Hamilton explores declaring state of emergency over opioid overdoses and deaths

The City of Hamilton, Ont., is exploring whether to declare a state of emergency over its opioid crisis, with the municipality’s top doctor saying it's a significant issue that's worsening. Prescription pills containing oxycodone and acetaminophen are shown in Toronto, Dec. 23, 2017. THE CANADIAN PRESS/Graeme Roy

The City of Hamilton is exploring whether to declare a state of emergency as it grapples with an opioid crisis, with the municipality’s top doctor saying such a step could help it respond to a growing problem.

A motion was introduced and carried unanimously on Jan. 12 to have the city's top doctor determine the threshold of opioid-related deaths and overdoses that would warrant such a declaration.

Dr. Elizabeth Richardson, Hamilton's chief medical officer of health, said declaring a state of emergency is typically for acute problems such as a large fire or accident, so the municipality is looking at what sort of action and funding the move would allow.

Richardson said there is not a specific funding stream that automatically opens up if the municipality declares an emergency, but that's something council would explore if the motion is ratified at a meeting next week.

"Looking at the worsening opioid crisis, a lot of this has to do with the toxicity of the illegal drug supply and the contamination with fentanyl and the challenges that brings for people who do use drugs," she said, speaking generally about the crisis in Canada and around the world.

"We know that with the pandemic, many of these underlying issues around why people may choose to use drugs in a hazardous way … were exacerbated," Richardson said.

Coun. Alex Wilson described the motion as "a positive step" and said increasing opioid-related overdoses and deaths are an issue affecting every community in Hamilton.

"Drug use is not necessarily contained to a specific population by any means, but we are seeing a disproportionate health impact on folks who are multiply marginalized or experiencing homelessness in our community," Wilson said.

Opioid-related deaths "have increased exponentially," according to a report presented at the city's board of health meeting earlier this week.

The report says there were 26 opioid-related deaths in 2005 compared to 166 in 2021, noting that over 65 per cent of them were among males between 25 and 65 years old.

Hamilton paramedics responded to 814 incidents related to suspected opioid overdoses in 2022, according to city data, compared to 430 such incidents in 2017.

"In particular there are shelters and other places where drug use is having very acute impacts in terms of lack of safe supply, lack of harm reduction possibilities," Wilson said. "And so it's really, really clear that there are some opportunities to intervene to save lives."

Wilson said council is looking to draft a separate motion that would look at scaling up supervised consumption sites and other harm reduction strategies within shelter spaces.

Opioid deaths have increased in Ontario by more than 100 per cent since 2017 and took a marked jump when the pandemic hit in March 2020.

Abe Oudshoorn, a founding member of the Ontario Alliance to End Homelessness and an associate professor at the University of Western Ontario, said declaring a state of emergency to deal with the crisis in the city is long overdue.

"I would suggest that if it weren't for the pandemic taking the vast majority of our focus on public health concerns, this would have already been declared an emergency a number of years ago," Oudshoorn said.

In addition to a tainted drug supply and an increasing presence of fentanyl, he cited rising rent and other living costs as main factors behind crises like Hamilton's.

"We've had far more people who are experiencing street level homelessness. We've seen our shelters vastly overwhelmed," Oudshoorn said.

"I think (Hamilton is) on the right track to be taking this as seriously as it is, but it's also going to need systemic level approaches. Public health alone can't solve this," Oudshoorn said.

"They can definitely help by providing more safe spaces for people to be using substances. More access to safer substances and access to supplies to make use more safe."

Fentanyl remains a major contributor of fatal opioid overdoses in Ontario, with the substance found in 85 per cent of deaths last year. Other drugs like cocaine, methamphetamine and non-pharmaceutical benzodiazepines have also recently been found in a significant number of opioid deaths.

This report by The Canadian Press was first published Jan. 20, 2023.