Over 100 organizations endorse call for access to Emergency Safe Supply

Dear Hon. Deputy Premier and Minister Elliott and Hon. Minister Tibollo,

The deep impact of COVID-19 in Ontario is further complicated by another ongoing crisis - the opioid overdose and drug poisoning crisis affecting people and communities across our province. But while Health Canada has called on communities to adapt behaviours in order to contain COVID-19 and stop its community spread, people who use drugs cannot practice physical distancing without support from trusted healthcare providers.

We cannot contain the impacts of COVID-19 or the opioid crisis without adopting ambitious and forward looking strategies, like British Columbia’s new protocols providing clinical guidance to providers on expanding safe supply. The protocols ensure clinicians “support patients in mitigating competing priorities and compounded risks and enable social distancing and self-isolation measures,” to reduce and prevent the spread of COVID-19. B.C’s proactive and evidence based approach has been endorsed by Canada’s Chief Public Health Officer.

We urge you to expand access to Emergency Safe Supply in Ontario, an evidence based strategy that will reduce harms linked to the opioid crisis and provide the necessary infrastructure to help communities contain COVID-19 and actively participate in reducing the community spread of the pandemic.

Our province is ready to expand access to safe supply. As early as 2019, Ontario based providers developed Emergency Safe Supply Program protocols for providers working in primary care settings. The expertise to support the implementation of these evidence based strategies already exists in Ontario. We urge you to work with leaders in this sector in developing and immediately implementing programs that work in our context.

Here’s why it is important: there are barriers to the ability of people who use drugs (PWUD) meeting public health recommendations to practice physical distancing, limit public gatherings and practice self-isolation. PWUD cannot adapt these practices unsupported due to barriers including the criminalization of drugs and drug use, which forces PWUD to access drugs in an unregulated market -- necessitating more public interaction than is recommended in the current context. Additionally, Ontario’s opioid and overdose crisis is driven by a tainted drug supply. Harm reduction best practice guidelines tell people using drugs from unregulated markets to avoid using alone. In the context where COVID-19 prevention measures are limiting access to supervised consumption and overdose prevention services, the risk of fatal overdoses in the community increases. PWUD need viable solutions that will allow them to practice physical distancing without risking overdose and death. Without untainted substances, the risk of overdose increases exponentially. Providers in Ottawa and Toronto have already reported increases in fatal community overdoses as COVID-19 limits access to overdose prevention facilities and services.

Our province urgently needs expanded access to clinical care models of Safe Supply. These low-barrier models reach people who are alienated from other models of health care due to structural barriers. Safe Supply programs already exist in our province and other parts of Canada, keeping people connected to care, and reducing preventable deaths. As the COVID-19 pandemic escalates, Ontario needs interventions that will reduce barriers to care. We call on you to immediately expand access to safe supply to mitigate risk to communities experiencing these dual crises.

COVID-19 and the opioid crisis both present unprecedented crises. We cannot address one at the expense of the other. We urge you to implement interventions today that will enable communities to address the impact of both.

This open letter is endorsed and signed by 111 organizations and 693 individuals.

Organizational Endorsements: