June 28, 2017

Dear Residents of Waterloo Region,

Thank you for taking the time to read this letter. We live in a safe and vibrant community with a tradition of
collaboration and partnership. As families, neighbours and friends, it is important to be aware of the risks of
drugs, including overdose. We have shared the contents of this letter with our School Boards, specifically
addressed to parents and guardians. This is our open letter to you, from one resident of Waterloo Region to
another.

Ontario and Waterloo Region have seen a rise in opioid related deaths in recent years. There are many
factors contributing to the rise of overdose in our community, one being the presence of a drug called fentanyl.
According to the Office of the Chief Coroner for Ontario, the number of drug related overdose and deaths in
Ontario is increasing. Local data shows that the number of overdose deaths in Waterloo Region doubled
between 2009 and 2015 and continues to rise.

On June 27, 2017 Waterloo Regional Police Services reported that there were 35 suspected overdose related
deaths in Waterloo Region since the start of the year, thats nearly as many deaths as the entire 2015 year.

Being a parent, a neighbour, a friend or a concerned citizen in the current climate of opioid discussion can be
very difficult and stressful. As residents, we may constantly worry about the safety of those around us. Drugs
are part of our society and the best way to decrease harms is to have accurate information. We are hoping
this letter will bring some familiarity with those around you about the current issues of drug use, including the
risks of overdose, the use of prescription medications (from a pharmacy or made on the street) and the
dangers of combining drugs with alcohol. This approach includes both preventing substance use and
decreasing harms to those in our community who are using drugs. Overdose does not discriminate - it can
happen to anyones family. It is important to equip ourselves with knowledge about drug use including the
signs and symptoms of overdose and what to do in an overdose situation. Part of this includes reminding
everyone that a person who calls 911 in an overdose situation is protected from police charges of drug
possession (Bill C-224/Good Samaritan Drug Overdose Act).

As we continue to explore innovative approaches to harm reduction and the protection of our community, we
need you, the resident of Waterloo Region, to understand the importance of this issue. Having supportive
conversations is a good place to start. For more information and support please visit
www.waterlooregiondrugstrategy.ca. We have included more detailed information below to help you start a
conversation at home, at your workplace, or in your neighbourhood.

We thank you for taking the time to read this information letter.

Sincerely,

Dr. Liana Nolan Chief Bryan M. Larkin

Commissioner and Medical Officer of Health Waterloo Regional Police Service

John Bryant Loretta Notten

Director of Education, WRDSB Director of Education, WCDSB
There can be different reasons why people use drugs, including:
Curiosity On a dare
Escape usually from emotional pain Substance use happening at home
To relate to others better, peer pressure Low self-esteem
Copying behaviour of family/siblings Deal with negative feelings
To get a rush

Some signs and symptoms of drug use among people:

Problems at school or at work absenteeism, decreasing effort, frequent distraction

Increased secrecy about possessions, friends and activities
Use of incense, room deodorant, or perfume to hide smoke or chemical odours
Increased need for money or missing money
Drug related posts on social media
Less attention to personal care/hygiene
Increase in sleeping/naps. Nodding off at inappropriate times; or
Increase in hyperactivity outside of what is usual
Missing prescription drugs especially narcotics and sedatives from the family home or extended
family homes
Friends, colleagues or family may also find items in the subjects possession that indicate drug use.
These include:
o Drug paraphernalia (such as bongs, pipes, small baggies, pills, powder, needles and rolling
papers)
o Inhalant products (such as hairspray, nail polish, correction fluid or household products)
o Other unusual over the counter medicines such as cough medicine
o Rags and paper bags, which may be used as accessories with inhalants

What can I do to support my child when it comes to substance use?

Strong, open relationships between parents or caregivers and children decrease the likelihood that
teens will abuse drugs.
As a parent or caregiver, it is important to talk to your children about drugs and alcohol. Start early and
keep the lines of communication open. Discuss a broad range of issues not limited to substance use
with your child and invite their opinions even if they are different from your own.
Let your child know their safety comes first and they can depend on you to help them if they feel
concerned about their own or a friends safety.
Set an example by being responsible about your own use of alcohol and other drugs.
Stay in the know. You dont have to be an expert. Recognize that experimentation and mistakes
happen. Help your child to reflect on a mistake but be sure to wait until you are both calm.
It is good to know the symptoms of drug use among teenagers. Keep in mind that some signs of drug
use overlap with very common teenage behaviours (such as moodiness and withdrawal).
Where can I get more support and information?
Please visit: http://www.waterlooregiondrugstrategy.ca/en/home/.

Additional Resources
Name of Organization Contact Information
Here 24/7 (Canadian Mental Health 1-844-437-3247
Association Waterloo Wellington)
www.here247.ca

Sanguen Health Centre 519-603-0223

www.sanguen.com
Region of Waterloo Public Health and 519-575-4400
Emergency Services
www.regionofwaterloo.ca/harmreduction
Waterloo Region Integrated Drugs
Strategy http://www.waterlooregiondrugstrategy.ca/en/home/
Ray of Hope (providing youth and 519-743-2311
addiction services)
Info@rayofhope.net

References: Opioids and Addiction: a primer for journalists. CAMH 2016

Parent Action on Drugs.org
https://www.canada.ca/en/health-canada/services/substance-abuse/about-substance-abuse/signs-symptoms-drug-abuse.html
 Things You Need to Know
1. It is possible to experience harm from drug use, even if youre doing it occasionally or for the first time.

2. Mixing drugs can be dangerous and should be avoided. It increases risk of overdose.

3. If you are buying drugs off the street it is impossible to know exactly whats in them. Any illegally-
purchased drug can be cut (mixed) with other drugs without you knowing.

4. Opioids (heroin) and opioid pain medication (oxycodone, morphine, fentanyl) can reduce pain and
emotional response to pain. They are also addictive and can slow your breathing, with a chance your
breathing might stop if you take too much.

5. Avoid combining opioid pain medication with other depressant drugs (alcohol, anxiety or sleeping
pills). This makes it even more likely you will experience difficulty breathing.

6. You may have heard about an opioid drug called fentanyl that is causing a lot of harm in Alberta and
across Canada. Fentanyl can be prescribed or made illegally in a lab and is about 100 times more toxic
than morphine or other opioids.

7. Bootleg Fentanyl (made on the street) has the potential to be even more dangerous than prescription
Fentanyl because:
A small amount can be fatal as little as equivalent of 2 grains of salt
people may not be aware that they are consuming it as it can be mixed in with other drugs
you cant see it, smell it, taste it or test for it

8. There is a risk of opioid overdose, even if you are not using opioids. This is because opioids can be
mixed in with other drugs.

9. If you are using drugs, or are with someone who has used drugs, know the signs of an opioid overdose:
slow or shallow breathing, not breathing at all, snoring or gurgling sounds, cold clammy skin, pinpoint
pupils, limp body, vomiting or choking, blue lips/nails.

10. Naloxone is a medication that temporarily reverses the effects of an opioid overdose.
If someone has overdosed from an opioid and is in trouble:
Call 9-1-1 immediately
Administer Naloxone if its an opioid overdose
Stay with the person until help arrives
Put the person on their side (recovery position)

Remember, if someone is experiencing an opioid overdose,

Call 9-1-1 immediately
(naloxone only works for about 30 minutes)