Canada's big-city mayors are calling for the expedited approval of new supervised drug-consumption sites, improved data collection and the expansion of unconventional therapies, such as heroin-assisted treatment, to address a national overdose crisis that shows no signs of abating.
The formal recommendations from the Federation of Canadian Municipalities' task force on the opioid crisis come as the Vancouver Police Department issues its own call for expanded addictions programs, including heroin-assisted treatment.
It's believed to be the first time a Canadian police force has formally called for the expansion of the therapy, which involves providing pharmaceutical-grade heroin to users to sidestep toxic street drugs cut with deadly illicit fentanyl.
"It shows how dramatic and deplorable the crisis is when there's consensus across the board for drug-policy change and massive health interventions to stop the death toll," said Vancouver Mayor Gregor Robertson, who chairs the task force for the Big City Mayors' Caucus.
The task force also wants the federal government to set national targets for reducing overdoses, with a progress report to be issued by September.
Federal Health Minister Jane Philpott was unavailable for an interview on Thursday but a statement from her office said she is "committed to using every lever at her disposal to combat the crisis, and to work with all levels of government and partners across the country to do so."
Mr. Robertson said the objective is to mobilize all governments to take urgent action.
"Big-city mayors are seeing a huge spike in death and carnage in our cities and are calling for the federal and provincial governments to step up and take leadership and help solve this with us, because we don't have the tools to deal with it on our own," he said.
"We need the federal government's overall co-ordinating role and funding support but, ultimately, the provinces are responsible for health care and have to deliver the treatment and care that's required."
One hope is that Ottawa will be able to compel provinces to improve surveillance and data collection, and issue minimum quarterly reports, Mr. Robertson said.
For example: Ontario's most recent data on opioid-related deaths, released Wednesday, only cover the first half of 2016. (It found that such deaths jumped 11 per cent compared with the same period in 2015.) Such dated information hinders the emergency response to a rapidly evolving situation that has seen new records being set every few months.
The Public Health Agency of Canada (PHAC), through a special advisory committee on the overdose epidemic, said in an e-mail sent Thursday that it has developed a common reporting template for opioid-related deaths for provinces and territories to submit on a quarterly basis. However, the e-mail says jurisdictions "with available opioid-related death data" are sharing it, suggesting there is not yet a requirement for provinces and territories to provide timely or consistent data.
The PHAC did not provide further details by deadline on Thursday.
Other recommendations for the federal government include establishing comprehensive timelines, measures and evidence-based targets related to a harm-reduction strategy; the adoption of a pan-Canadian action plan that "addresses the root causes of the opioid crisis;" and working with cities to develop more social and affordable housing.
The task force, struck in February, convenes mayors of 13 cities: Vancouver, Surrey, Edmonton, Calgary, Regina, Saskatoon, Winnipeg, Hamilton, London, Kitchener, Toronto, Ottawa and Montreal.
Meanwhile, Vancouver police on Wednesday issued its own report and recommendations relating to the overdose crisis, noting "we cannot arrest our way out of the opioid crisis."
"First responders are uniquely positioned to help refer individuals to treatment services," the report states. "Unfortunately, there is a lack of services that are immediately accessible. This usually means that the cycle of addiction and crime continues."
In addition to the expansion of heroin-assisted treatment, the department's recommendations include creating a system in which drug users seeking treatment can access it immediately and 24/7; creating a provincewide information system for tracking waiting lists and other addiction treatment data; and developing a drug-testing system that can inform the creating of an early warning system when new drugs enter the market.
Both the mayors' task force and the VPD also continue to call for more public education campaigns on the risks of opioid use, how to respond to and treat overdoses and where to seek treatment and support.