Public health officials in Ottawa have no firm idea how many people have died of opioid overdoses this year, CBC News has learned.
The city doesn't track drug-related deaths, relying instead on the province to pass along data based on reports it receives from the regional coroner.
Those reports can take months to complete, but Ottawa Public Health (OPH) confirmed it hasn't seen any new data since December 2016, making the agency's latest figures on opioid deaths nearly a year out of date.
"Mortality data is always an important part of looking at the bigger picture, but it is only one part," said Andrew Hendriks, OPH's director for health protection.
"And so we look at morbidity-related issues [such as] substance use, overdoses, non-fatal overdoses. So you have to piece all that data together."
The regional supervising coroner for Ottawa told CBC she has submitted the figures for opioid-related deaths that occurred as recently as this summer to the province.
CBC requested that information directly from the coroner, but was told Monday it would take several days to produce.
Only partial data available
The province recently stated there were 336 opioid-related deaths across Ontario from May to July 2017, up from 201 during the same period last year. However the province hasn't released a geographic breakdown of those 336 deaths, so officials here have no idea of the scope of crisis in their own city.
In turn, Public Health Ontario's interactive opioid tracker attributes the regional data it collects — including the number of deaths due to opioid overdose — to OPH. The tracker currently has no data for deaths in Ottawa in 2017.
The lack of available information doesn't appear to bother OPH, however.
"It takes a while for coroners to do their investigations and make sure they provide accurate and high-quality data to us — and that's really the most important thing," Hendriks told CBC News on Monday.
"We're not sitting and waiting on any data point. Our focus and responsibility is being out on the ground, on the front lines, and responding to opioid overdoses in our community."
Tracking ER visits
The city does track suspected drug-related hospital visits, and estimates more than 2,500 emergency room visits so far in 2017 have been opioid-related.
However front-line workers say few overdoses result in 911 calls because drug users still fear legal repercussions, so those hospital visits could represent the tip of the iceberg.
While "fresh" 2017 data — already months old — is expected soon, no numbers will be released for January to April. That's because the coroner changed the procedure for toxicology reporting in May, rendering earlier autopsies inconclusive.
"Last year we understood the theory of the opioid crisis. We're living it now," Wendy Muckle, executive director of Ottawa Inner City Health, said Friday.
Muckle said no one was expecting the opioid crisis to hit Ottawa this hard, this fast.
Fentanyl deaths quadrupled
Meanwhile workers with a street-level view of the opioid crisis say they're worried about the lack of current data.
'This fall alone I've gone to I don't know how many funerals.' - Stan Kupferschmidt, harm reduction worker
Fentanyl deaths in Ottawa have almost quadrupled from five in 2013 to 18 last year, according to the data that is available.
Deadly fentanyl and carfentanil have been found in drugs seized by Ottawa police, and a bad batch laced with the additives could kill dozens in a matter of weeks. With the delay in releasing death statistics, there is no opportunity to warn users of bad drugs currently in circulation, experts say.
"Just because of how slowly things have moved, we're always trying to stay one step ahead, but we're always one step behind," said Stan Kupferschmidt, a harm reduction worker at Somerset West Community Health Centre (SWCHC).
He told CBC News SWCHC is aware of four people who've died in the last three weeks alone, and peer workers are reversing as many as 15 overdoses each night.
"This fall alone I've gone to I don't know how many funerals."