Montreal is in an opioid overdose crisis, advocates say

A naloxone anti-overdose kit is shown in Vancouver, Friday, Feb. 10, 2017. A drug used to temporarily reverse the effect of fentanyl overdoses will be offered free of charge in Quebec pharmacies.The province will follow the example of at least Ontario, British Columbia, Alberta, Nova Scotia, New Brunswick and Prince Edward Island in offering the life-saving naloxone without people requiring a prescription. THE CANADIAN PRESS/Jonathan Hayward

Public health authorities have closely monitored Canada's "overdose crisis" since 2016, and the phenomenon continues to claim victims -- including in Montreal, where advocates say the problem is getting worse.

Speaking to The Canadian Press on Tuesday, Annie Aubertin, executive director of the outreach organization Spectre de rue, said she dealt with one to two overdoses daily over the past week at her supervised consumption service (SCS).

"Normally, we don't have an overdose a day at our place. We have one or two a week," she says. The Ontario Street location is open seven days a week from 8:30 a.m. to 4:30 p.m.

The same is true of CACTUS Montréal, open between 2 p.m. and 2 a.m. An average of "two overdoses per day" are reported, according to general manager Jean-François Mary.

In addition to on-site overdoses, workers intervene directly on the street with those using the safety equipment provided by these organizations.

"If it's possible to increase a crisis, well, it's increased," says Annie Aubertin.

Montreal's public health authority (DRSP) recognizes the scope of the problem.

Dr. Carole Morissette, a medical advisor on preventing STIs and reducing drug-related harm, affirms that "since the pandemic, the illicit market is extremely unstable and dangerous."

As a result, outreach organizations have begun offering substance analysis services to prevent adverse reactions.

According to Aubertin, the increasing popularity of these tools reflects drug users' growing distrust and concern about the products on the market.

LACK OF RESOURCES

In a recent public statement, the CIUSS du Centre-Sud-de-l'Île-de-Montréal nurses' union denounced the lack of medical staff in supervised consumption services.

Community organizations have confirmed this reality.

While nurses are not essential to the operation of SCSs, since staff are trained to intervene in the event of a problem, their medical expertise is greatly appreciated.

When an overdose occurs, the presence of a health professional has a "reassuring" effect on the team in place, says Aubertin.

The CIUSSS is working to complete its team of nurses dedicated to SCSs. But due to the pandemic and the shortage of manpower in the network, recruiting and retaining qualified personnel remains a major challenge.

But beyond this collaboration, the community sector is pleading for adequate funding and better recognition of its support and prevention work with a vulnerable clientele.

"We're in an opioid crisis for real. We're in an overdose crisis for real. And all the while, we have to fight for funding," laments Aubertin.

She compares the small network of supervised sites to "mini-emergency rooms" -- an image that echoes Dr. Morissette's statement that, since 2020, there has been a five-fold increase in cases requiring emergency intervention.

The number of emergency interventions in SCSs has risen from an average of 9.3 interventions per month in 2019-2020 to 49 interventions per month in 2022-2023, according to DRSP data.

Dr. Morissette points out that these organizations prevent many deaths, as well as a large number of ambulance transports and visits to hospital emergency units.

This report by The Canadian Press was first published in French on July 6, 2023.