Outside the entrance to the community warming shelter on the north-side downtown core in Thunder Bay, Ont., paramedics respond to a suspected overdose.
Staff at Elevate NWO, a community-based harm reduction organization in northwestern Ontario, had called 911 after an individual was non-responsive in its lobby.
At the same time, staff were called a block up the street because there was another person who was non-responsive.
A day earlier, someone overdosed in the organization’s parking lot, Elevate NWO executive director Holly Gauvin said. Two weeks earlier, someone had overdosed in the bathroom.
“That’s not uncommon for us over the last two years. We’ve been in this location for about six years now, and we’ve never seen numbers like we’re seeing now.”
In 2021, it’s suspected 118 people died from an opioid-related overdose in the Thunder Bay district alone, according to the most recent numbers from Ontario’s chief coroner.
That’s one person dying nearly every three days last year.
When talking about the opioid crisis, B.C. is often mentioned, as six years ago, the province declared a public health emergency because of drug-related deaths. Since then, the situation seems to have worsened.
On a per-capita basis, however, more people died in Thunder Bay than in Vancouver, as well as every other public health unit in Ontario.
The Thunder Bay District Health Unit’s catchment area had 76.3 deaths per 100,000 population in 2021, while the Vancouver health service delivery had 72.6 deaths per 100,000 population, according to public data released by the coroner’s offices in Ontario and British Columbia.
The situation in the Thunder Bay district has left front-line organizations scrambling to save lives while navigating a social services landscape vastly altered by building closures and other pandemic-related restrictions.
Elevate NWO is a prime example. Traditionally a harm reduction organization focused on providing HIV and hepatitis C treatment, care and support, it expanded its mandate considerably to create safe spaces for all community members during the pandemic.
Elevate NWO opened and expanded a warming centre — one of two in Thunder Bay this past winter — so people could learn more about harm reduction and access resources like clean needles to reduce the transmission of diseases.
“Last month alone, we saw 1,600 people through our doors. That’s with the same staffing levels that we had seven years ago, when we might have seen 30 people through our doors on a busy day,” Gauvin said, adding an important addition to their team was a First Nations elder who provides culturally safe supports and teachings.
The organization also moved into the supportive housing field, as it opened “harm reduction housing” through funding from the Thunder Bay Indigenous Friendship Centre and the District Social Services Administrative Board.
The housing consists of three clusters of five-bedroom units — each person has a bedroom and bathroom, and a common space is shared. Instead of opening up rooms to individuals, Gauvin said, they focus on bringing established communities of people who are homeless into the apartments.
“Because they’re part of a community when they move into the units, they naturally watch each other’s backs. So there is an opportunity for somebody to say, ‘Hey, I’m going to be using some substances tonight. Can you watch out for me?’
“But I’ll say, even with that precaution in there, we have had some losses,” added Gauvin. “That is just how toxic the substances are. That is just how dangerous it has become, and why we need to continue to push for safer supply here in Thunder Bay.”
A spring 2021 study out of Lakehead University paints a picture of just how deadly the supply of drugs in Thunder Bay has become.
The research also indicates two-thirds of study subjects who were taking drugs were using substances alone, without any supports or mechanisms to increase their safety.
In Thunder Bay, there’s no “safe drug supply” program, whereby eligible individuals using drugs would receive regular, prescribed doses as an alternative to the toxic, illegal drug supply.
Ways to get a handle on what’s in illicit drugs
But Juanita Lawson, chief executive officer of NorWest Community Health Centre, said the centre has purchased a new, state-of-the-art tool that could improve knowledge about what specific substances — such as benzodiazepines, fentanyl or other synthetic opioids — are in the drugs people are using.
“It’s a new cutting-edge machine that’s coming out, and I think it’s the first one in northwestern Ontario, so we’re really excited to be able to launch that,” Lawson said.
The machine, expected to arrive in the next couple of months, Lawson said, will be based at Path 525, the only safe consumption site in the city since it was opened in 2018.
She added that while a growing number of people have used Path 525 during the pandemic, NorWest is working to see how it can make the service more easily accessible for community members who do not use the safe consumption site.
NorWest previously offered fentanyl test strips, which are used to test injectable drugs, pills and powdered substances to see if there is any fentanyl in the substances. But Lawson said people were hesitant about these strips, as it required a significant amount of the drug they were using and they didn’t show the full scope of what substances were in those drugs or how toxic they were.
During the pandemic, Lawson said, NorWest also has worked to increase knowledge about the toxicity of the drug supply. That includes promoting the Lifeguard app, which provides real-time information about substances in the city and life-saving information. NorWest has also partnered with paramedics to help people saved from overdoses connect with harm reduction workers.
While the leaders of both harm-reduction organizations believe their resources and tools will improve safety for some using substances, they agree it’s not enough.
“We’re not getting there,” Gauvin said.
There still needs to be significant investments in harm reduction, supportive housing, community-based supports and poverty reduction to reverse overdose death rates, added Elevate NWO’s executive director.