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Ontario Harm Reduction Network

The Ontario Harm Reduction Network (OHRN) supports harm reduction efforts in Ontario by providing training, networking opportunities and consultations to service providers and agencies.

A message from OHRN

Hello OHRN stakeholders & friends,

We hope you were able to enjoy some sun this summer. This newsletter contains a brief recap of some of what we’ve been up to over the summer, as well as relevant or related articles, reports and events.

We are currently in the process of hiring for a Knowledge Exchange Lead as Christian Hui left at the end of August. Before he left, Christian lead the development of an online “cross cultural harm reduction training” series for a group of Indigenous and ethno-specific AIDS Service Organizations in Toronto. The slide decks and related resource are here: “Cross Cultural Harm Reduction Training” - please contact us if you are interested in viewing the session recordings.

We had great discussions about the intersections of race, culture, drug laws, stigma, and approaches to harm reduction. It was a co-learning environment for us as these organizations have varying histories of offering harm reduction services and engaging with PWUD and we have a limited history of engaging extensively with Indigenous and ethno-specific ASOs. A very special thanks to our Drug Culture Experts: Sam, Colin, Adrian and Ashley! The webinar series left us, and the participants, feeling optimistic about being able to scale up harm reduction efforts and engage people who use drugs across sectors as much as we can as the overdose crisis continues to escalate.

In Ontario, opioid overdose deaths, as well as stimulant deaths, have been going up year-after-year for over two decades. Drug prohibition and criminalization have contributed to an increasingly toxic illegal drug supply. More recently, necessary public health responses to COVID have unfortunately made the overdose situation even worse. To better understand the potential impacts of COVID on people who use drugs, Public Health Ontario reviewed existing evidence from other “periods of disruptions” and developed two documents, noted below, which OHRN was consulted on.

Since COVID started, drug overdose deaths in Ontario have gone up significantly - in 2019, 1,509 people died from opioid related overdose; from January to May, 2020 there were 879 confirmed or probable opioid overdose deaths (Ontario Coroner’s Office).

While we often hear about overdose deaths, there are many more non-fatal overdoses that stress the healthcare system and impact communities and individuals. These statistics aren’t just numbers - they are friends, lovers, family members, colleagues… And alongside many of these people are harm reduction workers, who are increasingly dealing with devastating loss and trauma.

In an effort to provide some support for workers, the Ontario Ministry of Health has provided support for OHRN and ABRPO to hold online discussion sessions with Vikki Reynolds – you can learn more about Vikki and her work, as well as access free resources at www.vikkireynolds.ca. The discussions have been held with 4 different cohorts over the past 2 months with many participants expressing their appreciation for the unique and validating opportunity. Still, workers require a variety of opportunities for debrief and support that responds to their needs, and much more and still needed.

Increasingly there is public recognition that prohibition and criminalization have not only lead to a failed “war on drugs”, they are making things worse. With more recent conversations about defunding and reallocating police resources, we hope to see a new approach in how we think about drug use in society.

Upcoming and Ongoing

Webinar: Harm Reduction Satellite Sites Program Guide Launch

Save the date: Monday, October 26, 2020 - 1:00pm (Details TBC)

The Alliance for Healthier Communities will be hosting a webinar about this guide. Watch their site for details.

Download the guide.

Webinars: Caring for Women Living with HIV: Women-Centred HIV Care Toolkit

The Women and HIV Research Program and partners* present a two-part webinar series to launch the Women-Centred HIV Care Toolkits, providing more information on how each kit can be used.

  • Part I - Webinar for women living with HIV and community-based service providers on October 1, 2020
  • Part II - Webinar for clinicians and healthcare providers on October 6, 2020.
Register and get more information.
Black Health Summit, Tuesday, October 6, 2020 - 9:30am - 11am. Register for free (click). Women's College Hospital.

When it comes to race-based research and data, the healthcare sector is severely lacking. The result? Persistent, systemic disparities that are putting the lives, health and well-being of Black Canadians at risk.

Join leading Toronto health experts and advocates on October 6 for an in-depth panel discussion about why research focused on the unique needs of Black women and their health is vitally important, and to learn how Women's College Hospital is leading the way when it comes to closing gaps in healthcare for the Black community.

This online webinar is free of charge.

Register today.

Women, Drugs, Pregnancy and the State

Stimulus Connect, July 2020

Find more information about this webinar and other past and upcoming Stimulus Connect webinars. Recordings include the following topics: 'My safe supply'; 'Support. Don't punish'; 'COVID-19's affect on the Canadian drug market'; and 'What's new in harm reduction supply distribution?'

Indigenous Cultural Safety Collaborative Learning Series

This national webinar series provides an opportunity to share knowledge, experiences and perspectives in support of collective efforts to strengthen Indigenous cultural safety across sectors.

  • Upcoming: Status Quo: How health system design prevents impactful transformation of Indigenous patient care
  • Recording available: Spirit Bear’s Guide to Reconciliation Cindy Blackstock, PhD

Get more information about the webinars and learning series.

Webinar Recording from CATIE: Community-driven harm reduction programs in Canada

Did you miss last month's webinar? The recording is now available for viewing. This webinar highlights these novel, low-barrier approaches to harm reduction programs, how they are being delivered, and what lessons have been learned.

Voices from the field

Water - We are not the virus

Podcast from Encampment Support Network

In Toronto’s downtown eastside, Moss Park’s encampment is home to a lot of people with deep ties to the neighbourhood. The site of the city’s first overdose prevention facility—a hard-won resource that started in an unsanctioned trailer—Moss Park’s residents are used to claiming space and fighting for what they need. Relationships are important in every encampment. And in Moss Park, people go way back, but while blood may be thicker than water...you can’t drink blood. And the city isn’t delivering water. On two days of a July heatwave, residents walk us through life in the park and share strategies for living in a pandemic without access to life’s most vital resource.

Listen to the podcast.

This short 'Support. Not Stigma' video was made by the Wellington Guelph Drug Strategy in time for Overdose Awareness Day 2020.
On the frontlines of COVID-19
We know that our networks are continually changing up their response to the the dual crisis of the overdose crisis and the COVID-19 pandemic. In this quarter, we wanted to spotlight programs and workers who have been on the frontlines. 
Find COVID-19 resources

Windsor Essex Community Health Centre Hepatitis C Treatment & Support team

Windsor Essex Community Health Centre Hepatitis C Treatment & Support team is a specialized inter-professional team that works collaboratively with healthcare, and social service providers. Over the past 6 months our Outreach Team has done some amazing work within the communities we serve, in response to the COVID pandemic. We organized grocery and harm reduction delivery to those individuals in need throughout Windsor-Essex County, Chatham, Wallaceburg and Walpole Island.

Our team worked on securing grocery donations from local foodbanks and grocery stores as well as offered clients education in harm reduction and provided virtual support through our Nurse Practitioner and Social Worker. We partnered with local grass roots organizations to served over 150 individuals weekly, who are the most vulnerable in our communities.

Our team had to shift the way we worked to best support our clients and we are very proud of everyone’s flexibility and effort as we continue to shift our program to accommodate our public health crisis and still meet the needs of the clients within the communities we serve.

Connect with the team

Data

Opioid-related morbidity and mortality in Ontario

Practices of care among people who buy, use, and sell drugs in community settings

Gillian Kolla and Carol Strike, Harm Reduction Journal 2020

Conclusion: Our results suggest a potential for harm reduction programs to incorporate some people who sell drugs into programming. Taking practices of care seriously may remove some barriers to integration of people who sell drugs into harm reduction programming, and assist in the development of more pertinent interventions that understand the key role of drug buying and selling within the lives of PWUD.

Read the full report.

What’s in the Unregulated Drug Supply? An Update from Toronto’s Drug Checking Service

Between June 1 – August 31, 2020, 392 drug samples were checked by Toronto’s drug checking service. Download the full report.

Key Findings from June 1 - August 31, 2020:

  • 46% of the samples checked were expected to be fentanyl
  • Benzodiazepine or benzodiazepine-related drugs were found alongside fentanyl in 49% of the expected fentanyl samples checked
  • 18 unexpected noteworthy drugs were found alongside fentanyl – these are drugs that are highly potent, linked to overdose or other adverse effects, or may not be desired by some clients
  • 11% of other drugs not expected to be fentanyl contained unexpected noteworthy drugs

Visit the new interactive website. Having checked over 1000 samples in its first year, Toronto’s drug checking service will now publicly share regular drug market information, supporting more evidence-based harm reduction practices, policy, research, and care for people who use drugs. Information about samples checked will be updated every other week to begin. The website also houses regularly released reports and alerts.

Best Practices

Recorded Webinar: Peer engagement to inform public health action on substance use and health equity

This webinar explores the BCCDC document titled Peer engagement principles and best practices: A guide for BC health authorities and other providers as a practical tool to inform health system decisions and priorities to reduce substance use related harms.

Get more information.

Blog: How we can help keep people who use drugs alive during COVID-19

In this blog post, Matt Bonn highlights promising practices to help prevent overdoses during COVID-19 and beyond.

Resources

Public Health Ontario

Rapid Review

OHRN was consulted by Public Health Ontario on the following documents:

Impacts of the COVID-19 Pandemic on People Who Use Substances: What We Heard

Canadian Centre on Substance Use and Addiction

Summarizes consultations with people who use or have used substances, their families and friends, harm reduction workers and people providing peer support services. The consultations were held to help understand the day-to-day realities of people who use substances during the COVID-19 pandemic in Canada. Respondents identified several challenges faced by people who use substances as a result of the pandemic, as well as strategies to help mitigate some of these concerns.

Read this report from CCSA.

Safer Drug Use During COVID-19

Black CAP

Access this 'Safer Drug Use During COVID-19' poster produced by Black CAP's Toronto Urban Health Fund Harm Reduction Outreach Team, Black Health Alliance, and UofT’s Black Medical Students Association with support from the Confronting Anti-Black Racism Unit

Good Samaritan Drug Overdose Act

The Good Samaritan Drug Overdose Act: The Good, The Bad, And The Ineffective

Canadian HIV/AIDS Legal Network, June 25, 2020

In 2019, with the support of a research grant from the Law Foundation of Ontario, the Canadian HIV/AIDS Legal Network (HIV Legal Network) embarked upon a research study in Ontario to evaluate familiarity with the Good Samaritan law, and what people who have experience with drug use believe to be true about this law. In the midst of the ongoing overdose crisis in Ontario and across Canada, it is critical to understand people’s awareness of this law, how (or whether) they interact with it, and how they experience its real-world impacts.

Read the full report in English or in French.

How Structural Violence, Prohibition, and Stigma Have Paralyzed North American Responses to Opioid Overdose

Policy Forum August 2020 - AMA Journal of Ethics
Mark Tyndall, MD, ScD and Zoë Dodd, MES

As of 2020, North America is now into the fifth year of an unprecedented increase in drug overdose deaths driven by a toxic, unpredictable, and unregulated drug supply. While the genesis and drivers of and response to the opioid overdose crisis have wide regional variations, structural violence, prohibitions against illicit drug use, and stigma consistently play a central role.

Keep reading.

News
New program sees paramedics distributing naloxone: 'To be able to give these kits and then have people get revived and continue to live, that to me is an achievement in itself' - Timmins Today, September 4, 2020
Canadian drug users need us doctors to step up with safe supply - Filtermag, August 24, 2020 
Dr. Andrea Serada
London-based safe opioid supply program gets $6.5M boost from the feds: The funding will support programs aimed at helping people at risk of opioid overdose - CBC News, September 21, 2020
Canada takes an important step toward decriminalizing drugs:
Federal prosecutors told to avoid criminal prosecution in cases of simple drug possession in nearly all circumstances - NOW Magazine, August 23, 2020
New figures reveal the racial disparity in Vancouver drug charges:
The VPD "should be commended" for not prioritizing drug possession charges, says one criminologist - Vancouver Sun, August 7, 2020
From our community partners

CATIE News: Why many people may not disclose substance use to healthcare providers

Many people may not disclose substance use to their healthcare providers. Find out why in this research summary of a B.C. study.

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