Overdose outreach team disbands as federal funding expires

Jason Smith still gets emotional talking about the job he left a couple months ago.

Smith was a member of the Mobile Support Overdose Resource Team (MSORT), a federally-funded pilot project that responded to people in the Peterborough region who had recently had a drug overdose or were at risk of one. 

But the team – made up of a paramedic, harm reduction workers and case managers – has now disbanded, after funding for the temporary program dried up at the end of March.

Smith said he has now moved on to a new job, but still feels the loss of the MSORT team, a group of people he said did their best “every single day” to support those impacted by the toxic drug crisis. “I may grieve the loss of that team a little bit in this moment,” he said in an interview with Currents last week.

But even more affected by the loss are the people who relied on MSORT for things like wellness checks, wound care and emotional support.

“Folks that I encounter are very upset that it is no longer accessible,” said Smith, who was a harm reduction specialist with MSORT. “It’s not an expression of anger that I’m getting, it’s an expression of grief.”

Starting in 2021, the MSORT team travelled around the city and county providing people impacted by the toxic drug supply with minor medical care, harm reduction supplies, and help with things like finding housing.

Between April 2022 and September 2023, the team helped approximately 160 people access mental health services and drug treatment and detox programs, and helped approximately 20 people get housing, according to Peterborough County-City Paramedics. Dozens of people a day also received wound care and harm reduction supplies like clean needles and the overdose-reversing drug Naloxone.

But harder to quantify was the sense of safety the team offered people, according to Smith.

“I hear a lot of talk from different people in community about how they always felt safe [with the MSORT team],” he said. 

Hearing that was “very impactful” to Smith, since people who are accessing a toxic drug supply or surviving without a roof over their heads likely don’t “feel a lot of safety in their lives,” he said.

He and his colleagues built trust with people by meeting them “in whatever space they felt comfortable” – whether it was in their home or in a public park. Whenever they could, the team would also bring along food and survival gear, such as tents, sleeping bags, backpacks, hats and mittens.

For many, having MSORT come to them was more comfortable than going to an office or clinic, where they might fear facing stigma for using drugs.

“If you have to come into an office and you have to sit across the desk from someone, there’s automatically a massive power imbalance, as opposed to meeting someone in a park and sitting down in the grass with them, and just sharing space and having a conversation,” Smith said.

Federal government funded pilot project for over three years at a cost of $2.7 million

The idea for MSORT emerged in 2018, when calls were growing for a supervised drug consumption site in Peterborough, but Doug Ford’s newly-elected government “didn’t seem very cooperative,” according to Peter Williams, Peterborough Police’s community development and engagement coordinator at the time.

In the absence of a supervised consumption site, Peterborough Drug Strategy (PDS) members wanted to find a way to bring potentially life-saving services, like harm reduction supplies and wound care, directly to drug users, according to Williams. PDS partnered with addiction treatment provider Fourcast, Peterborough County-City Paramedics and HIV support agency PARN on the project. Also involved was the Peterborough Police Service, which applied for a grant under the federal government’s Substance Use and Addictions Program to create a mobile team to support people impacted by the toxic drug supply.

The federal government provided almost $2.7 million toward the project, according to Health Canada’s website.

The goal from the beginning was to “actually meet people where they’re at in a non-judgmental way, and not just reinforce stigma and trauma,” according to Williams. That required including peers with lived experience of drug use on the team, he said.

One of those peers was James Davy, who was an intensive case manager with MSORT. In a video PDS made about the program in 2022, Davy talked about how his own experience of homelessness helped him build trust with the people he served.

“I spent 25 years out on the streets. I bring that connection with people,” he said. “If I see someone struggling, I’ll say, ‘I was out there on the streets for 25 years and I’ve been clean for three and a half. I kind of get what you’re saying and what you’re feeling.’”

The trust Davy built with people helped them feel comfortable approaching the team for medical care, according to MSORT paramedic Audrey Thomas.

In the video, she described how when the team first started doing outreach “nobody would approach me.”

“I could show up into a parking lot with 50 people and they would scatter within 10 seconds,” she said. But that changed after Davy began introducing her to people. “Within a matter of a few weeks people were seeking us out,” she said. “We could pull into an empty parking lot and people would come out to interact with us.”

Thomas was then able to treat people’s wounds and refer them to further medical treatment. Without that care, some people likely would have lost limbs, according to Craig Jones, Peterborough County-City Paramedics’ (PCCP) deputy chief of community programs. “It changes their lives,” he said of the wound care MSORT provided, during a presentation to Selwyn Township council in February.

A man named Duane had a wound on his arm for three years when he first started getting visits from MSORT.

“They helped me get into the nursing clinic and saved my arm,” he said in the PDS video.

Duane and his wife Jess first became connected to MSORT after their nephew, Robert, died from an overdose. 

“That was a big turnaround in our lives because we had overdosed but we had made it through,” Jess said.

The team also helped them get into addiction treatment. If not for the support they received “one of us would have been gone by now, I’m definitely positive of that,” Jess said. “I’m so thankful that they have been here because they have helped keep us sober.”

New street paramedic program will partly continue MSORT’s legacy

In 2023, the federal government extended MSORT’s original funding for an extra year, but there was no opportunity for an extension this year, according to Emily Jones, Peterborough Police’s community development and engagement coordinator.

“We know it’s flawed, but we go into it knowing it’s going to be a pilot program,” she said.

But she said MSORT is a “success story.” 

“We had… paramedics coming together with peer support workers,” she said. “That’s never been done in this community.”

Craig Jones, with Peterborough County-City Paramedics, said it was a “shame” to lose funding for MSORT, even though he understands it was always meant to be temporary.

But he said paramedics will continue to do outreach with people experiencing homelessness; PCCP has created a new “street paramedic” position, focused on wound care, with provincial funding. 

The new street paramedic service, called the Community Paramedic Outreach Program, won’t offer everything that MSORT did, according to Fourcast executive director Donna Rogers. The new program lacks harm reduction workers and case managers who can help connect people to services, she said.

But Rogers sees the new program as a continuation of MSORT’s “legacy” of building “better relationships” between paramedics and people who are unhoused or use drugs. “Paramedics were strong partners to us,” said Rogers, who helped oversee the program. 

Building relationships was at the core of MSORT’s mission, and a big part of its success, according to Jason Smith.

The team took time to get to know people and win their trust. And Smith said he feels an “overwhelming amount of respect” for the people who decided to “open their hearts” to him and his colleagues “and allow us into some of the pieces of who they are.” 

“There’s a lot of beauty in that,” he said.