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

2. 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

3. 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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10. Addressing opioids in Simcoe Muskoka: 4 Pillar drug strategy
Source:

11. 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

12. 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.

13. 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

14. 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

15. 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