada make the lagging and inadequate response to drug-related deaths related to the opioid crisis all the more striking.

Despite warnings from public health experts, affected communities and human rights advocates, restrictive drug policies and social inequities have resulted in more than 13,900 deaths nationwide between 2016 and 2019. (So far, some 2,100 people have died worldwide from coronavirus, most of those in China.) Although some action has been taken to address the issue, demands for a more concerted response from policymakers continue to go unheeded in Ontario.

Why has one public health emergency resulted in widespread fear and rapid action while the other has been marked by limited response, inconsistent resources and political apathy?

It’s true that the coronavirus is transmissible and represents the potential for a pandemic. The importance of a potential outbreak should not be minimized.

However, the response to coronavirus also serves as a grim illustration of the discriminatory ways that public health crises are handled.

Ontario’s overdose crisis has been apparent for years, yet overdose rates are still rising. In the case of overdose prevention, government officials on municipal, provincial and federal levels have yet to follow the advice of experts who advocate for the decriminalization of all drugs. Efforts to support health care providers pushing a safe supply to people who use drugs has also been non-existent. Steps in providing primary prevention have been stagnant.

According to Dr. Ahmed Bayoumi, a scientist at MAP Centre for Urban Health Solutions at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, the main difference in responses is due to the “imperative to act”.

Despite the limited knowledge on how to go about containing and treating the coronavirus, all avenues of response have been pursued immediately, he says.

Both Bayoumi and Nick Boyce, director of the Ontario Harm Reduction Network, note that the “value-laden” political ideologies that discredit the lives of people who use drugs contribute to the difference in responses. And that drug-related stigma is perpetuated through our current drug policies, which Boyce characterizes as a “drug policy crisis.”

Common examples include the lack of engagement from Ontario’s Opioid Emergency Task Force, restrictive policies surrounding harm reduction programs (such as supervised injection sites) and the restraint placed on data available on the overdose crisis.

The most effective responses in addressing the overdose crisis have come from the harm reduction workers on the frontline and individuals with lived experiences, who have opened their own overdose prevention sites and expanded the availability of naloxone and methadone along with the provision of high-dose injectable hydromorphone.

But the number of overdoses are still rising. How can this be addressed?

Changing the current state of drug policies in Ontario – which are over 100 years old – is necessary for achieving this goal. But so far there doesn’t seem to be the political will or a “political champion” for decriminalization.

Bayoumi says efforts to address the issue should go beyond decriminalization. Additional areas of focus should include extensive work with people who use drugs to create support for drug-related health effects and grief counselling for frontline harm reduction workers. Bayoumi also highlighted the need for an Indigenous-specific and rural area focused overdose strategy.

To develop a sense of public awareness and support for the overdose crisis, Boyce recommends “telling stories” about those affected by drug use. In this way, we can begin to expose biases toward those who use drugs.

Governments and health care agencies have shown they can skilfully respond to a public health crisis as significant as coronavirus. It is time that the overdose crisis receives the same action.

@nowtoronto

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