Opioids are defined as a class of drugs naturally found in the opium poppy plant and are essential in ensuring that the brain produces a broader range of effects. Medically, they are primarily used to relieve pain, suppress diarrhea, reverse the overdose of opioids, and mitigate cough. In some scenarios, they are used as replacement therapy for opioid use disorder. However, this medication has several side effects such as nausea, sedation, itchiness, and long-term use can cause unpleasant withdrawal symptoms. Euphoria also plays a vital role in attracting frequent and recreational use, which eventually leads to addiction. In Ontario, Canada, the opioid crisis is complicated health and the social issue often associated with devastating effects for families, individuals, and communities.
Opioids are among the globe’s oldest known drugs in the modern world. The earliest traces of these drugs were the paper somniferous discovered around 5700 to 5500 BC during the Neolithic period. Its seeds have also been discovered at the Cueva De Los Murcielagos in the Peninsula of Iberian and La Marmotta in the Italian Peninsula. Nevertheless, opium was also shared and well known to the Greeks as Hippocrates, and his students valued it because of its sleep induction characteristics and pain treatment (Fischer et al., 2019). However, during the Islamic Golden Age period, Avicenna was totally against opium not unless it was the last option or resort.
In Ontario, the opioid crisis has been an intricate problem that impacts individuals and the entire community. For example, in three years between 2016 and 2019, approximately 12800 Canadian citizens died because of an overdose of opioids (“Opioid- and stimulant-related harms,” 2021). Typically, this crisis is growing and developing in Canada, especially in Ontario, because it is driven by the illegal and prescription use of this form of drug. Mostly, analogs and fentanyl are responsible for accelerating the rise of opioid-related deaths in Ontario (Irvine et al., 2018). In addition, there were 16 opioid-related hospitalization complications a day and 2900 deaths in the calendar year 2016 (Irvine et al., 2018). Thus, the crisis has significantly contributed to and impacted the lives of Ontario residents and Canadian citizens.
Fentanyl and Carfentanil are regarded as the most dangerous types of opioids, and they have been found on the streets of Ontario. Any form of drug that a qualified and certified medical practitioner does not prescribe could contain a form of fentanyl and Carfentanil (Irvine et al., 2018). Legally these two types of opioids can be used to treat and manage severe pain, while their illegal use is that they might be pressed into more tiny pills and then later sold as fake opioids. As a result, they might lead to overdose and eventually death.
The opioid crisis primarily affects every region and province in Canada, but Ontario and the western provinces of British Columbia are the most affected regions. This is not a challenge that only affects individuals illegally using street drugs. Still, it is a national health concern that affects all individuals across Canada, all age groups, and all social-economic groups (Piske et al., 2020). It is also evident that in Ontario, since 1999, the prescription rates of opioid drugs have increased as it is the fourth most used drug after tobacco, alcohol, and Cannabis sativa, making it the most misused form of drug when comparing it to heroin and cocaine.
There are a variety of routes that have paved the way for the diversion of nonmedical use, which include prescription fraud and forgery, the street drug markets, and also internet purchases that have made it hard to determine the exact proportion that has been diverted or converted. According to Piske et al. (2020), the most common origin of these drugs without a prescription was a family member; however, no significant measures of the prevalence of illegal consumption of opium were detected. Thus, despite opioid overdose and use disorder being a significant challenge, social determinants can play a significant role in preventing and treating opioid use disorder.
Nonetheless, opioid use disorder (OUD) can be evaluated by examining the number of individuals seeking treatment for their levels of opioid dependence. In Ontario, the number of people enrolled in opioid agonist treatment (OAT) has significantly increased from 6000 to above 50000 (Morin et al., 2017). This implies that the province is implementing appropriate and effective policies to mitigate and control the opioid crisis. However, the opioid epidemic or crisis is quite complex as close to 50% of the individuals with OUD tend to have also mental health disorders. An illustration of this is that approximately 87% of individuals with OUD in Ontario also tend to have mental health disorders. In addition, this form of the disorder is common among individuals ranging between 15 to 34 years old (Morin et al., 2017). Thus, more effective treatment strategies should be implemented to help the affected individuals.
In Ontario, there are also cases of substance dependence and stigmatization. Canada generally lacks a consensus on this issue and appropriate and practical solutions, which is a critical barrier to addressing the opioid crisis in Ontario. An example of this is how the perception of addressing and finding practical solutions toward curbing the opioid crisis is incompatible (Fischer et al., 2019). There are also several existing discrepancies between the policy ideas and the research. Therefore, in conjunction with the national government, the Ontario healthcare stakeholders have advocated for various techniques and strategies to mitigate the opioid crisis.
The government has initiated drug prescription and monitoring programs. It has advocated for using a prescription drug monitoring program (PDMP) to identify patients misusing the prescription of opioids or any other drugs. This form of technology alerts and makes one aware of the prescription information and interventions that could be lifesaving. In addition, the national government, in collaboration with the Ontario province, patient education has improved the storage and disposal of these drugs (Fischer et al., 2019). Quality improvement programs have also been initiated and implemented. They have played a vital role in increasing the recommended prescription practices that are crucial to Canadian residents.
Nevertheless, awareness has also been created, especially on the costs associated with overdose of opioids, families and the patients, and most importantly, the risks concerning the prescription. Policymakers and individuals also play a crucial role in resisting and advocating for change regarding the opioid crisis (Fischer et al., 2019). For instance, in November 2018, a multi-year campaign was initiated to increase awareness of opioids. This was followed by the Good Samaritan Drug Overdose Act with a focus to help individuals facing stigma (“Federal actions,” 2021). Thus, the main beneficiaries of curbing the opioid crisis are Ontario residents and general Canadian citizens.
In conclusion, it is clear that despite opioid being essential in relieving pain, it is also associated with several shortcomings and has posed serious health and social problem in Ontario. The drug is often linked with nausea, vomiting, diarrhea, sedation, dizziness, constipation, and even in some scenarios respiratory depression. In addition, Ontario has ensured that individuals affected by matters surrounding opioids have been given full support by adding more front-line workers and ensuring harm reduction. They have achieved this by expanding the naloxone supply and, most importantly, creating more rapid access to addiction clinics with a 10-year funding agreement with the federal government.
References
Federal actions on opioids to date. (2021).Government of Canada. Web.
Fischer, B., Pang, M., & Tyndall, M. (2019). The opioid death crisis in Canada: Crucial lessons for public health. The Lancet Public Health, 4(2), e81-e82. Web.
Irvine, M. A., Buxton, J. A., Otterstatter, M., Balshaw, R., Gustafson, R., Tyndall, M., Kendall, P., Kerr, T., Gilbert, M., & Coombs, D. (2018). A modeling study is the distribution of take-home opioid antagonist kits during a synthetic opioid epidemic in British Columbia, Canada. The Lancet Public Health, 3(5), e218-e225. Web.
Morin, K. A., Eibl, J. K., Franklyn, A. M., & Marsh, D. C. (2017). The opioid crisis: past, present and future policy climate in Ontario, Canada. Substance abuse treatment, prevention, and policy, 12(1), 1-7. Web.
Opioid- and stimulant-related harms in Canada. (2021). Government of Canada. Web.
Piske, M., Zhou, H., Min, J. E., Hongdilokkul, N., Pearce, L. A., Homayra, F., Socias, E., McGowan, G., & Nosyk, B. (2020). The cascade of care for opioid use disorder: A retrospective study in British Columbia, Canada. Addiction, 115(8), 1482-1493. Web.