Opioid hotline goes 24-7 amid Hamilton overdose crisis

When the woman's voice on the other end of the line went silent, the operator called 911.

And that saved her life," recalls Rebecca Morris-Miller, founder of Grenfell Ministries.

That call was to the faith-based organization's new Overdose Prevention Line, which aims to prevent overdose deaths.

The volunteer-powered line, which started as a pilot project in February, will be open 24 hours a day across Ontario in time for International Overdose Day, which is Monday.

Between Feb. 1 and May 16, operators fielded 82 calls. Most were from service providers.

Grenfell's line is still building trust, but 14 calls were from people wanting peer support while using drugs.

Just that one time, an operator called 911, notes Morris-Miller, who battled fentanyl and heroin addiction herself.

So far, the line (1-888-853-8542) relies on 22 volunteers, who like her, have experiences with substance use.

The over-the-phone support comes during an unprecedented time that some say has produced parallel pandemics: COVID-19 and the opioid crisis.

Last year, Hamilton lost 104 people to overdoses and 124 in 2018 - both big spikes over the 88 deaths in 2017.

In the first four months of 2020, there were 34 confirmed and probable opioid-related deaths in the city, according to the latest data from the provincial coroner's office.

That's fewer than the 48 tallied in the first four months of 2019.

But due to the three-month lag in coroner's office analysis, no mortality figures are yet available for after April 30.

Morris-Miller - like others who work on the front lines of the opioid crisis - isn't holding her breath. We've seen more overdoses than we've ever seen before."

This will eventually be borne out in the coroner's data, she says.

Morris-Miller also points out a significant number of regular users don't call 911 during overdoses, but administer naloxone themselves.

These cases wouldn't be reflected in the paramedic calls for suspected overdoses the city tracks publicly.

And it's not just the number of calls that matters; the severity of the crisis is also down to the volatility of drugs on the street right now, Morris-Miller says.

That includes a powerful mix of fentanyl - which has long driven the overdose crisis - and benzodiazepine, a sedative.

When people use this, it's difficult to revive them with naloxone, which is meant to temporarily reverse the effects of opioids.

This is why a safe supply," or regulation of drugs normally only available via the illicit market, is crucial, says Morris-Miller, also an advocate for decriminalization.

Earlier this week, Dr. Theresa Tam, Canada's chief public health officer, expressed concern the COVID-19 pandemic was influencing the volatility of street drugs.

There are indications that the street drug supply is growing more unpredictable and toxic in some parts of the country, as previous supply chains have been disrupted by travel restrictions and border measures," she said in a statement.

Public health measures designed to reduce the impact of COVID-19 may increase isolation, stress and anxiety, as well as put a strain on the supports for persons who use drugs," Tam added.

Last year, about 1,500 people were lost to opioid-related deaths in Ontario.

The pandemic period has seen a roughly 35 per cent increase in fatal overdoses compared to the same time in 2019, notes Dr. Dirk Huyer, this province's chief coroner.

Huyer says it takes about three months to analyze deaths - including local information - for quarterly updates.

We are working hard to try to give the opioid data as promptly and as quickly as we can."

By contrast, on Aug. 25, the B.C. Coroners Service posted suspected and confirmed mortality data up until the end of July.

That includes provincewide and local figures, including a variety of metrics such as gender and age, type of substance, and generally where deaths occurred.

In Hamilton, any information after April 30 is a patchwork of tallies from institutions that report suspicious deaths, including potential overdoses, to the coroner.

For instance, public health notes out of 352 suspected opioid-related paramedic calls as of Aug. 15 this year, four involved patients who died on scene.

Hamilton Health Sciences reported less than five deaths this year as of June. St. Joseph's Healthcare says less than five as of July. Police say they don't keep track.

But this is only a fraction of the deaths the coroner could later determine were overdoses.

Dr. Elizabeth Richardson, the city's medical officer of health, notes this gap can be due to deaths initially reported as other causes, such as heart attacks.

Richardson says in the best of all worlds," it would be beneficial to know coroner-confirmed overdose deaths sooner.

But paramedic calls, hospital visits, naloxone use and regular check-ins with community agencies offer a solid and timely local outlook, she adds.

So we have a whole bunch of other things that tell us is something going on."

But for Don Seymour, executive director of Wesley Urban Ministries in Hamilton, the information void on deaths is not serving the system well at all."

Seymour questions how the public would react if COVID-19 death counts were similarly delayed.

I don't think it's an inability. I think it's just a decision where to use resources. I find that ludicrous, to be honest."

Keeping Six, a harm-reduction group, has also noted a spike in overdoses during the pandemic.

Member Lisa Nussey says people have first-hand experience of the opioid crisis that can't be subordinated to an absence of data-based evidence."

But even when such evidence is produced, it's ignored, she added.

Fundamentally, this is because we are not dealing with a dearth of information; we are dealing with a dearth of political will."

Teviah Moro is a Hamilton-based reporter at The Spectator. Reach him via email: tmoro@thespec.com