Muskoka is not immune to the worldwide opioid crisis. Although opioid-related calls to Muskoka Paramedic Services (MPS) dropped in 2021, they have more than doubled since 2018, and opioid-related deaths continue to rise across Simcoe Muskoka.
When used appropriately, opioids are efficient painkillers—the opioid family includes morphine, codeine, OxyContin, Percocet, and Vicodin, among others—but they are highly addictive making them a target for illicit drug use.
Street drugs containing opioids are often much more potent than prescription opioids. Fentanyl is 100 times stronger than morphine and 40 times stronger than heroin. Carfentanil is a sedative used for large animals, and is 100 times more potent than fentanyl and 10,000 times more potent than morphine.
A very small amount of fentanyl can lead to an overdose and, if medical help isn’t immediately available, death.
Opioid calls to MPS down slightly in 2021
According to a report presented at the District’s health services committee on March 24, MPS observed an 11.5 per cent decrease in opioid-related calls for assistance in 2021 compared to 2020. But 2021 numbers are still more than double those of 2018.
Despite the increase in calls for assistance, MPS administration of Naloxone, or Narcan, a drug that can reverse the effects of opioids, has remained relatively consistent, MPS Commander Brad Davies told committee. That’s due in part to an increase in the rate of bystander administration of Narcan thanks to public awareness campaigns and the availability of Narcan kits through the health unit or local pharmacies.
Opioid deaths on the rise
Opioid-related deaths per 100,000 population were higher in Muskoka during the period from 2017 to 2020 compared to Simcoe County, notes the MPS report, but those numbers don’t take into account the seasonal populations in Muskoka, to which some of the deaths may be attributed.
In a March 16 letter to provincial health minister Christine Elliott, Anita Dubeau, the board of health chair for Simcoe Muskoka District Health Unit (SMDHU) noted that, “In the 19 months of available data since the start of the pandemic (March 2020 to September 2021) there have been 245 opioid-related deaths in Simcoe Muskoka. This is nearly 70 per cent higher than the 145 opioid-related deaths in the 19 months prior to the start of the pandemic (August 2018 to February 2020), when our communities were already struggling in the face of this crisis. The first nine months of 2021 saw an opioid-related death rate more than 33 per cent higher than the first nine months of 2020, suggesting the situation has not yet stabilized.”
Dubeau urged the provincial government to ramp up its opioid crisis response, including increasing harm-reduction strategies and treatment strategies. Read the full letter here.
Emergency department visits and hospitalizations are up, too
The Simcoe Muskoka District Health Unit (SMDHU) reports on hospitalizations, “because it is difficult to report on overdoses in the community, as many of them do not end up in hospital where a true diagnosis can be made. Hospitalizations do not capture all overdoses but are indicative of community trends,” notes the MPS report.
Per capita emergency department (ED) visits in Muskoka are consistent with the provincial rates while hospitalizations are higher than the provincial average.
What to do if you witness an overdose
The SMDHU notes the following signs, symptoms, and risk factors for an overdose, as well as what to do if you are witness to an overdose.
Signs/symptoms of an overdose
- Blue lips, fingernails, or toenails
- Very slow or no breathing
- Faint pulse or no pulse
- Pale and clammy skin
- Unresponsive to calling their name or to pain
- Snoring or gurgling noises while asleep or nodding out
Risk factors
- Using a greater amount or a stronger potency of a drug
- Mixing with alcohol or other drugs
- Inconsistent drug quality and potency (illegal drugs are unregulated and therefore unpredictable)
- Using drugs after a period of time of not using them (tolerance is less)
- Using alone (there is no one to help)
What to do in the event of an overdose
Step 1: Shout and shake.
Step 2: Call 911.
The Good Samaritan Drug Overdose Act provides some legal protection for people who call 911 or need emergency help during an overdose. The Act can protect you from charges for possession of a controlled substance and breaches of certain legal conditions. The Act does not provide legal protection against more serious offences like outstanding warrants or production and trafficking of drugs.
Step 3: Give Naloxone (also known as Narcan).
Naloxone kits are available from most pharmacies. Naloxone is a medication that can temporarily reverse the effects of an opioid overdose. It actually ‘kicks’ the opioid off of the receptor in the brain, temporarily blocking its harmful effects and helping the person breathe again. It starts to work in 1-5 minutes and works for about 30-90 minutes. Naloxone only works with opiates. It does not prevent overdoses with alcohol, cocaine, ecstasy, LSD, etc. but it would not cause any harm if it was given in circumstances where opioids were not used.
Step 4: Perform rescue breathing and/or chest compressions. (During COVID 19 only chest compressions are recommended.)
Step 5: Is it working? If no improvement after two to three minutes, repeat steps 3 and 4.
Step 6: Stay with them.
Learn more about opioids and the health unit’s opioid strategy here.
Related: Muskoka opioid deaths expected to be highest on record for 2021
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