Front Burner - Overdoses and a small city state of emergency

Episode Date: February 15, 2024

Last week, paramedics in Belleville, Ontario responded to 13 drug overdoses in a single hour. By the time the city declared a state of emergency two days later, the total had reached almost two dozen.So how did these near-simultaneous overdoses unfold? What caused them? And how can we stop the spikes of drug poisonings that have been happening in cities across Ontario?Dan Taekema is CBC’s reporter covering eastern Ontario communities from Belleville, to Kingston, and beyond.For transcripts of Front Burner, please visit: https://www.cbc.ca/radio/frontburner/transcriptsTranscripts of each episode will be made available by the next workday.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Damon Fairless. There was five individuals who were outside walking on the sidewalk, and all five of them collapsed at the exact same time. This is JJ Cormier, the executive Director of the John Howard Society in Belleville.

And she's describing what happened last Tuesday near a church where the society provides food and showers for vulnerable people in the area. Belleville is a city in southeastern Ontario with a population of only about 55,000. But on that day, there were 13 drug overdoses in a single hour, all within a couple square blocks. By Thursday morning, the overdoses were up to 23, and the city declared a state of emergency. The magnitude, these issues, and pressure being felt by our emergency services have reached a breaking point. Remarkably, thankfully, there were no reported fatalities, but it's not the first time Belleville has been hit by overdose surges like this. It's becoming clear that it's a problem first time Belleville has been hit by overdose surges like this. It's becoming clear that it's a problem stretching beyond the province's largest cities,

one that often puts an outsized burden on smaller communities. So what happened on the streets of Belleville last week? What caused it? And how can we stop these spikes of overdoses happening across Ontario? I'm talking to CBC's Daniel Takama, who covers a large number of communities in southeastern Ontario. He's been reporting on this, and he's here to talk about it. Hey, Dan, thanks for coming on FrontBurner. It's great to have you here. Yeah, thanks for coming on FrontBurner. It's great to have you here. Yeah, thanks for having me.

Okay, so on Tuesday last week, what was the first indication you and your colleagues had that something unusual was going on in Belleville? Yeah, so I think on our end, it really started with a media release from the police in Belleville that landed in our inbox around like 4, 4.30. So you can imagine you're kind of like winding down. It's sort of end of the day. And suddenly we get this media release that says, don't come downtown. I think that was the thing that really caught our producers eyes. On top of that, it says, you know, emergency crews have been responding to 13 overdoses in an hour. They described the situation as an overdose emergency. And very quickly, we're trying to wrap our heads around, okay, what exactly is going on? I'm on the phone scrambling to try to get a staff sergeant at the police station, talk to me what's

going on, trying to line up EMS, talk to them. And I actually reached Carl Bowker. He's the head of the paramedic service down there. And he was still on the scene when we chatted. And he said, look, I can't talk right now. Let me call you in 20 minutes. And so we caught up a little bit after that. So then, you know, that's the day of you're trying to get a sense of you in 20 minutes. And so we caught up a little bit after that. So, so then, you know, that's the day of you're trying to get a sense of what's going on. And then the next morning, as I understood it, you, you went and you talked to folks who were at the epicenter. Tell me about the accounts you got from them. What did you hear about the overdoses as they were going down? So the next morning I was there and we had heard from the emergency folks that sort of the epicenter of this, where all these people were going down,

was around Bridge Street, United Church. It's pretty central in downtown, like honestly, a stone's throw or a short walk away from City Hall. What happens is they run a drop-in there. The John Howard Society runs a drop-in where folks can do things like, you know, get a shower, eat some food. And so that's where I started. I pulled up probably around 8, 8.30 in the morning, and there were already a lot of folks up front. And as soon as I approached, they knew why I was there. I was introducing myself and people were saying, yeah, you're here about what happened yesterday. the afternoon before, and you could tell that it was really difficult for him to talk about. You know, he was kind of fighting through some things as we were chatting, but he wanted to talk about it because a lot of the people involved were his friends. There was fire trucks, there were people everywhere, and there was cops,

people leaving on structures, and they're all my friends. Like, I know every one of them. It's a tough, tough goal. What he was describing and what J.J. Cormier, who was the head of the John Howard Society there, she told me later, they both described these scenes where one minute everybody's milling around on the sidewalk and the next minute people start to drop. Yeah, people dying on the sidewalk, basically.

Going out on stretchers, ambulance, left, right and center. It was ugly. Yeah, they had seen overdoses before. They'd seen suspected drug poisonings before. But absolutely nothing like this. All kinds of people at the same time going down. This is happening in a city. It's a small city. There's 55,000 people roughly there, a little over that. So those 13 doses in an hour, like what kind of strain was that on Belleville's emergency services? Yeah, absolutely. And I think that goes back to what, you know, the head of EMS there, Carl, was telling me.

You know, I called him in the midst of it. Think about that. Like the head of your EMS service is one of the people responding. So kind of underlines it, right? He was telling me that, you know, on a normal day, they have seven ambulances, period. To the whole city? Yeah, even beyond the city, right? They cover kind of the Quinte Hastings region. So seven ambulances across the whole area. And at one point, they had seven calls

at the exact same time. It overwhelms all our resources. Like on day shifts, we only have seven ambulances in Belleville. So we're pulling outside resources in to kind of support that. It's overwhelming police and fire services, fire there alongside us responding because we're getting overwhelmed. So they're frustrated, police are frustrated, and so are we. And we're just looking for solutions to this issue. And at one point, police actually shut down a section of the street by the church. And they kind of gave two reasons for that. One is they said to give emergency crews space to do their work because there were so many ambulances

in and out at the same time. And also because these people who were experiencing these overdoses, there was some sort of unusual behavior and they wanted to make sure, you know, that traffic heading through the area, that there weren't safety concerns around that too. So the picture I'm getting is that like,

we've got in addition to 13 folks overdosing in an hour, it's also it doesn't quite fit the pattern of a typical overdose. So what do we know about what caused this? Yeah, and I think that is the big question, right? So there have been conversations in other communities thinking of places like Toronto, Ottawa, sort of the bigger centers. And recently, health officials there have been talking about these animal tranquilizers, ones called xylosine. Highly potent animal tranquilizer has been found circulating in Toronto's unregulated drug supply. One is only approved for use on animals, while the others used on both humans and animals for sedation and pain relief. And these are substances that are usually used to sedate,

like think like a cow or a horse, like big animals. And recently they've been found in the drug supply in those communities. Now, I want to be clear that folks in Belleville, they don't know exactly what they were dealing with. And I think it's important to underline that. But, you know, the medical officer of health for the region, he said it's pretty clear to him that there was some sort of tainted substance or filler in here.

And the other day when I spoke again with the paramedic chief, he said his suspicion is some sort of strong sedative. And the reason they believe that's the case is that with these overdoses, folks weren't responding to Narcan or Naloxone, right? So that's what can reverse the effect of an overdose. And particularly, I mean, this was tainted drugs, so you weren't seeing the Narcan working. We still get a high... That is a behavior that's been spotted in these other cities where these tranquilizers were involved. So that really ratchets up the danger factor because it's one thing to be able to administer Naloxone and bring somebody back. It's another when you can't, and that's when you get so many hospitalizations, which is what they were dealing with.

In terms of the pattern of overdose, the speculation is that it's an overdose of this unknown other thing potentially cut in with what people are typically taking. That's kind of the picture we're getting. Yeah. And I chatted with Justine McIsaac. She runs the supervised injection site here in Kingston. And what sheatted with Justine McIsaac. She runs the supervised injection site here in Kingston. And what she did is she really outlined for me the difference between a drug poisoning and an overdose. And I think that's sort of at the core here, right? That an overdose is somebody over consumes and yeah, likely an opiate or fentanyl or something like that. Drug poisoning is when somebody is consuming what would be a typical amount,

but there's something else in there. And so there's really dire consequences as a result. Substance itself is not consistent and toxic. So you could use as little as possible and still experience an overdose. After this kind of unfolds a couple days after on Thursday, Belleville's mayor, Neil Ellis, he declared a state of emergency. So why did he take that step, the state of emergency? Yeah, very quickly, the mayor and other officials were saying, like, look, this is too big for Belleville to handle on its own. We need provincial help. We need help from other levels of government.

We need a plan from the provincial government. And as much as I hate to say things is some of these things, all three levels of government have to work together. But there's a crisis out there. And when you look at... And I think really that is what's at the core of what they're asking for. By declaring this emergency, they're hoping to raise the alarm on it and make sure people take notice. We need to be part of a larger plan focusing on harm reduction and rehabilitation. As a municipality, we are ready to help and do whatever we can to be part of the solution, but we need some guidance from upper levels of government. And they have kind of

two specific asks that came with that declaration. The first is they've bought this old banquet hall in town, and what they want to do is turn that into a community hub. Think of a place like the drop-in at the church where that was sort of the epicenter of all this, but it can provide, you know, wraparound services. So everything from addiction support to showers and meals, but also kind of employment and other kind of supports. And Belleville's already put $2 million of their own into that. They asked the province for help six months ago with it, and they hadn't heard anything back. So their hope is, for help six months ago with it, and they hadn't heard anything back. So their hope is, look,

we've put 50% of what's needed into this property. Can you come through provincial government with the other $2 million and we can get this up and going? And then the other thing they're asking for is a detox center. So somewhere that can help people afterwards. I think that was something that was really underlined is that communities of this size, they have emergency resources that can respond when somebody collapses, but it's the what comes after, you know, you're not just patting somebody on the back and saying, okay, you know, you're done your time in hospital, good luck out there. They want to actually look toward a solution instead of just that on the spot care. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization.

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I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Cops. Belleville's not responding just to this, you know, this really alarming thing that happened last week, but there's a bigger picture here, right? So there's been a surge of overdoses in Belleville recently, like over the last few months, right? Yeah, exactly. This isn't the first time. And in fact, it was described as the latest surge or the latest spike rather than a first time event. And this goes back to November when a very similar media conference to what was held last week was held hosted by police. And they were talking about what they described as an astronomical spike in overdoses. So basically, they said they usually have maybe six or seven overdoses

in a week. But between November 1st and November 6th, 7th, they saw 90. That's 90 calls about it. Yeah. And so that was the first time they brought everybody together. They started working on their strategy. And, you know, some months later, they find themselves in this situation again. I feel like the EMS services in Belleville must, I mean, I can only imagine how like stressed they've been then, if that's the case. Absolutely. And it's a couple of things, right? Is a lot of the folks who are using substances, you know, it's not a one-time thing. These folks are reoccurring patients, right? Is a lot of the folks who are using substances, you know, it's not a one-time thing. These folks are reoccurring patients, right? And so when I talked with the EMS Chief Carl about

this, he was saying the staff are feeling burnout on a couple levels. We're starting to see a lot of burnout and compassion fatigue start to affect our crews, but also with police and fire as we continually pick up the same patients day after day after day. After a while, that weighs on you too, that you feel like you're sort of in this never-ending cycle and you're not really getting anywhere. Okay, so that's Belleville, but you report on the region, one of the cities you report on in Southeast Ontario is Kingston. And there's a really interesting comparison there because a year before this happened in Belleville, Kingston declared a mental health and addictions crisis. And requests the Ontario government immediately invest in additional health care resources, including treatment and rehabilitation beds in Kingston to support those in need.

So that's a year ago. Yeah, exactly. Yeah. So what are overdoses in Kingston like now? Yeah. So what are overdoses in Kingston like now? It would be nice to be able to say, oh, well, they declared their crisis and look, now they've got it fixed. But that was the exact opposite of the message I got. I chatted with the mayor the other day and he was frank. He said, I think we're still in crisis. I think that communities across the province are in crisis.

I don't think you could describe it any other way. There were investments from the province kind of at a province-wide level, you know, more money going toward, you know, treatment and supports. But he said basically that one-time investment, as appreciated as it was. I think that the challenge is that this issue, this problem is so big that that one investment, as important as it was, is not enough to move the needle on this. So that's why we're... And he really underlines, as everybody does, that it's not just one community that's dealing

with it. You hear about this all over the province. And going back to Justine McIsaac, who runs the supervised injection site, I called her up and I said, Belleville's seeing this. Are you seeing anything like this? She was frank with me. She said, yeah, the week before Belleville declared their emergency, they had something like 30 overdoses at their site alone. That's not even counting what paramedics would have seen in the community.

And again, she described really unusual behaviors. I think she called them scary behaviors. She talked about people's, the blood draining from their faces the minute they injected. She talked about hypertension withpertensia with their heart, vomiting blood pressure, hallucinations, trying to maintain people's hearts and things like that and preventing what could potentially be a cardiac arrest.

There's these sort of frightening hallucinations and with that comes unusual behaviors, safety concerns for the folks using and for the general public. And yeah, she talked also about just how long people are staying sedated, that it's very different than what she usually sees. And so like Justine's observation, the treatment coordinator you're talking about in Kingston, is what you're saying that she's speculating there's something different about the drug supply there as well? Yeah, our conversation was around the same things. I don't know if she has a definitive explanation for what exactly was in the substances, but

she, like the folks in Belleville, suspects some sort of sedative or some sort of unusual filler or cut that is resulting in these really unusual behaviors. And again, I do want to underline that Kingston isn't alone. You know, when it comes to these communities, we're hearing from folks in London, Ontario, in Thunder Bay, in Guelph, and they're all talking about the same thing, sort of unusual behaviors, possible sedatives in the drugs, and there being really often you think of drug problems as a big city issue obviously that's kind of naive but i guess there is this emerging picture that there is something you know significant going on in the smaller and medium-sized cities in ontario so are we starting to see recognition of that yeah i think that's the case and i do think that know, they feel things more acutely

in a town the size of Belleville, in a city the size of Belleville. You know, you have an event like this downtown, you can't ignore it. You sit up and take notice, right? It's right in the heart of the city. And the big difference is what you're describing there, that, you know, a big city may have facilities, it may have that detox center, it may have treatment beds, but a place like Belleville does not. And that is where their plea is coming from. They don't have a supervised injection site, right? They are really strapped when it comes to ways to respond to this. And all they have are these emergency or, you know, traditional health care tools of a hospital. Even the prime minister has been

commenting on this, right? He got looped in, He was asked about Belleville and he underlined that this phenomenon of toxic drug supply is not just hitting our biggest cities. They're hitting small towns and communities across Ontario, right across the country. And he said that the government, the feds, need to step up and respond along along with the provinces, because these communities don't have the resources they need to respond. So we talked about what Belleville's mayor has asked for from the province. What's the province said about how they're tackling this overdose crisis? Yeah, the province points to something they call their roadmap to wellness. It's this sort of 10 year plan where they're going to rebuild the mental health system. They sent kind of boilerplate responses when I asked about the situation in Kingston versus

Belleville, just with some, you know, slight tweaks. You know, they underline $525 million since 2019 toward support services. They talk about a 5% boost in base funding for community-level organizations that do sort of mental health and addictions work. That's in the most recent budget. But as always with these kinds of things, it's hard to track down what's actually new money, what's the sort of regular investment. There were some specific things about the situation in Belleville because that really did seem to catch people's attention. So the province said that it was prioritizing

limiting the spread of what it described as a laced substance. And they said that they had contacted all 34 public health units to make sure that they had resources and a plan in place just in case they run into something similar. So for me, whether you're a city or the provincial government here, the real mystery is what's causing this? Where's it coming from? How's that being approached? Yeah, so when it comes to Belleville specifically, when there is something like this, when there's an overdose, when there's suspected drug poisoning, samples can be provided at a lab that does a determination to figure out what exactly is in there. Usually that takes some time. But in Belleville's case, the police chief said they've reached an agreement with folks at

the provincial level that they can have whatever substances they capture or anytime there's an incident like this, they can do that testing to try to figure that out and get a result in 24 to 48 hours, which is a lot quicker. And I think the hope there is that they can respond more quickly to what they're seeing on the ground and just kind of wrap their head around the reality of what they're facing. And simultaneously at a local level, the police chief in town was saying, yes, we are investigating who exactly is bringing these substances in, but that's not exactly a snap your fingers solution either, right? That takes a lot of time and in resources. And even then, you know, you cut off one head of this hydra, maybe another one appears. So, you know, the next week, the next spike

could be something completely different. Right. So we talked about how declaring a crisis didn't really solve things in Kingston. The cities are asking the province for resources. I guess I want to get a sense of like, what are the missing pieces here? Like what are advocates and organizers from different cities telling you about the missing links that could prevent overdoses, lead to better outcomes in Ontario? Yeah, you really get kind of two messages, I think, depending on who you're talking to. So sort of the official side, the mayors, the emergency services side of things, they're talking about treatment beds, right? More treatment beds, more spaces where we can care for these people after the event. So it's not just you experienced

drug poisoning. Now you're back out on the street. That detox center that Belva wants so badly, that would really help make a difference. And the police chief was saying, you know, without this element, I really feel that we're going to be in the same position that we've been in for the last few years. And we're just spinning our wheels in the sand. And truthfully, if the definition of insanity is doing the same thing over and over again and expecting a different outcome, we're there. On the other side of things, or the other thing you tend to hear is more kind of from the advocate or frontline providers of support for these folks. And they talk about needing to stabilize or improve the safety of the drug supply. And that's where decriminalization comes in.

That very quickly is brought up that if substances were decriminalized, there could be more control and more just methods of keeping these dangerous substances out of it so that folks could be a little bit more confident, I guess, in what they're using when they are injecting something. That's really what they want the focus to be on is sort of, yes, recovery, yes, improving places where people can go to actually get supports and, you know, make choices in their life, whatever they wish to do. But also starting at the root cause, which is if these drugs aren't safe, how do we get safer drugs into the hands of people who we know are going to use them?

All right, Dan, thanks for coming on and talking about this. It's great reporting. Yeah, thank you for having me. All right, that's it for today. I'm Damon Fairless. Thanks for listening to FrontBurner. I'll talk to you tomorrow. For more CBC Podcasts, go to cbc.ca slash podcasts.