In each “Behind the Scenes” segment, Village Media's Scott Sexsmith sits down with one of our local journalists to talk about the story behind the story.
These interviews are designed to help you better understand how our community-based reporters gather the information that lands in your local news feed. You can find more Behind the Scenes from reporter across Ontario here.
Today's spotlight is on Sudbury.com's Jenny Lamothe, whose story 'Scramble is on to save city’s supervised consumption service' was published on Oct. 6.
Here is the original story if you need to catch up:
Amber Fritz, manager of services at The Spot supervised consumption site, told Sudbury.com there are very few overdoses happening in Sudbury.
Not because people have stopped dying, far from it. Sudbury still holds the No.2 spot for opioid deaths in Ontario.
It’s because it is nearly impossible to ‘over’-dose on something when you can’t know the dose.
Most Sudbury deaths due to opioids can be tied to drug poisoning, which is to say the problem is not the dose people are taking; it's the added chemical adulterants that are present, unknown to the user.
For the last year, people who use substances have countered this danger at The Spot. Come December, that could change.
Funding from the city could dry up at the end of this year, and provincial funding has yet to be approved.
Fritz said The Spot submitted an application to the Ministry of Mental Health and Addictions 25 months ago, in August 2021. “We still have not been given any indication if we are going to be funded,” she said.
With more than 1,000 visits in the last year, 200 in August alone, the loss of the site will mean a loss of life-saving services.
Fritz is very specific that the supervised consumption site is not the answer to the opioid crisis; it is a tool to be used to keep people alive while the crisis gets solved. It’s one way — and a highly effective one addictions experts say — to stem the seemingly neverending tide of lives destroyed or foreshortened.
In a June 13 presentation to city council, Ontario's chief coroner, Dirk Huyer, said that since 2013, there's been 483 people in the Great Sudbury Area who have died from opioid toxicity.
Locally “the rate of opioid toxicity death has increased by almost 200 per cent since 2018,” said Huyer. Ontario has seen a 60-per-cent increase.
Between 2018 and 2022, there was an increase in Sudbury from “26 deaths per year to 116 passing last year in 2022,” which he said represents a 346-per-cent increase.
According to the latest national data, there have been more than 38,500 opioid-related deaths in Canada since national surveillance began in 2016, with an average of 21 people a day dying from January to March 2023.
In a recent release, the federal Minister of Mental Health and Addictions, Ya'ara Saks, stated that between October 2017 and June 2023, almost 50,000 overdoses have been reversed in supervised consumption sites across Canada.
“Additionally, more than 256,000 referrals were made to connect people with health and social services, including primary medical care, counselling, and housing and employment supports. These sites save lives and improve health outcomes,” she said.
There are many reasons why people first try a substance. For some, a party, for others, to escape trauma or mental health issues. Not only do opioids like fentanyl numb physical pain, they numb emotional pain as well, thanks to the opioid receptors present in the human brain.
Addiction is now understood to be a neurological disease.
The brain’s reward system evolved as a way to reinforce behaviors we need to survive, such as eating. When we eat, the reward system activates a chemical called dopamine, giving us the feeling of pleasure. This encourages you to eat again in the future.
When a person develops an addiction to a substance, it's because addictive substances trigger an outsized response when they reach the brain. Instead of a simple, pleasurable surge of dopamine, many substances — such as opioids, cocaine or methamphetamines — cause dopamine to flood the reward pathway, sometimes 10 times more than a natural reward.
The brain remembers this surge and associates it with the addictive substance. However, with chronic use of the substance, over time the brain’s circuits adapt and become less sensitive to dopamine. Achieving that pleasurable sensation, that high, becomes a requirement, but at the same time, the user builds tolerance and needs increasing amounts of the substance to reach the level of high their body craves.
Sudbury.com spoke to several substance users to understand what ‘dopesick’ feels like, the common term for the feeling of withdrawals a substance user experiences.
Most described a feeling of pain throughout their bodies. One woman said, “My skin hurts, my hair hurts, my head hurts, and my brain is screaming at me to get high.”
She said that often she is overcome by the need to vomit and has explosive diarrhea, often both at the same time. Her statements came with agreement from the other five members of the group she was with. One of those five added that he once had a seizure, a common response to the body sinking too far into withdrawal without medical assistance.
One man said he also had an issue with trying to meet the needs of his fentanyl addiction by using a substance that had been adulterated with benzodiazepine, a nervous system depressant and sedative. There was so little fentanyl in the supply, he not only blacked out for an extended period of time, but woke up sicker and in more pain than when he ingested the substance, owing to his addiction to fentanyl not being met.
For that reason, The Spot has also invested in basic substance testing equipment, not the ideal but what they could afford.
“If someone gets their drug checked, and you know, their fentanyl comes up with benzodiazepines or Xylazine, then we can sit and have a conversation with the individual, ask ‘are you familiar with these substances, or have you heard of Xylazine before?’
Some are familiar, she said, others need more information. Either way, the message will also make it around the community of substance users.
“It's not just benefiting the one individual that comes in for drug checking, it gives people a lot more knowledge when it comes to something that's completely unregulated, with zero quality control,” said Fritz.
She said that many people use the site several times a day, and they come from all walks of life.
“Drug poisoning can affect anyone, the toxicity of the supply doesn't discriminate,” she said. “If you're using alone in a tent in an encampment, or using alone in a condo in a fancy tower, chances are, you're going to lose your life. That's just the toxicity of the supply.”
She said while the faces of the crisis seem to be the homeless population, mainly due to their visibility, “we also have folks that have full-time jobs, part-time jobs, people that are in school, it really kind of runs the gamut of people that come here.”
She said the amount of gratitude and the amount of just appreciation that they show the staff and that they show the service is, is incredible,” said Fritz. “It's more than a little heartbreaking, because as far as I'm concerned, this is kind of the bare minimum, we're just giving people a safe place where they feel cared for and accepted and not judged and welcomed.”
The Reséau ACCESS network is currently hosting an online petition to save The Spot. You can find that petition here.
Jenny Lamothe covers vulnerable and marginalized communities for Sudbury.com.
