Inhaling drugs surpasses injections in Ottawa, and experts want new tools to fight it

As drug use continues to change, Ottawa Public Health (OPH) is looking for more money and resources to help tackle the city's ongoing opioid crisis.

On Monday, the health agency presented an update on its overdose response strategy at aboard of health meeting, outlining some old and newer ideas to address addictionand reduce deaths.

Some of the recommendations are already well-known,including adding more mental health support, more affordable housing and better co-ordination between first responders.

But there are a number of other proposals, including creating aMental Health, Addictions and Substance Use Health Urgent Care Centre; implementing grief counselling and trauma support for those who use drugs, their families, and thosewho work with them;and expanding a pilotproject that allows members of the homeless community take the lead in helping each other.

Many of the recommendations would rely on Ontario government funding, and the report requests that the board of health's chair writea letter to the Minister of Health and the Minister of Children, Community and Social Services to ask for it.

"We know that this is a complex challenge that we're facing," said Dr. Vera Etches, Ottawa's medical officer of health, at Monday's meeting.

"And so what you'll see today is a strategy in progress ... you'll see new data as the community requested."

Inhalation surpassing injection

According to OPH data in the report, there's been a shift in how people are consuming drugs in recent years.

Community health experts saythat's a factor of the drugs themselves; they're more poisonous and often need to be taken more frequently to obtain the same high, leading to collapsed veins.

The OPH report asks the board to urge the provinceto work on reducing deaths caused by inhalation and for sustainable funding for safer inhalation services.

The percentageof accidental opioid deaths from inhalation more than doubledfrom 16 per cent in 2018 to39 per cent in2022, according to the report.

That corresponded with a proportional decrease in accidental overdose deaths from injections.

"It used to be we thought that encouraging people to smoke rather than inject was a safer way to use drugs, andthat's no longer the case," said Wendy Muckle, past executive director of Ottawa Inner City Health.

"Currently in Ottawa, more people are dying from inhalation than they are from injection for the first time in our history."

She said while those on the street do tend to congregate near supervised injection sites where they can get help if they overdose, the situation is far more dangerous for anyone who smokes at home.

The report also urges for more funding for outreach services like peer-based programs.

It gives the example of Ottawa Inner City Health's 'block leaders' pilot program, which trained about120people who have experience living on the street and using drugs to become leaders themselves, ready to interact with their fellow community membersin the ByWard Market and Lowertown neighbourhoods.

Since the Canada Day long weekend, many of them venture out for two-hour shifts, six hours a day, seven days a week, providingfellow community members with snacks and water on hot days and handing outnaloxone and needle disposal containers.

"Those very simple measures are very effective in reducing overdoses," she said, adding they're often the first to administer naloxone.

But most of all, the program also provides hope to those leaders, said Tabitha Morris, program and case management team lead with Ottawa Inner City Health.

"If you're staying in a shelter and you don't have a steady place to be where can you get a job?" she said. But withthe two-hour shifts, "it really opens the door to be able to do something for your community, feel a bit better about yourself and have some sort of schedule where time seems very lost and the only ability to cope is through drugs."

So far, the organization has spent about$50,000 over the past five months, but only hasenough funds to continue the pilot until the end of the year.

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Tabitha Morris is a program and case management team lead with Ottawa Inner City Health. The organization launched its 'Block Leaders' pilot program in July, which employs community leaders who are unhoused and drug users themselves to interact with people in the ByWard Market and Lowertown communities.

Grief counselling

Another of the recommendations revolves around implementing grief and trauma support for drug users, their families and those on the front lines who are witnessing dozens of overdoses each month.

In the last three months, alone, the Sandy Hill Community Health Centre saw approximately 80 overdoses each month.

"So if you can imagine frontline staff are not only providing harm reduction services and supports, they have relationships with these people," said Wendy Stewart, director of the health centre's OAISIS program.

• Read the full OPH report here

More engagement needed, say residents

Several residents from Sandy Hill, Lowertown and Vanier presented their response to the report and shared their experience living in areas where overdoses areon the rise.

Some recommended adding more public toilets and designated green space with seating in their neighbourhoods, and asked for provisions to reduce the over-concentration of service providers in their neighbourhoods.

Others shared they felt the report didn't go far enough to addresscommunity safety, and felt OPH didn't consult residents enough. They saidthe term "community"in the report is misleading and lackingdefinition.

"I'm disappointed and frustrated and angry by the report," said Calla Barnett, aresident and vice-chair of Action Sandy Hill. "We can't keep fighting each other. It's not us versus them. But the report sets it up to be dichotomous ... Please, let us help."

"There are some common themes here that inspire me that we can get to a better place, about sadness and concern about safety and lots of people willing to work together and wanting to be part of the solution,"Etches said in her concluding remarks.

"... We can work with that. We'll be able to make progress as a community."