On March 28, 2024, Dr. Kieran Moore, Ontario’s Chief Medical Officer of Health, released his 2023 Annual Report, Balancing Act: An All-of-Society Approach to Addressing Substance Use and Harms.

This report examines the challenges resulting from substance use and the rise in substance-related harms, and makes evidence-based recommendations for an all-of-society approach to these pressing issues.

The report looks at the use of mood-altering substances in Ontario, with a focus on cannabis, alcohol, opioids, tobacco and vaping products that contain nicotine. Data show that during the COVID-19 pandemic, Ontario saw disturbing trends in substance use and harms, including dramatic increases in opioid-related deaths; more use of vaping products containing nicotine amongst people who had not smoked commercial tobacco; more adults using cannabis and subsequently more cannabis-related emergency department visits; a significant increase in alcohol toxicity deaths; and a growing number of youth in Grades 7 to 12 who reported using alcohol, cannabis, and vaping products more frequently.

Although the rate of cigarette smoking is declining, it is concerning that vaping has increased among youth and people who have not previously used tobacco products. Meanwhile, rates of alcohol, cannabis and opioid-related harms are also rising in Simcoe Muskoka. On average, 25 suspected overdose emergency department visits occur in our region every week and in 2023, tragically 144 people in Simcoe Muskoka died from a suspected opioid-related poisoning – most often at an age of only 25 to 44 years old. So far in 2024 (up to July 18), 98 people lost their lives to a suspected drug-related death in our communities.

Although regulated substances such as alcohol, tobacco, and cannabis are more predictable than unregulated drugs like illicit opioids, their use still leads to many hospitalizations and deaths in society given the high number of people who use them and the often-long-term nature of use. Notably, more people die from alcohol-related causes than opioids, and more deaths continue to be attributed to tobacco use than from all other substances combined. Between 2014 and 2018, there were an average of 211 alcohol-related deaths each year among people aged 15 and older in Simcoe Muskoka. Meanwhile, smoking-related health conditions caused an estimated 861 deaths, 3,516 hospitalizations and 7,058 emergency room visits annually in the region among adults aged 35 years and older.

The overwhelming toll of substance-related harms on individuals, families and communities has made it a key priority for public health and many other sectors. To address the complex range of upstream and downstream factors that contribute to substance use and its harms, a balanced approach is required. We agree with Dr. Moore when he identifies the need to involve communities, people with lived experience of substance use, all levels of government, Indigenous governments and agencies, and the health care, public health and social service sectors, while using a range of thoughtful, evidence-based strategies. The goals of this approach are to work together to build healthy families and communities and ensure people have the knowledge, skills, supports and services to lead healthy lives and avoid substance use harms – as well as the harm reduction and treatment services they need if they do use substances or develop a substance use disorder.

As an active member of the Simcoe Muskoka Drug Strategy, a partnership of agencies, organizations and individuals, SMDHU remains committed to partnering to address the harms of the current drug toxicity crisis throughout our region. The health unit also continues to deliver programs that prevent substance use by helping build healthy families and communities, including the Healthy Babies, Healthy Children program for a healthy start in life, education programs like ‘Not an Experiment’ for vaping prevention (developed by SMDHU and being implemented by 33 of Ontario’s 34 health units), and work towards creating healthy places and policies that enable people to reduce their use and harms from alcohol, cannabis, tobacco, vaping, and the unregulated drug supply. As well, the health unit provides a range of important harm reduction services.

For more information about the health unit and its programs visit smdhu.org. To speak with a public health professional, call Health Connection at 705-721-7520 or 1-877-721-7520 Monday to Friday from 8:30 a.m. to 4:30 p.m. 

Dr. Charles Gardner is the Medical Officer of Health for the Simcoe Muskoka District Health Unit.

Dr. Lisa Simon is an Associate Medical Officer of Health for the Simcoe Muskoka District Health Unit.

- 30 -