While the opioid crisis in Ottawa has faced serious challenges in recent years…
Front-line workers are reporting that the additional burden of the novel coronavirus outbreak has made the situation much more dire.
“I always thought that the opioid crisis was the most intense and challenging thing I would ever experience in my career,” Anne Marie Hopkins, supervisor of peer outreach services at Ottawa Inner City Health, said. “Then coronavirus came.”
The outbreak is putting a huge strain on people who use drugs, Hopkins said, and the homeless in general. Common sources of income, such as panhandling, have all but disappeared, while drop-in centres and other popular venues are closed.
The pandemic is also putting a strain on health-care workers, as the March break and stricter guidelines regarding self-isolation and quarantine further tax an already exhausted workforce.
OIHC operates the supervised consumption site on Murray Street, at the Shepherds of Good Hope. About 80 per cent of their clients are homeless, a population in which nearly half always have a cough, with many also suffering respiratory issues and infection-related fevers, all common symptoms of COVID-19, Hopkins said.
“So it’s hard to assess for COVID symptoms, because we have people who have fevers often, who cough often and have shortness of breath.”
Clients at the consumption trailer aren’t given masks, as that could interfere with determining whether they are overdosing, she said.
“One of the ways that we look at people who are overdosing is the colour of their face, so we need to be able to see them turn blue in order to do a proper assessment, so they can’t wear masks.”
On top of that, the agency is reluctant to close any of their consumption booths, because that will only induce people using substances to do so in nearby streets, where overdoses may go unnoticed until it’s too late, Hopkins said.
In the meantime, the organization’s Telus mental health van has been repurposed as a mobile COVID-19 assessment unit, while isolated beds in the shelter have been made available for any clients suspected of contracting the illness.
OICH is also worried about a possible COVID-19 outbreak in its shelters, where large numbers of homeless people share relatively small spaces, Hopkins said.
At the Sandy Hill Community Health Centre, meanwhile, Oasis program director Rob Boyd said that, at least in these early days of the outbreak, the supply of fentanyl appears to be drying up, possibly due to self-isolation practices in drug-producing countries, coupled with a greater difficulty shipping illicit drugs.
That leaves open the possibility that people’s tolerance to substances will drop precipitously, and thus sharply increase overdose deaths when the drug supply returns to normal.
Overall, the pandemic is reducing people’s access to care that they need, Boyd said.
“Changes to the drug supply may mitigate that, but we’re really just delaying that second crisis. It’s like when you’re at the beach and you suddenly see the tide go out, and so now you know what’s coming — it’s going to be a tsunami that comes after that.
“That, I think, is where we’re at with the drug supply.”
During the coronavirus outbreak, Sandy Hill is screening clients for coughs or fevers as they arrive, and limiting services to those deemed essential, including supervised consumption, opiate agonist treatment, and two walk-in health clinics. Their drop-in centre has closed because of coronavirus, just one of many such venues, including libraries and community centres, that their clients use on a daily basis.
Sandy Hill has also reduced the number of available consumption booths from five to three, to aid social distancing and accommodate any reduction is staff due to March break or self-isolation or quarantine.
“This is all new,” Boyd said. “Our clients are frightened, and because they might not have access to the internet and email, they might not have as much information as we have.”