Harm reduction activists are calling on the TTC to install naloxone kits and train employees to administer the life-saving drug after an activist waited half an hour for paramedics to respond to what she says could have been a deadly overdose.

Paramedics have responded to 771 suspected opioid overdoses — 34 of which have been fatal — in Toronto so far in 2019, according to Toronto Public Health data.

Five people have died from suspected opioid overdoses this month alone as the city continues to grapple with the ongoing opioid overdose crisis.

Alannah Fricker, a Toronto-based harm reduction activist, said she was worried she might have been witnessing another deadly overdose in a subway station last week.

When she saw a man who was not responsive lying on a bench in the station, Fricker said she approached nearby TTC employees to see if he was alright.

"I asked if they had naloxone on hand in case it was an opioid overdose," she told CBC Toronto.

Naloxone, which can reverse deadly opioid overdoses once given, comes in injectable and nasal spray kits. (Sarah MacMillan/CBC)

Fricker said the employees told her they did not have the drug — the antidote to opioid overdoses — but that they had put him into a recovery position and called 911.

TTC in talks about naloxone training

First aid training is mandatory for front-line supervisors, customer service agents and other TTC employees who work on the track level.

"Our operators are not trained to use naloxone and do not carry naloxone under any directive from the TTC," said Hayley Waldman, a spokesperson for the public transportation agency.

However, Waldman said the TTC has been in talks about training special constables to administer the drug and carry the kits "for some time now."

When CBC Toronto asked if there are any liability concerns with employees using naloxone, Waldman said that a lot of different people, both within and outside the TTC, need to be consulted before they make any decisions.

After waiting for 30 min for EMS to respond to a poisoning/<a href="https://twitter.com/hashtag/overdose?src=hash&ref_src=twsrc%5Etfw">#overdose</a> on the <a href="https://twitter.com/hashtag/ttc?src=hash&ref_src=twsrc%5Etfw">#ttc</a> today, I am wondering why supervisors, constables, and operators are not trained in overdose recognition/response & not carrying <a href="https://twitter.com/hashtag/naloxone?src=hash&ref_src=twsrc%5Etfw">#naloxone</a>. Shameful & putting lives at risk. <a href="https://twitter.com/TTChelps?ref_src=twsrc%5Etfw">@TTChelps</a> <a href="https://twitter.com/cityoftoronto?ref_src=twsrc%5Etfw">@cityoftoronto</a> —@atfricker

Fricker said that the TTC, being a public service accessed by so many different people — drug users included — has an important role to play in combating the opioid crisis.

"We could work to decrease the numbers of opioid overdose deaths in our city if public sector employees like TTC employees were equipped with naloxone and were adequately trained to respond to overdoses," she said.

Time critical in overdose response

Fricker said she looked for signs of an overdose when she saw the man in the subway and then stood by, with a naloxone kit on hand, until his breathing improved and he said a word.

In that time, about 30 minutes later, she said paramedics still had not arrived.

"Sometimes overdoses take a long time, other times people can die within minutes. Time is really of the essence," said Fricker, a social work student who founded the Canadian Students for Sensible Drug Policy chapter at Ryerson University.

Alannah Fricker says she always carries naloxone. (Maggie Macintosh/CBC)

She has since started a petition to equip TTC employees with naloxone, with dozens of signatures so far.

Everyone is a first responder during crisis

Leigh Chapman, a registered nurse who became a harm reduction activist after her brother died from an overdose in 2015, said the TTC is not acting fast enough.

Neither the TTC nor paramedics track the overdoses that happen on public transit, but Chapman — a coordinator with the Toronto Overdose Prevention Society — said she frequently hears about incidents taking place on subway platforms and on vehicles.

"It would give [TTC employees] a sense of agency, equip them as allies," she said about training them in naloxone.

"This opioid overdose crisis is an opportunity for everyone to be a first responder."

Waldman said the TTC has a contract with Toronto EMS, in which two paramedics are stationed in the subway system during morning and evening peak travel times.

All subway stations are equipped with defibrillators and first aid kits. (Maggie Macintosh/CBC)

Both Chapman and Fricker also want subways, streetcars, buses and stations to be equipped with naloxone kits.

"What is so sad about this crisis is that there are people dying and they are community members, family members and peoples' friends," Fricker said. "But it's also the fact that they are preventable deaths."

They are preventable deaths. - Alannah Fricker , Toronto-based harm reduction activist

In 2017, 308 people died from opioid toxicity causes in Toronto. That is a 66 per cent increase from the previous year and a 125 per cent increase from the year before that.

Toronto Public Health has not yet published the total numbers for 2018.