'Refusals' mean many non-fatal opioid overdoses not in tracker data

The number of calls to paramedics for non-fatal opioid overdoses in Waterloo region has more than doubled in the last five years. But the number of non-fatal overdoses, where a person refuses to accompany paramedics to hospital after being revived are not included in a trackingwebsiteset up by the province and run by Public Health Ontario.

• Opioid overdoses killed 38 people in Waterloo region in 2016
• Harm reduction workers call on Ontario to declare emergency over opioid crisis
• Carrying on after son's deadly overdose: Mike Zettler's story

Robert Crossan, deputy chief of paramedic services, told CBC News the statistics on calls foropioidoverdoses:

• 2016, 437 calls.
• 2015, 230 calls.
• 2012, 176 calls.

By the end of August of this year, paramedics in the region had already responded to 355 calls and Crossan said they forecast a total of about 520 by year's end.

"We've obviously been paying a lot of attention to this in the last 24 months, but four years ago, we were doing 200 opioid overdoses a year," Crossan told CBC News, noting opiates like OxyContin, codeine and heroin have always been present in the region.

Bootleg fentanyl, he said, has been"a game changer."

"I mean, 200 a year, that's still 15, 16, 17 a month when there was no crisis as opposed to now when we're in the 45 to 50 range per month," he said.

'A lot of refusals'

Many of the calls paramedics are arriving to find the person has been revived by someone carrying naloxone. When that happens, it's often the case the patient doesn't want any more medical attention or to go to the hospital.

"We do get a lot of refusals. They're woken up with naloxone prior to us getting there, often it results in refusal," Crossan said.

• How pharmacists are becoming the first line of defence against opioid overdoses
• PC leader Patrick Brown promotes pill pressing machine ban to fight opioid crisis

"We work hard. We work with our partners in police to try to convince them to come with us, but, you know, some people are adamant that they have no interest in that. They don't want to do that."

When paramedics do come across someone who has overdosed, they only administer naloxone in about 30 per cent of cases.

"We would much rather just look after their breathing and not wake them up and have them conscious and alert and we would like to take them to the hospital and get them potentially into some addiction services," he said.

Scope of the crisis

The number of non-fatal overdose cases where a person declines to go with paramedics to the hospital after they are revived are not included in the provincial government's tracking website.

It's a major number missing from the data, said Michael Parkinson of the Waterloo Region Crime Prevention Council.

He and and other advocates have been calling for better reporting on the number of overdoses,including non-fatals.

• Fentanyl seizures explode in 2016 in Waterloo region
• Why Ontario won't declare the opioid crisis a provincial emergency

He said the numbers released earlier this week by Public Health Ontario, which show 38 opioid overdose deaths and 24 of those involved fentanyl, shows the crisis is a serious concern here in Waterloo region.

More data will help people understand the scope of the problem, he said.

"In Waterloo region, we are up 65 per cent in opioid-related deaths in 2016 versus a provincial average of 19 per cent," Parkinson said. "Both of those numbers are going the wrong way."

And the problem is only getting worse.

We work with our partners in police to try to convince them to come with us, but, you know, some people are adamant.They don't want to...- Robert Crossan, deputy chief of the region's paramedic services

"Notwithstanding some recent improvements from the province and from the federal government, early indications in 2017 are that those overdose deaths will continue to rise and they will continue to affect people who are dependent on opioids and people who are using substances occasionally," he said.

But there is hope. There are community task forces coming together, including in Cambridge, to focus on the problem and people are talking about it.

That, Parkinson said, is a start.

"The data looks grim, but the good news here is that people are starting to pull together and recognize the scale of this crisis and starting to get a move on it," he said.