New safe-drug supply program in Thunder Bay, Ont., called 'a powerful step' forward

Harm-reduction advocates and front-line workers in Thunder Bay, Ont., are welcoming a new pilot program that helpspeople who use and rely on illicit drugs receive a prescription for safe opioidsand get access to "wraparound"supports like housing and counselling.

The program, operated in the city by the NorWest Community Health Centre as a 15-month pilot, aims to helpone of the communities hit hardest by Canada's drug overdose crisis. The concerns centre on the growing rates of overdose deaths in the northwestern Ontario cityand across Canada, and reports about the toxicity and unpredictability of the illicit drug supply.

The pilotis being funded by Health Canada, through its Substance Use and Addictions Program, and is among 17 government-backed programs offeringor evaluating safer supply programs across the country. Mostof the programs are based in larger cities like Vancouver, Toronto, Victoria, Ottawa and Fredericton,but anumber of themare in other large urban centres in southern Ontario.

"With the overdoses that we're facing here [in Thunder Bay], funerals are becoming, sometimes it seems, weekly. It's constant," said Kyle Arnold, who has lived experience with addiction and now works as the harm-reduction outreach worker for the safer supply program.

"This is the first step to making a difference here in Thunder Bay. It's a powerful step in the right direction," he said about the new pilot program.

In 2021, 122 people died from an opioid-related overdose in the Thunder Bay district alone, according to data from Public Health Ontario.

That's one person dying nearly every three days last year.

On a per-capita basis, Thunder Bay had an overdose death rate more than three times the average in Ontario, andthe most deaths of all public health units in the province. Already this year, between January and August, it's suspected 73 people died from a drug overdose in the district, according to preliminary data from Ontario's chief coroner.

From first aid to finding housing

Recent research conducted at Lakehead University also showed just how unpredictable the street supply of drugs has become, with more than two-thirds of study respondents reporting they had unexpected or unknown drugs show up in their system.

"The safer supply programs are intended to replace that toxic street supply where people don't know what they're getting and ultimately the goal is to prevent death by overdose," said Jennifer Lawrance, director of health services for NorWest.

Lawrance said other potential benefits of the programinclude:

• People in need will be given a safe source of drugs, so they don't have to turn to the illicit drug trade.
• Reduced burden on emergency services with people using safe drugs rather than those that may be toxic.
• Less strain on the justice system, as people using legal substances may not turn to the criminal trade.

Under the pilot, people who access the safe drug supply at NorWestwill also be offered services from basic first aid, to getting help filling out applications for housing or social assistanceand on ways to navigate thejustice system, she added.

"Ultimately, over time if you end up with a safer supply program with hundreds of people involved, you could see this could have quite a significant ripple effect," Lawrance said, adding it's too early to know how many people need or may access the program.

Debbie Reid believes her son Johnny may still be alive if this program had existed in Thunder Bay years ago. He died from a drug overdose in March 2020.

"As a mom of someone who was horribly addicted to fentanyl, I am 100 per cent in support of this," said Reid, a member of a local chapter of Moms Stop the Harm, a network of Canadian families impacted by substance use.

"I think people need to realize that people who are using drugs need to be treated with compassion and dignity, and [this program is] keeping people alive."

Where we really are seeing the need for more programs and more innovative models for providing safer supply are in those more rural and remote communities.- Rebecca Penn, project manager, National Safer Supply Community of Practice

The program ispartof a growing number of initiatives across Canada, said Rebecca Penn, project manager for the National Safer Supply Community of Practice, which is funded by Health Canada to scale up the medical model of safer supply and expand the continuum of care for people who use drugs.

"Where we really are seeing the need for more programs and more innovative models for providing safer supply are in those more rural and remote communities," she said.

Penn acknowledged that health-care providers may be hesitant to prescribe opioids, because previous waves of the opioid crisis werefuelled by huge amounts of prescription opioidslike OxyContinthat were being distributed into the community.

"What we have now is a completely different crisis, and we have to have solutions that address the current wave now," Penn said.

"This wave is caused by the toxic and unpredictable drug supply, and so trying to have health-care providers understand that this is a different situation can allow us to approach this in a different way."

Moving forward, Penn said, Canada needs to expand options and increase the accessibility of existing care models for people who use drugs.

"There's a lot of momentum happening around addressing the needs of people who use drugs, and we need to keep those conversations happening."