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A large memorial for people who have died from opioid overdoses in Sudbury, Ontario.Gino Donato/The Globe and Mail

Opioid-related overdose deaths increased by nearly 60 per cent in Ontario in the first 11 months of 2020, bringing renewed calls for a provincial overdose strategy.

The province recorded 2,167 confirmed and probable opioid-related deaths from January to November last year – a 59-per-cent increase over the same period in 2019, according to a report from the Office of the Chief Coroner.

B.C., Alberta and Saskatchewan also had their worst years on record for drug deaths in the period since the COVID-19 pandemic began.

The Ontario numbers show November was the deadliest month on record, with 240 opioid-related deaths – an average of eight a day.

Gillian Kolla, a postdoctoral research fellow at the Canadian Institute for Substance Use Research at the University of Victoria, called the latest figures shocking and disheartening.

“It’s so overwhelming to think about the scale of the overdose deaths that continue to happen in this province, the impact that this is having on families and friends and community members, and the fact that there is, in Ontario, no response and no urgency,” said Dr. Kolla, who lives in Toronto.

Health Minister Christine Elliott was not available for an interview Thursday, and her office was unable to respond to e-mailed questions by deadline. The coroner’s report has been distributed to public-health units as well as programs that provide harm-reduction and consumption and treatment services; the government has not publicly acknowledged the latest figures.

The provincial numbers came the same day Statistics Canada released new surveillance on “excess mortality” in 2020. Excess mortality is the difference between the total number of deaths during a crisis and the number that would have been expected in normal circumstances. Canada had an estimated 296,373 deaths last year, 13,798 more than would have been expected had there been no pandemic, according to the statistical agency. Statscan said the number includes an increase in overdose deaths it believes could be an indirect effect of the pandemic.

Fentanyl continues to drive the overdose crisis, with the synthetic opioid being detected in 85 per cent of opioid-related deaths in 2020, similar to findings in British Columbia, according to the coroner’s report. A combination of an opioid and stimulant such as cocaine or methamphetamine directly contributed to about half of these deaths since the start of the pandemic, according to the Ontario coroner’s report.

Opioid-related deaths among people who are homeless or precariously housed doubled, with 342 from January to November, 2020, compared with 173 for the same period the previous year.

Dr. Kolla said health groups are urgently calling for evidence-based responses, including overdose-prevention services in shelters, treatment that provides injectable medications and an expansion of programs providing pharmaceutical alternatives to toxic street drugs, colloquially referred to as “safe supply.”

The province also needs more options for medications to be available for safe-supply programs to effectively reduce or end people’s reliance on illicit drugs, she added.

“We’re very limited in Ontario compared to B.C. in terms of the medications and the dosages for the pharmaceutical opioids that can be used within these treatment programs,” Dr. Kolla said. “The province has not responded to any requests to put new medications on the formulary for this, which has taken a massive tool out of the toolbox.”

Adrienne Spafford, chief executive officer of Addictions and Mental Health Ontario (AMHO), said she was “devastated” to learn of the new numbers.

She credited the province for establishing the Mental Health and Addictions Centre for Excellence to oversee the delivery and quality of mental-health and addictions services, and committing $3.8-billion over 10 years for these services. But she said she has yet to see a plan to address the overdose crisis.

“What is missing is – in the same way that we’ve seen in cancer and cardiac and renal [care] – a consistent, aggressive plan to prioritize access to consistent, high-quality services with a focus on reducing wait times for those services.”

Ms. Spafford said the province must urgently increase access to programs geared to whatever stage people who use drugs have reached in their addictions. This includes low-barrier overdose-prevention services, rapid access to addiction medicine clinics, housing and income supports, and outpatient and residential treatment.

AMHO is one of seven groups behind a campaign launched this week called Everything Is Not OK, pushing for timely access to mental-health and addiction care in the province.

The Dalke and Seibel families share a tragic connection: Both lost a child to opioids. Now they plead with others to steer clear of illicit drugs, and to get help for mental illness if possible. Preliminary numbers show 5,233 Canadians died of opioid-related toxicity in 2020, the deadliest year since national tracking began.

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