Pubdate: Fri, 06 Jan 2017
Source: Toronto Star (CN ON)
Copyright: 2017 The Toronto Star
Contact:  http://www.thestar.com/
Details: http://www.mapinc.org/media/456
Author: David Rider
Page: GT1

TORONTO LAUNCHES EFFORT TO KEEP FENTANYL AT BAY

Toronto officials don't know why B.C.'s deadly fentanyl crisis has not
yet spread to the city, but they're aiming to ensure it never does.

On Monday, Dr. Barbara Yaffe, Toronto's acting medical officer of
health, will chair the first in a series of monthly gatherings in a
joint effort to prevent any spike in overdoses involving fentanyl and
other illicit opioid drugs.

Mayor John Tory, city manager Peter Wallace, paramedics, police,
harm-reduction advocates and others in the "Toronto overdose
surveillance and alert partnership" will focus at home while warily
looking west to the shocking toll fentanyl, a highly potent anesthetic
commonly used for surgery, has taken on Vancouver.

Last month the B.C. coroner's office issued an urgent warning after at
least 11 people in the province died on one day, six in Vancouver's
Downtown Eastside. In B.C. there were 374 overdose deaths involving
fentanyl detected between January and October 2016 - up 194 per cent
over the previous year.

Fentanyl, often mixed by traffickers with heroin or cocaine, is up to
100 times more toxic than morphine. B.C. victims include addicts with
jobs, families and children as well as those in Vancouver's infamous
"shooting gallery."

"I don't think anyone truly has the answer to the question why they
are seeing so many deaths in Vancouver and we're not yet seeing that
situation here," said Shaun Hopkins, manager of the Toronto Public
Health's "The Works" harm-reduction program, in an interview Thursday.

"By putting preventative measures in place and looking at this issue
in a comprehensive way, hopefully we will not experience the kinds of
deaths and situations they are seeing in Vancouver."

There are signs in Toronto of increased fentanyl use, including a
"bootleg" version - but nothing like the explosion seen out west.
Toronto paramedics used overdose-reversing drug naloxone 161 times
last year, up from 110 in 2015. They caution that naloxone is also
used for overdoses involving other drugs and at least part of that
jump could be attributed to the fact that all paramedics now carry the
antidote.

That figure may also underestimate fentanyl use because family members
of addicts can get and administer naloxone themselves, averting
overdoses that would not necessarily get recorded by emergency services.

Toronto police seized about three kilograms of fentanyl last year - up
from 350 grams in 2015, but still a tiny fraction of all drug seizures.

"We've seen a change from primarily patches in 2015, with some pills
primarily disguised as oxy (contin), but now we're seeing more
fentanyl powder in the last year," police Acting Insp. Steve Watts
said.

Toronto police track overdoses, and have recorded one involving
fentanyl since starting to specifically look for that drug late last
year, Watts said. However, police figures don't capture overdoses when
someone is privately transported to hospital.

While acknowledging patient confidentiality concerns, he said "it
could be helpful, in terms of oversight of the problem, that we do
more (information) sharing between public health, hospitals and the
police."

As well as real-time tracking of fentanyl and other narcotic deaths,
the joint effort being launched Monday could prompt, or call for,
wider public access to naloxone, new outreach efforts to drug users
and improved treatment options.

One major step already in the works - three supervised injection sites
approved by council - is in limbo awaiting federal approval,
provincial funding of $1.8 million in annual operating costs and
$350,000 in onetime renovation costs.

Ontario's health ministry is "currently working with the city to
review their (safe-injection) proposal," Shae Greenfield, a
spokesperson for Health Minister Eric Hoskins, told the Star on Thursday.

Tory, meanwhile, said, "I think we've done everything we need to
do.

"I just hope (the province) takes a look at this and says 'This is a
very small amount to invest to save lives and to address a problem
that is increasing in prevalence in our cities.' When it comes to
saving lives, what's more important than that?"
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MAP posted-by: Matt