People battling addiction due to the worsening opioid problem locally now have another option in their road toward kicking the disease.
An open house was held Monday in Barrie to unveil the North Simcoe Muskoka Regional Rapid Access Addiction Medicine (RAAM) clinic, located at 70 Wellington St. W.
It opened for business on Tuesday and will run three days a week in Barrie. A similar clinic will also open this week in Orillia, operating two days a week, followed by another in Midland beginning in July.
The facility offers help for people to reduce cravings, avoiding withdrawal symptoms and a place to talk about substance use.
The Barrie clinic will be open Mondays from 9-11:30 a.m., Wednesdays from 1:30-3:30 p.m., and Thursdays from 9-11:30 a.m.
The Orillia clinic is located at 169 Front St. S., and is accessible through the side entrance. It will be open Tuesdays from 9-11:30 a.m. and Thursdays from 1:30-3:30 p.m.
According to Gilbert Centre statistics, the rate of deaths from opioid-related causes, as well as emergency-room visits from opioid poisoning, are much higher in Simcoe Muskoka than the provincial average.
Statistics also show that the crude rate (per 100,000 people) for opioid overdose ER visits in 2017 was highest locally in Barrie, Penetanguishene, Orillia and Midland, based on 2016 population estimates. Barrie led the way with 204 opioid overdose visits, followed by Orillia (42), Midland (22), Innisfil (19) and Bradford West Gwillimbury (15). Penetanguishene had 13.
Angela McCuaig, Royal Victoria Regional Health Centre’s manager of addiction services, said the new RAAM facility will help fill in some service gaps, an issue that has been identified for some time.
“There are services that are offered, but they can’t meet the need, can’t meet the demand,” she said. “So they have wait lists and people are struggling.
“When they’re ready to seek help, sometimes there’s no open door,” McCuaig added. “That’s why we want to fill that gap. We can provide that opportunity for people to come in, get the help and to talk.
“Right now, it can be tough to navigate and frustrating when you can’t get to a service when you are motivated to make a change.”
McCuaig said the RAAM isn’t replacing any services already available, but staff at the clinic will work closely with other care providers.
“We want to ensure that their care beyond the clinic is continued,” she said, adding they will also work closely with family doctors as well as RVH’s withdrawal management and emergency departments.
RAAM is designed primarily for people who are seeking help to get clean right now. It doesn’t require physician’s referral and there is no fee.
“You just walk in and can be seen, get some help and get some direction,” McCuaig said.
The Ontario Telemedicine Network will be put to use by way of a secure Skype-like video in order to speak to clients who can’t get to the clinic, or to health-care professionals or staff off-site at other clinics.
Last year, there was a spike in opioid-related deaths in the region, particularly in Barrie and Orillia where there were more visits to local hospitals for substance-abuse problems.
The reason behind the increase in opioid-related deaths has been linked to more dangerous drugs available on the streets, including an influx of Fentanyl and Carfentanil, McCuaig said, “both of which are potent and deadly.
“Carfentanil is much, much stronger than Fentanyl,” she added. “It’s essentially an elephant tranquilizer.”
Those substances are being mixed in with other drugs, “so people don’t know what they are getting,” she said.
For more information on the RAAM clinic, call 705-797-3095 or toll-free 1-833-797-3095.
GILBERT CENTRE
At a different point of the care spectrum, the Gilbert Centre has applied to the province for an overdose prevention site (OPS) in Barrie in an effort to reduce the number of overdoses in the city.
The Gilbert Centre is waiting on a decision from the province, which they hope will come “in the next few weeks,” Matt Turner, harm reduction co-ordinator at the Gilbert Centre, said during a recent presentation to city council.
On Tuesday, Turner told BarrieToday the delay in receiving word on the OPS is likely due to the provincial election. He expects to get a clearer picture of the province’s new view on the worsening opioid issue on Friday when premier-designate Doug Ford takes office.
A provincial opioid strategy was announced in the fall of 2016, followed in August 2017 by the opening of Moss Park, an unsanctioned OPS. That fall, Ontario increased its supervised injection sites and needle-exchange program. In December 2017, OPS’s were allowed to operate in Ontario and, a month later, the application window opened.
On Jan. 22, 2018, staff from the Gilbert Centre, the Barrie Community Health Centre, the David Busby Street Centre and the Simcoe Muskoka District Health Unit visited KeepSIX and Moss Park overdose prevention sites.
On March 13, the Gilbert Centre and Canadian Mental Health Association (CMHA) agreed to be the applicant and co-applicant for an OPS in Barrie.
That same day, the Gilbert Centre’s board of directors approved applying for an OPS and a week later, the CMHA board of directors got on board, too.
Their application is submitted to the province April 10.
The Gilbert Centre is also looking at a plan to apply to the federal government for a supervised consumption site (SCS), which is more clinical in nature than an OPS, which Turner said could be as simple as a tent in a park or a trailer, and is designed to help long-term drug users who have been marginalized.
“You could have one and not the other,” he said of the difference between an OPS and an SCS, adding an SCS would offer more services.
There would be a public consultation as part of the SCS application, but for the OPS there is not, as the site would be deployed once it's provincially approved, said Turner, adding there would be an open house prior to its opening.
If the public is against an SCS opening in Barrie, however, Turner said people will have a chance to speak up.
“There will be lots of opportunities to give that opinion,” he said of public input around an SCS application. “If (people) want to get their pitchforks up and complain about it, they will at least have an opportunity to do that.”
The Gilbert Centre is a community-based, not-for-profit charitable organization that has been providing programs and services as the AIDS Committee of Simcoe County for close to three decades. It changed its name to the Gilbert Centre for Social and Support Services in 2015.
The Gilbert Centre currently offers a needle exchange, counselling services on how to reduce use as well as safer administration of drugs, and overdose prevention training.
“We don’t condone drug use; we want people to get care,” said Turner, adding the centre will also work in conjunction with the RAAM clinic.
The central-north area of Barrie had 10 times the rate of opioid overdose emergency-room visits in 2017 compared with the provincial average, according to the Gilbert Centre. This includes 34 visits among the homeless.
The northwest, northeast and south-central areas of Barrie all had significantly higher rates of opioid overdose ER visits in 2017 when compared to the province as a whole.
Turner said the time to act is now.
“The fact is, this is a crisis and we need to respond quickly,” Turner said. “Every overdose is preventable and we are responding as fast as we can … considering the situation.
“I’ve worked as fast as I can to get this in place, as well as to engage partners such as Barrie police, city council, the mayor’s office, the health unit (and) the board of health.”
After viewing the stats, Coun. Arif Khan asked what Markham, which has a much lower incidence of overdose, was doing differently.
“We know folks who overdose are on a lower income,” Turner said. “Barrie has the fourth-highest rent in the country, as well as other indicators of poverty.”
Khan asked Turner about the developing trends in Barrie and the catalyst behind the growing concern.
“A tainted drug supply,” Turner said quickly, “which is what we’re seeing nationally. Every municipality in Ontario, and across Canada, is seeing the same problem because of a tainted drug supply.”
Khan said he has been told Naloxone (also known as Narcan), a medication which can be administered quickly in the event of a suspected overdose, was rolled out as the “saviour of all saviours.” The councillor questioned whether this gives people “a false sense of security,” because there is a “miracle drug” that can reverse the effects of an overdose.
“Now, we don’t just see this problem in our downtown core, we don’t just see this within our most vulnerable sector, but we see this as a party-favour accessory,” Khan said.
Khan said first-responders have to “deal with this crisis on a daily basis and who have to subject their professionals to people who repeatedly subject themselves to near-death experiences, for any variety of reasons.”
Khan said it “seems to be an ill-informed decision to make this readily available to people” when they continue to use the potentially deadly drugs.
“We are hearing that is happening,” Turner said.
However, Turner also said surveys show high rates of stigma, “both from first-responders, health-care professionals, city staff and everyone.
“Stigma in general kills people, and that’s killing people on the streets of Barrie today,” he said.
“Stigma or drugs?” Khan asked.
“Both,” Turner replied.
“I think it’s an easy out, I’m sorry,” Khan said. “It’s an easy out to say that the first-responders’ stigma is killing people. I don’t think that’s the case. I think the first-responders are putting their lives on the line to help people and save their lives.”
Khan said people will continue to return to an OPS day after day, adding he’d like to see more treatment options available.
However, Turner said that’s not so easy. In his line of work, he has seen people trying to abstain and get off drugs, “but it’s a struggle. I have a client who I’ve worked with now since January, and he’s been trying to get off crystal meth since at least last year. It takes time.
“Not everyone can just quit like that and they’re done,” he added. “I would say Naloxone is comparable to an EpiPen. … Everyone is taking their own risk.
“Is Narcan a miracle drug? It is not,” Turner said. “It’s a Band-Aid, the same way EpiPens are for people who have allergies.”
Khan said he hopes advocacy groups will put greater emphasis on treatment.
“I don’t think, in isolation, a safe injection site is going to have the long-term, massive impact the community would hope for,” he said. “I think it involves treatment and I think it involves more senior levels of government, which have the resources to put a priority on it and to make sure we have a national strategy.
"Because I don’t think we can do it alone in Barrie.”
Turner said treatment is one of the five pillars for the opioid strategy, “so we are engaging treatment for our clients, as well as prevention, as well as harm reduction.
“We are treating folks for addiction,” he added. “We are trying to keep them alive just to get to treatment, but I need Naloxone to do that. I need a lot of other things.”
