Despite 'massive shift' towards smoking over injection, Ontario has only 1 supervised drug inhalation space
Advocates and researchers say Ontario is far behind when it comes to protecting the growing number of drug users in the province who are choosing to inhale opioids rather than inject them.
"We know what we need to help support people who smoke their drugs — and we've been really, really behind the curve on it," said Gillian Kolla, an assistant professor of medicine at Memorial University, who studies drug use across Canada.
Data shared with CBC Toronto last week from the Ontario Office of the Chief Coroner shows that in 2024, just four per cent of deadly opioid overdoses are thought to have been caused by injection alone — down from 20 per cent in 2018.
That's the opposite trajectory of the statistics for inhalation alone, which are thought to be responsible for 40 per cent of last year's fatal overdoses — up from 18 per cent in 2018.
Though Kolla cautioned that the coroner's data has some uncertainty baked in, since about half of overdose fatalities are listed as having no evidence at all as to what consumption method was used, she said the growing move toward inhalation has been a clear trend in Canada for years.
Opioid toxicity deaths in Ontario where inhalation was the only mode of usenearly doubled between 2017 and 2021, according to a study carried out by Kolla and academic colleagues.
"We have multiple sources of data that are telling us about this," she told CBC Toronto.
"We can see it when we talk to harm reduction programs which distribute equipment to people who use drugs," Kolla said.
"And when we talk to people who use drugs about how their use is changing, they are also talking about how they have been moving more towards smoking."
The growing need for safer ways to inhale drugs has long been obvious to Joanne Simons, Casey House CEO.
Her specialty Toronto hospital, which serves people who have HIV or are at risk of it, runs the province's only supervised inhalation booth, installed in 2021.
"It's a very simple setup," Simons said of the small room. "There isn't anything super technical about it other than a very powerful fan that is venting any of the smoke outside of the building."
She said the hospital decided to open the booth in the first place because clientele were requesting it, and that since then, about 80 per cent of the people who arrive to use supervised consumption services at Casey House are choosing to inhale over inject.
"We're thinking about doing a second one because the need is so great," said Simons, describing the move toward smoking as a "massive shift."
Ontario's 2019 consumption and treatment services plan, which approved 15 supervised consumption sites in the province, did not include funding for inhalation booths.
At a price tag that Simons estimates around $50,000, that means only supervised consumption services that can solicit private funding and donations — like Casey House — can foot the bill to build one.
"Since we've installed it, we have had consistent interest from [other health centres] across the country, in terms of what it does," said Simons.
"I think the barrier to entry actually is the funds."
The government "does not and will never support the use of illicit drugs in public spaces," said a spokesperson for Ontario Health Minister Sylvia Jones in a statement.
"Our focus is on connecting people struggling with addictions challenges to treatment and recovery, not giving them the tools to use toxic, illegal drugs," Ema Popovic said via email.
A couple of kilometres south of Casey House, at the MAP Centre for Urban Health Solutions in St. Michael's Hospital in downtown Toronto, Dr. Ahmed Bayoumi has been examining the health implications of the shift towards inhalation.
The researchers and advocates that spoke to CBC Toronto for this story all said that part of what's been driving changing habits is the belief among people who use drugs that it's safer. So, is it?
When it comes to the risks posed by needles specifically, Bayoumi says inhalation would "clearly be safer" since it dodges the possibility of infection via dirty equipment.
The risk of overdose may also be lower, he said.
"There is some evidence that … the rate at which the drugs accumulate in the blood is slower with smoking than it is with injecting, which allows people to control the amount of drug that they're taking in more precisely," said Bayoumi.
Calls to fund safe inhalation sites have been ongoing since Liberal Kathleen Wynne was premier in the mid 2010s, said Zoë Dodd, co-organizer of the Toronto Overdose Prevention Society.
Dodd said her organization set up a supervised inhalation tent in Moss Park in 2017, where they operated unsanctioned for a year. Eventually, they moved indoors and had to give up the tent.
"We saw thousands of people through that service. And we reversed many, many overdoses within that tent itself," she said, adding that now, she and other harm reduction workers have to run outside when they're alerted to an inhalation overdose.
This spring, Doug Ford's government closed nine supervised drug consumption sites and transitioned them into HART Hubs, their new concept for treating addiction and homelessness.
The province invested over $500 million to build 28 HART Hubs across the province, according to the health minister's spokesperson.
"HART Hubs will reflect regional priorities, providing community-based, life-saving services including mental health and addiction care, primary care, social and employment services," Popovic said.
Data from the coroner shows more than 2,200 Ontarians died from opioids in 2024 – a slight dip from the last few years – and more than triple the deaths from a decade ago.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
27 minutes ago
- Yahoo
Lilly's once-weekly insulin efsitora alfa demonstrated A1C reduction and a safety profile consistent with daily insulin in multiple Phase 3 trials
Results from the fixed-dose QWINT-1 study, along with the QWINT-3 and QWINT-4 studies, reinforce efsitora's potential to simplify insulin management with weekly dosing Lilly plans to submit efsitora for the treatment of adults with type 2 diabetes to global regulatory agencies by the end of this year INDIANAPOLIS, June 22, 2025 /PRNewswire/ -- Eli Lilly and Company (NYSE: LLY) today announced detailed results from QWINT-1, QWINT-3, and QWINT-4 Phase 3 clinical trials evaluating the safety and efficacy of investigational once-weekly insulin efsitora alfa (efsitora) in adults with type 2 diabetes who used insulin for the first time, previously used daily basal insulin, and previously used daily basal insulin and mealtime insulin, respectively. In each trial, once-weekly efsitora met the primary endpoint of non-inferior A1C reduction compared to daily basal insulin. The complete results from these studies were presented at the American Diabetes Association (ADA) 85th Scientific Sessions 2025. Simultaneously, results from QWINT-1, a first-of-its-kind fixed-dose study, were published in The New England Journal of Medicine, while results from QWINT-3 and QWINT-4 were published in The Lancet. In QWINT-1, efsitora reduced A1C by 1.31% compared to 1.27% for insulin glargine at week 52 for the efficacy estimand.1,2 In the trial, efsitora was titrated to four fixed doses at four-week intervals, as needed for blood glucose control.3 In QWINT-3, efsitora reduced A1C by 0.86% compared to 0.75% for insulin degludec at week 26 for the efficacy estimand.4 In QWINT-4, efsitora reduced A1C by 1.07% compared to 1.07% for insulin glargine at week 26 for the efficacy estimand.5 In these two trials, efsitora was administered using traditional insulin dosing with adjustments based on each patient's glucose level. "The novel fixed-dose regimen used in QWINT-1 for once-weekly efsitora, which consisted of only four single-dose titration options, has the potential to facilitate and simplify insulin therapy, reducing the hesitation often associated with starting insulin to treat type 2 diabetes," said Dr. Julio Rosenstock, senior scientific advisor for Velocity Clinical Research at Medical City Dallas, clinical professor of medicine, University of Texas Southwestern Medical Center, and lead trial investigator for QWINT-1. "A simpler, once-weekly regimen with efsitora may help people with type 2 diabetes initiate and manage insulin therapy with the goal of improving blood sugar levels. Across all QWINT trials, the results showed that once-weekly efsitora controlled glucose as effectively as the most popular once-daily basal insulins." QWINT-1 Primary EndpointEfficacy Estimand Treatment-RegimenEstimand6 Primary Endpoint – A1C Reduction (Resulting A1C) at Week 52 Efsitora -1.31 % (6.92 %) -1.19 % (7.05 %) Glargine -1.27 % (6.96 %) -1.16 % (7.08 %)QWINT-3 Primary and Key Secondary EndpointsEfficacy Estimand Treatment-RegimenEstimand Primary Endpoint – A1C Reduction (Resulting A1C) at Week 26 Efsitora -0.86 % (6.93 %) -0.81 % (6.99 %) Degludec -0.75 % (7.03 %) -0.72 % (7.08 %) Key Secondary Endpoint – Rates of Clinically Significant or Severe Nocturnal Hypoglycemic Events Per Patient-Year of Exposure up to Week 787,8 Efsitora 0.11 Degludec 0.10 Key Secondary Endpoint – Percent Time in Range (70-180 mg/dL) During the FourWeeks Prior to Week 26 Efsitora 62.8 % 61.4 % Degludec 61.3 % 61.0 %QWINT-4 Primary and Key Secondary EndpointsEfficacy Estimand Treatment-Regimen Estimand Primary Endpoint – A1C Reduction (Resulting A1C) at Week 26 Efsitora -1.07 % (7.12 %) -1.01 % (7.17 %) Glargine -1.07 % (7.11 %) -1.00 % (7.18 %) Key Secondary Endpoint – Participants Achieving A1C <7% at Week 26 Without Nocturnal Hypoglycemia Efsitora 39.5 % 38.6 % Glargine 36.6 % 35.9 % Key Secondary Endpoint – Rates of Clinically Significant or Severe NocturnalHypoglycemic Events Per Patient-Year of Exposure up to Week 26 Efsitora 0.67 Glargine 1.00 "Building on Lilly's legacy of innovation in insulin therapy, once-weekly efsitora may offer a significant advancement for people with type 2 diabetes who need insulin by eliminating over 300 injections per year," said Jeff Emmick, M.D., Ph.D., senior vice president of product development at Lilly. "These results reinforce the potential for once-weekly efsitora to help reduce the overall burden of insulin therapy through a simplified treatment approach. We look forward to working with regulatory agencies to bring this innovation to patients around the world." Across the three trials, efsitora demonstrated an overall safety profile similar to two of the most commonly used daily basal insulin therapies for the treatment of type 2 diabetes. In QWINT-1, efsitora resulted in approximately 40% fewer hypoglycemic events compared to insulin glargine, with estimated combined rates of severe or clinically significant hypoglycemic events per patient-year of exposure of 0.50 with efsitora vs. 0.88 with insulin glargine at 52 weeks. In QWINT-3, these rates were 0.84 with efsitora vs. 0.74 with insulin degludec at 78 weeks. In QWINT-4, estimated combined rates of severe or clinically significant hypoglycemic events per patient-year of exposure were 6.6 with efsitora vs. 5.9 with insulin glargine at 26 weeks. Lilly plans to submit efsitora for the treatment of adults with type 2 diabetes to global regulatory agencies by the end of this year. About the QWINT clinical trial programThe QWINT Phase 3 global clinical development program for insulin efsitora alfa (efsitora) in diabetes began in 2022 and has enrolled more than 3,000 people living with type 2 diabetes across four global registration studies. QWINT-1 (NCT05662332) was a parallel-design, open-label, treat-to-target, randomized controlled clinical trial comparing the efficacy and safety of efsitora as a once-weekly basal insulin using a fixed dose escalation to daily insulin glargine for 52 weeks in insulin-naïve adults with type 2 diabetes. The trial randomized 795 participants across the U.S., Argentina and Mexico to receive efsitora once weekly or insulin glargine once daily, administered subcutaneously. Participants treated with efsitora received a starting dose of 100 units of insulin, followed by escalation to fixed dosages of 150 units, 250 units and 400 units every four weeks, as needed, until achieving a target fasting blood glucose of 80-130 mg/dL. Participants with fasting blood glucose greater than 130 mg/dL on or after 16 weeks were transferred to flexible dosing. The primary objective of the trial was to demonstrate non-inferiority in reducing A1C at week 52 with efsitora compared to daily use of insulin glargine. QWINT-3 (NCT05275400) was a multicenter, randomized, parallel-design, open-label trial comparing the efficacy and safety of efsitora as a once-weekly basal insulin to insulin degludec for 78 weeks after a three-week lead-in followed by a five-week safety follow up period, in adults with type 2 diabetes who are currently treated with basal insulin. The trial randomized 986 participants across the U.S., Argentina, Hungary, Japan, Korea, Poland, Puerto Rico, Slovakia, Spain and Taiwan to receive efsitora once weekly or insulin degludec once daily, administered subcutaneously. The primary objective of the study was to demonstrate non-inferiority in reducing A1C at week 26 with efsitora compared to insulin degludec. QWINT-4 (NCT05462756) was a parallel-design, open-label, treat-to-target, randomized controlled clinical trial comparing the efficacy and safety of efsitora as a weekly basal insulin to insulin glargine for 26 weeks in adults with type 2 diabetes who have previously been treated with basal insulin and at least two injections per day of mealtime insulin. The trial randomized 730 participants across the U.S., Argentina, Germany, India, Italy, Mexico, Puerto Rico and Spain to receive efsitora once weekly or insulin glargine once daily, both of which were administered subcutaneously along with insulin lispro. The primary objective of the trial was to demonstrate non-inferiority in reducing A1C at week 26 with efsitora compared to insulin glargine. About insulin efsitora alfaInsulin efsitora alfa (efsitora) is a once-weekly basal insulin, a fusion protein that combines a novel single-chain variant of insulin with a human IgG2 Fc domain. It is specifically designed for once-weekly subcutaneous administration, and with its low peak-to-trough ratio, it has the potential to provide more stable glucose levels (less glucose variability) throughout the week. About Lilly Lilly is a medicine company turning science into healing to make life better for people around the world. We've been pioneering life-changing discoveries for nearly 150 years, and today our medicines help tens of millions of people across the globe. Harnessing the power of biotechnology, chemistry and genetic medicine, our scientists are urgently advancing new discoveries to solve some of the world's most significant health challenges: redefining diabetes care; treating obesity and curtailing its most devastating long-term effects; advancing the fight against Alzheimer's disease; providing solutions to some of the most debilitating immune system disorders; and transforming the most difficult-to-treat cancers into manageable diseases. With each step toward a healthier world, we're motivated by one thing: making life better for millions more people. That includes delivering innovative clinical trials that reflect the diversity of our world and working to ensure our medicines are accessible and affordable. To learn more, visit and or follow us on Facebook, Instagram, and LinkedIn. P-LLY The efficacy estimand represents the treatment effect on all participants who adhered to the study drug without initiating rescue therapy for persistent severe hyperglycemia. From a baseline of 8.20% for efsitora and 8.28% for insulin glargine. Participants treated with efsitora received a starting dose of 100 units of insulin, followed by escalation to fixed dosages of 150 units, 250 units and 400 units every four weeks, as needed, until achieving a target fasting blood glucose of 80-130 mg/dL. Participants with fasting blood glucose greater than 130 mg/dL on or after 16 weeks were transferred to flexible dosing. From a baseline of 7.80% for both efsitora and insulin degludec. From a baseline of 8.18% for both efsitora and insulin glargine. The treatment-regimen estimand represents the estimated average treatment effect regardless of treatment discontinuation or introduction of rescue therapy for persistent severe hyperglycemia. Blood glucose <54 mg/dL. Nocturnal hypoglycemia was defined as any event that occurred at night between midnight and 6 a.m. Cautionary Statement Regarding Forward-Looking StatementsThis press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about insulin efsitora alfa as a potential treatment for people with type 2 diabetes and the timeline for future readouts, presentations, and other milestones relating to insulin efsitora alfa and its clinical trials and reflects Lilly's current beliefs and expectations. However, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of drug research, development, and commercialization. Among other things, there is no guarantee that future study results will be consistent with study results to date, that insulin efsitora alfa will prove to be a safe and effective treatment for type 2 diabetes, that insulin efsitora alfa will receive regulatory approval, or that Lilly will execute its strategy as expected. For further discussion of these and other risks and uncertainties that could cause actual results to differ from Lilly's expectations, see Lilly's Form 10-K and Form 10-Q filings with the United States Securities and Exchange Commission. Except as required by law, Lilly undertakes no duty to update forward-looking statements to reflect events after the date of this release. Trademarks and Trade NamesAll trademarks or trade names referred to in this press release are the property of the company, or, to the extent trademarks or trade names belonging to other companies are referenced in this press release, the property of their respective owners. Solely for convenience, the trademarks and trade names in this press release are referred to without the ® and ™ symbols, but such references should not be construed as any indicator that the company or, to the extent applicable, their respective owners will not assert, to the fullest extent under applicable law, the company's or their rights thereto. We do not intend the use or display of other companies' trademarks and trade names to imply a relationship with, or endorsement or sponsorship of us by, any other companies. Refer to: Niki Biro; niki_biro@ 317-358-9074 (Media)Michael Czapar; czapar_michael_c@ 317-617-0983 (Investors) View original content to download multimedia: SOURCE Eli Lilly and Company Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
an hour ago
- Yahoo
'RHONJ' Star Dolores Catania Speaks Out After Health Emergency Leads To Surgery: 'I'm Too Young To Have This'
"" star is opening up about a frightening health scare that led to a secret heart surgery, and she's urging women everywhere to take their heart health seriously. In an emotional Instagram post over the weekend, the 54-year-old reality star revealed she was recently diagnosed with atrial fibrillation (AFib), a type of irregular heartbeat that can significantly increase the risk of stroke or heart attack. Dolores Catania, who has kept the condition private until now, shared video footage of her boyfriend, Paulie Connell, driving her to the hospital last month for a cardiac ablation, a procedure that destroys small areas of heart tissue responsible for the irregular rhythm. 'We are going to get my procedure done,' she told fans in the clip, adding with a smile, 'It's a cardiac ablation for my AFib. I know, I'm too young to have this.' As they approached the hospital entrance, Connell asked if she had any last words. 'Love you,' she sweetly replied. The "Real Housewives of New Jersey" star also shared post-op photos from her hospital bed, including a snap with her electrophysiologist, whom she jokingly dubbed her 'other electrician.' But behind the lighthearted moments was a very real and very serious health journey. 'About six months ago, I was driving when I suddenly felt a sharp pain in my chest that radiated down my arm,' she wrote in her caption. 'As women, we tend to ignore aches and pains, brushing them off as part of everyday life, but this felt different.' She began experiencing chest flutters that would even wake her up at night. After finally seeking medical help, she was given a heart monitor, and just hours later, her cardiologist confirmed the AFib diagnosis and referred her to a specialist. 'He told me, 'You're not the same girl I met two years ago when you came here with Paul,'' Catania shared, referencing Connell's own cardiac condition, Wolff-Parkinson-White syndrome, which also required ablation. Catania's message was loud and clear. Don't ignore your symptoms. 'That racing or fluttering in your chest you feel doing simple tasks during the day, that's your body trying to tell you something,' she emphasized. 'AFib increases your risk of stroke or heart attack.' Now, six weeks post-surgery, Catania says she's feeling like herself again. 'I'll be off all medication soon, and I haven't had any episodes since the procedure,' she said. 'Please don't wait. Your heart health is not something to take lightly.' She ended her post with a passionate reminder. 'Take care of yourself. You deserve it!!" she said, adding a red heart emoji. Cardiac ablation is a widely used treatment for patients suffering from arrhythmias, or irregular heartbeats. According to the Mayo Clinic, the procedure works by targeting the areas of the heart responsible for sending faulty electrical signals and either burning or freezing them to create tiny scars. These scars disrupt the problematic pathways, helping to restore a normal heart rhythm. In most cases, cardiac ablation is performed using a minimally invasive approach. Thin, flexible tubes known as catheters are inserted through blood vessels, usually through the groin or neck, and guided into the heart. Once in place, the doctor uses either radiofrequency energy (heat) or cryoablation (cold) to neutralize the malfunctioning tissue. While less common, some patients may undergo surgical ablation, particularly if they're already having open-heart surgery for another condition. Cardiac ablation is frequently recommended for individuals with atrial fibrillation (AFib), supraventricular tachycardia (SVT), or other rhythm disorders that haven't responded to medication. The procedure typically takes a few hours, and most patients are able to return home the same day or after an overnight stay, depending on their condition. Though recovery can vary, many people experience significant improvement in their symptoms and overall heart health following ablation.
Forbes
4 hours ago
- Forbes
Texas Governor Signs Medical Marijuana Program Expansion Bill Into Law
Texas Gov. Greg Abbott has signed a bill to expand the state's limited medical marijuana program, ... More leading activists to declare that Texas has become the 40th state to legalize medical cannabis. Texas Republican Gov. Greg Abbott on Saturday signed legislation to significantly expand the state's medical cannabis program. The new law opens the program to additional patients and products while allowing more licensed operators, leading cannabis policy reform advocacy group the Marijuana Policy Project to declare that Texas has become 'the 40th state to legalize medical cannabis.' 'Following in the footsteps of 39 other states, Texas has embraced a commonsense policy that will ensure that Texans facing serious medical conditions have access to a medicine that's already successfully improving lives nationwide,' Lauren Daly, MPP interim executive director, said in a statement from the group. 'This new law is a direct result of overwhelming public support, acknowledging medical cannabis as a valuable, scientifically supported option for managing chronic pain and debilitating illnesses.' The legislation, House Bill 46 (HB 46), was approved by the Texas House of Representatives on May 13. The state Senate passed an amended version of the bill on May 27, leading to the creation of a conference committee to rectify the differences between the two bills. Both chambers passed the compromise bill on June 2, sending the measure to Abbott for his consideration. The passage of the compromise medical marijuana program expansion bill was welcomed by cannabis policy reform advocates, including members of the Texas Cannabis Policy Center. 'For 10 years, most patients have been excluded from participating in the Compassionate Use Program,' Heather Fazio, executive director of the group, told Marijuana Moment at the time. 'We're happy to see that the legislature is finally expanding the program in a meaningful way.' New Law Expands Texas' Medical Cannabis Program The new law expands the list of conditions that qualify a patient to use medical marijuana, adding chronic pain, traumatic brain injury (TBI), Crohn's disease and other inflammatory bowel diseases. End-of-life patients in palliative or hospice care would also qualify for the Texas Compassionate Use Program (TCUP), as the state's medical cannabis program is known. The measure also expands the types of cannabis products authorized by the TCUP, adding medical marijuana patches and topicals, as well as suppositories, approved inhalers, nebulizers and vaping devices. The legislation also directs the state Department of Public Safety to increase the number of medical cannabis business licenses from three to 15. Licensed providers would also be allowed to operate approved satellite locations. Texas' new medical cannabis law adds new qualifying conditions to the current limited program. Under HB 46, medical cannabis patient registrations will be valid for one year, online cannabis news source Marijuana Moment noted in a report on Saturday. Registered patients will be allowed up to four refills of a 90-day supply of medical cannabis products. Licensed cannabis products will be limited to one gram of total THC per package, with a maximum of 10 milligrams THC allowed per dose. The new law broadens the scope of the TCUP, which was previously limited to patients with one of only eight qualifying medical conditions. The program also limited options for cannabis use, allowing only non-smokable products with less than 0.5% THC. 'For too long, the existing Texas Compassionate Use Program has been severely limited, leaving countless Texans without the relief they desperately need,' said Kevin Caldwell, MPP Southeast legislative manager. 'Texans have spoken, and their voices have been heard. HB 46 will expand access to medical cannabis, a relatively safe and effective treatment option that has long been sought by patients suffering from pain and several other serious medical conditions.' HB 46 requires state regulators to develop rules to implement the legislation by October 1.
