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Fight against overdose crisis must do more than target prescription opioids, study says – CBC.ca

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Canada needs a new approach to tackle its overdose crisis, says the lead author of a new study that highlights a prevalence of overdoses involving non-prescribed fentanyl and stimulants in British Columbia.

The study, published on Monday in the Canadian Medical Association Journal, looked at 1,789 overdose deaths in British Columbia between 2015 and 2017 in which the coroner was able to determine the substances relevant to the deaths.

It reported that despite decreases in the prescription of opioids across the province, the death rate from illegal drug overdoses has continued to rise.

Dr. Alexis Crabtree, the study’s lead author and resident physician in public health and preventative medicine at the University of British Columbia, says it highlights what isn’t working when it comes to tackling the overdose crisis.

“What we found is that this overdose crisis is not driven by prescribed medications and de-prescribing initiatives alone won’t solve the overdose crisis,” she said in an interview.

In most cases where prescribed opioids were implicated in a death, the toxicology report also flagged the non-prescribed opioids in the person’s system, Crabtree added.

The study’s findings also highlight the declining role of prescription opioids and heroin in the overdose crisis and the rise of synthetic opioids and stimulants.

The current strategies on battling the overdose crisis “must do much more” than target de-prescribing opioids, the study concludes.

There have been more than 15,000 apparent opioid-related deaths in Canada since 2016.

British Columbia has recorded more than 5,000 deaths from illicit drug overdoses since declaring a public health emergency in 2016.

Men continue to dominate the overdose death toll, making up more than 80 per cent of deaths, with people between the ages of 31 and 49 making up the predominant number of deaths.

A safe injection site is pictured in Vancouver in 2017. More access to overdose prevention and supervised consumption sites should be some of the next steps forward in B.C.’s fight against the overdose crisis, according to a new study. (David Horemans/CBC)

Prescribed medications aren’t driving risk, study finds

One aspect that is often overlooked is the efficacy of methadone and buprenorphine, opioids used to treat opioid addiction, Crabtree said.

The study showed that few overdoses involved people with those opioids in their system, which Crabtree said she believes should make doctors feel more comfortable in prescribing them to drug users.

In B.C., the provincial government expanded the access to a safe supply of prescription drugs near the start of the COVID-19 pandemic due to concerns about the number of overdose deaths arising from isolated drug users.

That program, and subsequent concerns raised over the prescribing of illicit-alternative drugs, prompted the decision to publish the study in the Canadian Medical Assocation Journal, Crabtree said.

“A question or concern physicians have is: ‘Is the medication I’m prescribing contributing to overdoses?”’ said Crabtree.

“I can understand why people have that concern. I think these results are really reassuring that prescribed medications are not a driver of overdose risks and supports physicians to prescribe under those risk mitigation guidelines.”

Provincial Health Officer Dr. Bonnie Henry in February. In a 2019 report, Henry called for the decriminalization of possessing small amounts of drugs, saying B.C. ‘cannot wait for action at the federal level.’ (Chad Hipolito/Canadian Press)

Next steps forward

She said she agrees with the recommendations of Provincial Health Officer Dr. Bonnie Henry, who called for the decriminalization of possessing small amounts of drugs in a 2019 report.

At the time, Henry wrote that the province “cannot wait for action at the federal level.”

She reiterated those recommendations in June 2020, which saw 175 suspected overdose-related deaths.

“COVID-19 has made clear the government can act in a very fast and effective way when it prioritizes a response to a public health emergency,” said Crabtree. “I would love to see that same effectiveness applied to responding to the overdose emergency and protecting the health of people who use drugs.”

More access to overdose prevention and supervised inhalation sites should be some of the next steps forward both in B.C. and across the country, she added.

The federal government launched a national consultation on supervised consumption sites last week, seeking comments from a variety of Canadians, including those who operate the sites and those who use them.

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1 new COVID-19 death, 58 new cases in Ottawa – CBC.ca

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Ottawa Public Health is reporting 58 new COVID-19 cases Sunday and one new death.

The city’s death toll now stands at 281.  There have been 4,063 cases of COVID-19 recorded in the nation’s capital since the start of the pandemic — and of those, 3,207 are considered resolved, approximately 79 per cent. 

Unlike yesterday, the majority of Sunday’s 58 cases are in people over age 30. 

There are now 575 confirmed active cases in the city, up eight since yesterday and an increase of 90 since the same time last week.

There are also 39 ongoing outbreaks at city institutions like long-term care facilities, child-care centres and schools.

Ontario reports 491 new cases, highest since May

The reports from OPH don’t necessarily reflect how many people tested positive for COVID-19 on the day they’re made public; rather, they indicate the number of new cases OPH is notified of as of 2 p.m. the previous day.

Provincewide, another 491 new cases of COVID-19 were reported Sunday, the highest number since May 2, and two new deaths.

As of 10:30 a.m., there had been 2,839 deaths in Ontario from COVID-19, according to provincial figures.

In western Quebec, meanwhile, health officials have confirmed 14 new cases since yesterday.

The region has had 1,265 cases of COVID-19 and 34 deaths since the pandemic began.

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Three employees of Regulars Bar on King Street West test positive for COVID-19 – Toronto Star

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Three staff at the restaurant Regulars Bar on King St. West have tested positive for COVID-19, according to Toronto Public Health.

The period for the potential exposure for those visiting the bar, 668 King St. W., is between Sept. 13 and Sept. 22, according to TPH’s news release issued Sunday. According to TPH, about 600 people may have visited during that span.

TPH said it has followed up with individuals that have been in close contacts with three employees that tested positive and have been asked to self-isolate for 14 days and get tested. Individuals that have visited Regulars Bar during Sept. 13 and Sept. 22 are considered as low risk, said TPH, but should monitor themselves for symptoms for 14 days after their visit.

Meanwhile, Reyna on King, a restaurant on King Street East, announced via Instagram Sunday that a staffer had tested positive for COVID-19. The employee last worked on Wednesday, Sept. 24. In the post, the restaurant said it will be closing down its doors until further notice and has since cancelled all reservations for the next couple of days.

On Saturday, the city of Toronto said it had shut down three King Street restaurants after COVID-19 violations.

Those restaurants include MARBL, Mexican eatery Caza Mezcal, and sprawling craft-beer purveyor King Taps.

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Ontario reports 491 new cases of COVID-19, highest daily increase since early May – CBC.ca

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Ontario reported that the province had 491 new cases of COVID-19 on Sunday, the highest number since May 2.

Toronto, Peel Region, Ottawa and York Region led the daily case count, according to Ontario Health Minister Christine Elliott.

Elliott said in a tweet that there are 137 new cases in Toronto, 131 in Peel Region, 58 in Ottawa and 58 in York Region.

A full 63 per cent of cases are among people under the age of 40.

The province processed more than 42,500 tests on Saturday.

As of Sunday at 10:30 a.m., a total of 2,839 people in Ontario had died of COVID-19, according to provincial figures.

A total of 112 are hospitalized, a number that is on the rise. On Saturday, the province reported that there were 100 people in hospital. 

Of the people in hospital, the province says 28 are in intensive care units and 16 of them are on ventilators. The number of people on ventilators has increased by one since Saturday.

Ontario has a cumulative total of 49,831 cases, of which 42,796 are marked as resolved. 

Rise in new cases ‘of great concern,’ province says

Ivana Yelich, spokesperson for Ontario Premier Doug Ford, said the provincial government is concerned about the increase in the daily case count.

“The rise in cases continues to be of great concern. That is why our government took action to tighten public health measures on private social gatherings as well as restaurants and bars. It’s important to note that the results of these actions will not be seen immediately,” Yelich said on Sunday.

“It is, however, critical that Ontarians continue to do their part in controlling the spread of COVID-19 by following the rules that are in place,” she added.

“We will continue to monitor the situation very closely and act on the public health advice of the Chief Medical Office of Health and the COVID-19 Command Table.”

The tightening of public health measures to slow the spread of the virus took effect in the last 10 days in Ontario.

Ontario’s bars and restaurants, for example, can no longer serve alcohol after 11 p.m. as of this weekend. Strip clubs have also been closed.

As well, private social gatherings across Ontario are now limited to 10 people indoors and 25 people outdoors. That limit was imposed on Sept. 19.

In a separate statement, the Ontario health ministry said it is keeping a close eye on the number of hospitalizations and is continuing to build capacity in the health care system.

“We are in the process of rolling out our comprehensive fall preparedness plan, which includes public health measures to prepare the health system for a second wave of COVID-19,” the health ministry said.

A closed sign is visible in the window of MARBL restaurant in downtown Toronto. Toronto Public Health has ordered three King Street West restaurant, including this one, to close as it seeks to protect the public from the spread of COVID-19. (Robert Krbavac/CBC)

Toronto Public Health closes 3 restaurants

In Toronto, where 1,178 have died of the virus as of Friday, Toronto Public Health (TPH) has temporarily closed three downtown restaurants to protect the public from COVID-19.

MARBL, King Taps and Casa Mezcal received orders on Friday night to close. A fourth is being served with an order.

TPH is notifying staff and patrons of two other establishments, Yonge Street Warehouse and Regulars Bar, this weekend that they may have been exposed to COVID-19. Seven cases are linked to Yonge Street Warehouse, while three cases are linked to Regulars Bar.

Individual protective measures matter, health officer says

On Sunday, Dr. Theresa Tam, Canada’s chief public health officer, said in a statement that, as of Friday, an average of 1,175 cases were being reported daily across Canada over a seven-day period.

She said labs across Canada continue to test at a high rate, with an average of nearly 70,000 people tested daily last week and 1.4 per cent of these testing positive.

“As we head into another week, we need to be vigilant about rising cases and increasing hospitalizations, particularly in areas where cases are increasing most rapidly,” Tam said.

“Surges in cases, leading to increases in hospitalizations can quickly overwhelm public health and healthcare system resources in localized areas, while increasing the likelihood of spread to more areas.”

People wait in a line for COVID-19 testing in Toronto. Dr. Theresa Tam, Canada’s chief public health officer, said abs across Canada continue to test at a high rate, with an average of nearly 70,000 people tested daily last week. (Evan Mitsui/CBC)

Tam said every protective measure that Canadians can take matters to lower the overall rate of infection in communities because every person that people encounter brings a “whole network of contacts history with them.”

Reducing the number, duration and closeness of encounters makes a difference, she added.

“The quickest and safest way for Canada to get back on the slow burn is for us all to for us to take every measure during every moment of our day, and always act in a way that can prevent the spread of illness to others,” Tam said.

That means keeping a two metre distance from others outside of individual bubbles, frequent hand washing, wearing a mask where appropriate, limiting the amount of time and number of people in close contact, choosing lower risk settings or situations where public health measures are in place whenever possible.


Still have questions about COVID-19? These CBC News stories will help.

Is another lockdown coming in Ontario? What do we know about the Ford government’s fall plan?

CBC Queen’s Park reporter Mike Crawley obtained a draft copy of the plan

What’s the latest on where I should get tested?

It’s confusing, but here’s an explainer complete with a flow chart

What’s the most recent guidance on mask use?

Reporter Lauren Pelley took a look at what the experts are advising

What should I do about my COVID bubble?

With cases going up, even small gatherings are getting riskier

Who is getting COVID-19?

CBC News crunched the data from across Canada to get the clearest picture possible

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