April 1, 2019
Issue
Increasing rates of opioid overdose across Canada have prompted action at all levels of government. In addition to the broad increases in opioid-related emergency department (ED) visits, hospitalizations, and deaths noted at the provincial level (Ontario Agency for Health Protection and Promotion (Public Health Ontario), 2017), a recent report identified Windsor-Essex having an increased burden of opioid-related harms (Windsor-Essex County Health Unit, 2017) relative to other regions in Ontario.
In October 2018, after a provincial review of existing Supervised Consumption Services (SCS) and Overdose Prevention Sites (OPS), the Government of Ontario announced its commitment to fund a re-purposed version of the Consumption and Treatment Services (CTS) program. The CTS program supports local organizations to address physical and mental health as well as social needs of people addicted to opioids and other drugs. In December 2018, organizations and communities considering a CTS who did not currently have one were encouraged to submit an application well in advance of April 2019. In order to apply, organizations need to ensure the provision of treatment and rehabilitation services, and offer connections to health and social services, including primary care, mental health supports, housing, and employment. Before and after each site is selected, community consultations are needed to ensure the voices of residents are heard. Applying organizations must also have a plan in place to ensure community concerns are addressed on an ongoing basis.
An opportunity exists to address opioid overdoses in Windsor-Essex with strategies driven by community need and a community focused approach to overdose prevention and harm reduction. The process of assessing local need for CTS, collaboratively developing an application, and supporting the implementation, operation, and evaluation of CTS requires an organization with a broad understanding of and connection to local need, to take a lead role in the successful completion and submission of an application for CTS.
Background
The rate of opioid use in Windsor-Essex is the 7th highest in the province. Opioid-related emergency department visits have increased by 3.6 times since 2003. Opioid related deaths in the City of Windsor are significantly greater than the rest of the county, with 19 out of 24 deaths county-wide occurring in the City in 2015. Based on the morbidity and mortality data in this region, the burden of illness for opioid misuse is disproportionately greater among the working-age (20-64 years-old) population (primarily males) in the City of Windsor (Windsor-Essex County Health Unit, 2017).
There are also significant public health concerns related to needle sharing and public injection and discarding of needles. The number of hepatitis C cases, a blood-borne infection, increased from 143 reported cases in 2016 to 181 reported cases in 20176. In 2017, 62% (101 cases) of the 164 confirmed hepatitis C cases that reported at least one risk factor other than unknown, reported injection drug use7. There have been 167 documented needle-related calls from January 1, 2014 to February 5, 2018 to local municipal services (3-1-1), predominantly in downtown Windsor8. The number of needle-related calls have significantly increased, from 43 in 2016 to 121 in 20178.
In December of 2016, the Windsor-Essex Community Opioid Strategy Leadership Committee (WECOSS-LC) was formed, bringing together leadership and key stakeholders across many sectors to collectively address rising rates of opioid use in Windsor and Essex County. The WECOSS-LC is committed to the ongoing development and implementation of the Windsor-Essex Community Opioid Strategy. As part of this strategy, community organizations are having conversations about consumption and treatment services including a safe injection site (SIS). As a result, in October 2018, the Windsor-Essex County Health Unit (WECHU) launched a community consultation regarding SIS. The goal of the consultation is to assess the need and acceptability of SIS in WEC.
Proposed Motion
Whereas, the Government of Ontario announced its funding commitment and endorsement of Consumption and Treatment Services in October 2018, and
Whereas, Windsor and Essex County is experiencing significant public health concerns related to the use of opioids and other substance use, including illnesses, deaths, blood borne infections, and public discarding of used needles, and
Whereas, Consumption and Treatment Services have the potential to address such public health issues, in addition to reducing health care costs.
Whereas, the Windsor-Essex County Health Unit’s (WECHU) lead role in the Windsor-Essex Community Opioid Strategy and understanding of harm-reduction services in the community, creates an opportunity for the WECHU to lead the successful completion of a comprehensive and collaborative application for Consumption and Treatment Services in our community.
Now therefore be it resolved that the Windsor-Essex County Board of Health supports ongoing public health led assessment of the need for and feasibility of Consumption and Treatment Services, and.
FURTHER THAT, should Consumption and Treatment Services be identified as a local need, as a result of such assessments, that, the Windsor-Essex County Health Unit, take a lead role to facilitate the completion of an application, in collaboration with key community partners and stakeholders, to the provincial government for Consumption and Treatment Services in Windsor-Essex.