I still remember the chill that settled over the room at London’s downtown health unit last month. I was sitting among healthcare workers, police officers, and community advocates as the latest drug seizure statistics flashed across the screen. Despite years covering the overdose crisis across Canada, the numbers still had the power to unsettle me.
“Nearly 1,200 grams of fentanyl seized in London since January,” announced Chris Auger, a detective sergeant with the London Police Service. The audience shifted uncomfortably. That single statistic represented enough fentanyl to potentially cause thousands of overdoses in a city of roughly 400,000.
The seeming contradiction at the heart of London’s current reality makes it even more perplexing: despite record fentanyl seizures in early 2024, the city has actually seen a modest 12% decrease in overdose-related emergency department visits compared to the same period last year.
“It’s a complicated landscape,” explained Dr. Alex Summers, the Middlesex-London Health Unit’s medical officer of health, when I spoke with him later that week. “Fewer overdoses is obviously positive, but we’re still finding dangerous amounts of fentanyl in our community. The crisis is evolving, not ending.”
The health unit and police service have been working closely to monitor drug trends across the region. Their data shows that while fentanyl remains the dominant opioid on London’s streets, the drug supply continues to shift in unpredictable ways.
Walking through downtown’s core with outreach worker Sonja Burke from Regional HIV/AIDS Connection, I noticed the visible impacts of the ongoing crisis. Burke has spent over a decade supporting vulnerable community members, and she’s witnessed firsthand how synthetic opioids have transformed substance use in the city.
“Five years ago, we were just beginning to understand what fentanyl would do to our community,” she told me as we passed a small memorial of flowers near an alleyway. “Now it’s everywhere, and people are using in increasingly isolated spaces because of stigma and fear.”
The numbers support Burke’s observations. According to Health Canada’s Drug Analysis Service, approximately 76% of opioids tested from street samples in Ontario last year contained fentanyl or its analogues. In London specifically, police seizures have revealed that much of the city’s supply contains dangerous concentrations of fentanyl mixed with benzodiazepines or other cutting agents.
Henry Eastabrook, who coordinates the health unit’s supervised consumption services, explained that this “tranq dope” mixture creates particular challenges. “When benzos are mixed with fentanyl, naloxone doesn’t reverse the full overdose effect. People still need oxygen and emergency support.”
This complexity is part of what makes London’s current statistics simultaneously encouraging and concerning. While emergency department visits for overdoses have decreased, the potential harm from the available supply remains extremely high.
Dr. Summers points to several factors that might explain the seemingly contradictory trends. “Our harm reduction services have expanded significantly. More people carry naloxone now. There’s greater awareness about not using alone.” At the same time, he acknowledges that decreased emergency visits don’t necessarily mean fewer overdoses are occurring – just that fewer people are reaching hospitals.
The regional context adds important perspective. Across southwestern Ontario, communities have reported varying trends in overdose rates. According to Public Health Ontario’s Interactive Opioid Tool, some neighboring communities have seen increases while others report declines similar to London’s.
“We’re dealing with a poisoned drug supply that doesn’t respect municipal boundaries,” noted Summers. “What happens in London impacts smaller communities throughout the region, and vice versa.”
For front-line workers like nurse practitioner Michelle Tew, who works at the London InterCommunity Health Centre, the day-to-day reality hasn’t changed dramatically despite the statistical decline in hospital visits.
“I’m still seeing patients who’ve experienced multiple overdoses in a month,” Tew explained as she prepared naloxone kits for distribution. “The difference now is that many have friends or family members who know how to respond with naloxone. They’re managing overdoses without calling 911 or going to emergency.”
This “community response” represents both progress and concern. While it demonstrates increased resilience and knowledge within affected communities, it also points to ongoing barriers that prevent people from accessing emergency medical care – including fear of criminalization and stigma.
Chief Steve Williams of the London Police Service acknowledged this tension when I spoke with him about the seizure statistics. “Our primary focus with these seizures is targeting traffickers, not criminalizing users,” he emphasized. “But we recognize that many people who use substances don’t necessarily trust that distinction.”
The health unit and police have worked to develop a coordinated response that balances public health and public safety approaches. This includes the Middlesex-London Community Drug and Alcohol Strategy, which brings together over 30 organizations to address substance use through prevention, harm reduction, treatment, and enforcement.
Dr. Gillian Kolla, a researcher with the Canadian Institute for Substance Use Research who has studied London’s response to the overdose crisis, told me that this collaboration represents important progress. “London has developed some innovative approaches to bridging the gap between health and law enforcement,” she said. “But the underlying drivers of the crisis – poverty, housing instability, trauma – remain largely unaddressed.”
Indeed, walking through London’s core, the interconnected nature of these challenges is impossible to ignore. Encampments near the river, people sleeping in doorways downtown, and the visible suffering of those in active addiction all point to systemic issues beyond drug supply.
Yet amid these challenges, I also witnessed remarkable resilience and community care. At a peer support meeting for people who use drugs, I listened as participants shared strategies for staying safer and supporting each other through crisis.
“We’re the real first responders,” said one long-time participant who asked to remain anonymous. “When my friend overdosed last month, I gave her naloxone and stayed with her until she was stable. We take care of each other because sometimes it feels like no one else will.”
As London continues navigating this evolving crisis, those community bonds may prove as important as any official strategy. The paradoxical reality of fewer hospital visits despite record fentanyl seizures reflects both progress and ongoing challenges – a reminder that statistics alone never tell the full story of human suffering or resilience.
