Opioid-related harms and responses Deputation to the City of Orillia Council Dr. Lisa Simon, Associate Medical Officer of Health June 26, 2017

What are Opioids? Opioids are a family of drugs used to treat pain and are often referred to as prescription painkillers (e.g. fentanyl, morphine, oxycodone, codeine, hydromorphone) Opioids can also be synthesized in illegal labs for sale on the street or online (e.g. illicit/bootleg fentanyls) Some people use opioids to get high (prescription or illicit opioids)  Opioids are depressant drugs - they slow down the part of the brain that controls breathing

factors contributing to opioid misuse and addiction Personal: Biological, psychological, and social risk factors Includes social determinants of health Health Care: Opioid marketing and prescribing Lack of access to multimodal pain treatment Lack of access to addiction treatment Societal: Illicit drug trade Approach to drug policy Inequality and social exclusion

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Addressing opioids in Simcoe Muskoka: 4 Pillar drug strategy Source: http://www.healthycanadians.gc.ca/publications/healthy-living-vie-saine/drugs-substances-strategy-2016-strategie-drogues-autre-substances/alt/pub-eng.pdf

SMDHU opioids communication strategy Public education including use of social media and earned media Targeted education and awareness (i.e. schools, people who use illicit and prescription opioids, seniors, parents, health care providers) Prevention Increase awareness of the potential harms related to opioids (both prescription and illicit use)   Harm Reduction Increase community awareness around decreasing the risk of an overdose and access to naloxone: Know what the risks are for an overdose and how to decrease them Recognize symptoms of an overdose and how to respond Know how to access and use naloxone Increase awareness of the Good Samaritan Drug Overdose Act

SMDHU harm reduction work Providing expertise and referrals to agencies throughout our region on harm reduction including access to naloxone: Naloxone training and provision of 170 kits since 2015 Increasing awareness of naloxone access through pharmacies and SMDHU, and exploring further partnership opportunities Education of staff/clients at multiple sites: correctional facilities, mental health institutions, community health services, shelters, municipalities etc. Distribution of over 250,000 clean needles and related supplies in 2016 Growth in Needle Exchange distribution partners over the past year.

drug and Alcohol collaboratives Simcoe Muskoka Alcohol and Other Drug Strategy (SMAODS) Barrie Drug Safety Strategy (BDSS) Muskoka Prescription Opioids Prevention Strategy (MPOPS) Harm Reduction Advisory Committee Midland Safe and Sober Awareness Committee NSM LHIN Mental Health and Addictions Committees

Gap analysis: remaining needs Widespread communication, education and coordination of activities Access to naloxone when/where and how most effective Rapid access to treatment for those wanting to tackle addiction Alternatives to medication for pain management Updated prescribing guidelines for physicians/pharmacists Overdose preparedness Training for first responders Healthcare provider training in suboxone therapy Decrease stigma associated with addictions and substance use Real time data on all overdoses in communities in SM Others

A cross-sector comprehensive opioid strategy for simcoe and muskoka Facilitate collaborative planning and action within and across sectors Capitalize on local analyses and activities to date Support and build on role out of provincial opioid strategy Set Simcoe Muskoka-wide objectives Facilitate community-adapted implementation Focus on action and outcomes