Simcoe Muskoka Opioid Strategy: Executive Summary 


Click here to read the full report. 

Over the last 10 years, jurisdictions across Canada and the United States have experienced a significant growth in the rates of morbidity and mortality linked to problematic opioid use. The Simcoe Muskoka region has been particularly impacted by this crisis. Opioid-related emergency department visits and deaths are occurring at rates higher than provincial averages, and are continuing to trend upwards.


In response to this issue, a wide range of sectors, including health agencies, police services, emergency response services, social services, and government at all levels, have begun to develop strategies to support local communities. Through work initiated by the Simcoe Muskoka District Health Unit (SMDHU) and the North Simcoe Muskoka Local Health Integration Network (NSM LHIN), a partnership called the Simcoe Muskoka Opioid Strategy (SMOS) was formed in May of 2017 to bring these and other sectors together. SMOS is a regional collaborative effort addressing the opioid crisis, founded on a multi-pillar approach. This includes: prevention, treatment/clinical practice, harm reduction, enforcement, and emergency management as action pillars, along with data and evaluation and lived experience as foundational pillars.


The work of SMOS is led by an overarching Steering Committee and consists of working groups based on the pillar approach. The Simcoe Muskoka Opioid Strategy Steering Committee created this report with the goal of providing a common understanding of the opioid crisis and the need for a collaborative response. It outlines a comprehensive plan for how the region can move forward together, to address this complex issue.


Divided into three parts, this report begins by providing contextual information on the opioid crisis and the history of SMOS. This background outlines the need for a collaborative opioid strategy in Simcoe Muskoka and details how this strategy aligns with existing approaches at both the federal and provincial levels. Part one also provides an overview on recent work carried out under the direction of the Aboriginal Health Circle to develop an Indigenous Led Opioid Strategy (ILOS). This work is an independent parallel strategy to SMOS, and is pivotal to help inform and direct the work of SMOS.


Part two details the SMOS Action Plan as two foundational pillars and five action pillars. One of the foundational pillars provides critical feedback and key information from the perspective of those with lived experience of opioid use. The other foundational pillar provides important information and direction on data and evaluation to inform the SMOS approach. Following the foundational pillars, the five action pillars are presented along with their associated work plans. For each action pillar prevention, treatment/clinical practice, harm reduction, enforcement and emergency management the goals are detailed, as well as short-term (2018) and long-term (2019-2020) activities that will be achieved through SMOS.


The third and final part provides an overview of next steps and future directions. This section outlines how SMOS will move forward over the next three years to deliver on the SMOS Action Plan.

Message from the Co-Chairs

Dr. Lisa Simon & Dr. Rebecca Van Iersel Co-Chairs, Simcoe Muskoka Opioid Strategy


In the spring of 2017, a wide range of interested delegates including North Simcoe Muskoka Local Health Integration Network, public health, Indigenous communities, social services, upper tier municipalities, educational institutions, corrections services, fire services, paramedic services and enforcement services came together with a common goal: to work collaboratively and comprehensively to address the opioid crisis in Simcoe and Muskoka. Recognizing the pressing nature of this issue and that we could do far more together than separately, the organizations committed to this collaborative effort towards an opioid strategy.


Now, one year on, we are pleased to share this report with our communities and partners. It is intended to provide a common understanding of the background and need for this work, as well as to outline the comprehensive action plans that have emerged from it. Much of that work is already well underway, and the remainder will be implemented in the coming years.


The burden of opioid misuse, addiction and overdose in Simcoe and Muskoka is an urgent problem. As an indication of this, rates of opioid-related deaths and emergency department visits in Simcoe Muskoka are well above provincial averages, and continue to climb substantially. Every sector involved in this work has experienced the dramatic rise in opioid-related harms in recent years. We also hear regularly from individuals with lived experience of opioid use, their family and friends, and concerned community members, about the extent of the impact of the opioid crisis in our region.


The origins of this issue are complex. Illicit opioids and addictions to them have been a part of society for centuries. The scope of our current problem has been escalated by the prevalence in recent decades of prescription opioids, combined with the more recent introduction of synthetic opioids, such as fentanyl, into the illicit drug market. The contributing factors to this deep-rooted issue reach as far back as childhood trauma, the social determinants of health, societal expectations of chronic pain management, the health care experience of those suffering from pain and addictions and the inadequacy of resources available to manage those conditions, perceptions and stigma surrounding addictions, and policy and enforcement approaches to substance use.


The complexity and magnitude of this issue demand a multi-sector response. We have organized our Simcoe Muskoka Opioid Strategy around a classic four pillar drug strategy – prevention, treatment, harm reduction, and enforcement – with the addition of emergency management, and informed by strong data, as well as the perspective of those with lived experience of opioid use. This multi-pronged approach is well aligned with federal and provincial opioid strategies and we believe it provides the foundation for a balanced, thoughtful, local response.


While this issue can seem overwhelming at times, we have also been heartened by the relentless efforts of those involved in this work, who strive to make a difference, and the accomplishments we have achieved along the way. We hope that the Simcoe Muskoka Opioid Strategy will continue to contribute to its vision of dramatically reducing the harms of opioids in our communities.