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'The drug is the devil and the devil has control'

Overdose calls almost double in 2017 in Simcoe County
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Front line experts from the medical field delivered straight talk and sobering statistics at a Community Lecture Series at Royal Victoria Regional Health Centre.

The event, titled Opioid Crisis in Simcoe County, was the first if its kind held at the hospital auditorium and the lecture Wednesday night attracted a large turnout.

"It is a crisis. It is an epidemic. And it's just on the news. It is here in our city. It's here in our neighbourhoods. It's getting to be like cancer where everyone knows someone who is touched by it in some way," said Dr. Chris Martin, a physician in Emergency Medicine and Intensive Care at RVH.

The goal of the lecture was to equip the community with information on current and trending health topics, Martin said. 

One of the speakers was Dr. Joey Rampton, an ER physician for 23 years, former chief of ER at RVH, addiction medical specialist for 15 years and chronic pain specialist for 13 years. 

Dr. Rampton described how in his career, there has been a big change in the last six months.

"We used to see opioid toxicity, one a year typically and in the last six months on a shift that I work, I'll see 3 to 6 a shift," said Rampton who also runs an addiction clinic. 

"In my population of addiction I would consider 2 to 3 percent of my patients street people. The rest are you guys sitting here. I'm telling you it's everybody. I'm pretty sure there's no one here not touched by it."

"It is devastating because the drug is the devil and the devil has control."

Kristen Gilmartin, Clinical Programs Supervisor for the County of Simcoe Health and Emergency Services and a primary and advanced care paramedic for 15 years presented disturbing stats from her front line perspective.

Overdose calls in Simcoe County in 2017 that came through 911 saw a spike in June that officials can't explain 

"Prior to that time we were experiencing about 30 overdose calls a week. Since that time we have been up to about 55 overdose calls per week," said Gilmartin. 

In 2017, overdose calls account for 2.8 percent of paramedics total call volume, she said, while In previous years- 2015 and 2016 - the overdose calls accounted for about 1.3 percent.

"So almost double in 2017," she said. 

The Top 6 municipalities for overdose calls were Barrie at 49 percent, 10 percent in Orillia 5 percent in Innisfil and Wasaga Beach and 4 percent in Colllingwood and New Tecumseth.

The top 3 cities where Narcan was given were 66 percent in Barrie, 6 percent in Orillia and 5 percent in Innisfil.

The larger populations can account for the bigger numbers and she noted a 'cycle of use.'

"Where people are using opioids, they're taking narcan and then using again, either in a way to try to enhance the high or as part of a party game. It's a very difficult situation to wrap your head around and understand where people are coming from because certainly we are exposed to people who overdose on opioids unintentionally and lose their lives. So to try to understand it why people would use it as a game is very difficult to process mentally," Gilmartin said.

"We do see some patients on a weekly basis where they go through this similar overdose cycles and we do see some patients on a daily basis as well," she noted. 

Dr. Rampton said the public health message for drug users not to use alone and be equipped with the opioid antidote narcan is part of the trend 

"Most of them now know, to stay alive, because they're not suicidal these people," said Rampton. "They want to stay alive but what they'll do, they need their addiction fix and they need the high and there's nothing like fentanyl. So they will go and they will do a little bit. Two of them together. They go one at a time, a little bit first and they will not give narcan unless you turn blue," said Rampton. 

"You could be unconscious and barely breathing. They will just sit and watch you because you have the ultimate high. You start turning blue, they'll get Narcan."

"There's lot of them that overdose 5, 6, 7 times in a week.  They go through narcan like there's no tomorrow. Narcan in that aspect is not the answer."

The experts spoke of how drugs are being cut with fentanyl, including marijuana, to unknowingly hook people.

"They put it in marijuana because you get hooked on it.  The person taking that marijuana doesn't understand they're now becoming an opioid dependent person because when they don't take their pot, they don't feel very well. When they smoke Larry's pot, 'I don't feel very good.' They'll go back to the other guy, 'I want your stuff. It's the best high,'" Rampton said.

The experts, which also included Angela McCuaig, Manager, RVH Addiction Services, all agreed more funding is critical for addiction services, long-term maintenance programs and housing and shelters. 

Solutions presented by Rampton included making possession of pill presses a criminal offence and stiff sentences for fentanyl dealers.

"You should just throw them in jail for at least ten years. If you're the dealer and you're selling stuff because you know that what you're selling is probably going to kill that person, or can."

Community members Wes and Lindsay who have battled addiction and survived also spoke, telling the audience that society needs to overcome the stigma of methadone use as a way of staying clean.