Ontario’s opioid strategy outdated, auditor general says

TORONTO — Ontario’s opioid strategy, even with its new abstinence-based model for treatment, is outdated and does not serve the current needs of the people, the auditor general found in her annual report released Tuesday.

Shelley Spence said the province needs to develop a new comprehensive strategy to deal with the opioid crisis as the current one has not been updated since 2016.

More than 2,600 Ontarians died last year due to overdoses, the vast majority due to opioid toxicity.

“We concluded that the ministry does not have effective processes in place to meet the challenging and changing nature of the opioid crisis in Ontario,” Spence wrote.

Premier Doug Ford’s Progressive Conservative government has taken a hard line on drug-consumption sites, passing legislation that prohibits and closes any sites within 200 metres of a school or daycare, and effectively stops any new sites from opening.

The government fast-tracked that legislation with reduced debate time and skipped the committee stage entirely.

In their place, the government is launching 19 new “homelessness and addiction recovery treatment hubs,” plus 375 highly supportive housing units at a planned cost of $378 million.

Spence applauded that move.

“Investing more in treatment, recovery and housing is a positive development toward addressing the opioid crisis,” she said at a news conference.

But Spence said the province has not planned properly for the transition to the new hubs.

Her team reviewed internal ministry documents that warned of increasing overdoses and deaths and increased public drug use.

“They identified it as a risk, but they haven’t identified their mitigation processes around that risk,” Spence said.

Health workers, advocates and users of the sites have warned of a spike in deaths when the sites close by March 31, 2025.

The province is set to close 10 supervised consumption sites because they are too close to schools and daycares. More than 1,600 overdoses were reversed at those sites in 2022-23, the auditor general found.

Not a single person died of an overdose at those spots during the same time frame, Spence said.

Health Minister Sylvia Jones said in August when announcing the new hub model that no one would die as a result of the transition.

The ministry did not provide a thorough, evidence-based business case for the hub model and did not provide proper impact analysis or do proper consultations with all affected people, Spence found.

“The ministry has not developed plans to mitigate the risks prior to making the decision, which include the number of impacted individuals, the increased overdoses and risk of death and the financial and operational burden on emergency departments,” Spence said.

The auditor general also found multiple branches of ministries are responsible for managing different parts of the opioid crisis with no one taking the lead.

“We found that accountability is lacking and remains unclear, with no specific party being designated as a lead to oversee and co-ordinate the work, no specific goals or targets being set for different parties to work toward and no ongoing monitoring or evaluation of performance and outcomes,” Spence wrote.

Only 10 of 24 performance indicators were tracked by the province. The remainder were either not tracked at all or monitored inconsistently, Spence found.

She also found a lack of data on the number and rate of hospitalizations for opioid overdoses and the percentage of people who are prescribed opioids and develop an addiction, among other oversights.

The ministry has accepted all seven of the auditor general’s recommendations, including the need to develop a new opioid strategy.

Jones did not answer several questions Tuesday about the lack of an opioid-specific strategy, missing mitigation plans or data tracking problems. But she defended her government’s approach to the ongoing opioid crisis.

“We are enabling and investing in a model that I believe will ultimately lead to people getting some hope and getting some pathways to treatment,” Jones said at a news conference.

New Democrat and Opposition leader Marit Stiles blasted Jones for her handling of the opioid crisis, especially the move away from harm reduction and supervised consumption sites.

“More people will die, lives will not be saved in the interim and they had no intention to,” Stiles said.

“They weren’t going to look at the data, they weren’t looking at the science, they weren’t looking at the experience and they certainly didn’t want to hear from any people about how this might impact them.”

This report by The Canadian Press was first published Dec. 3, 2024.

Liam Casey and Allison Jones, The Canadian Press