For paramedics in Thunder Bay, an average day includes responding to at least one opioid overdose.

The northwestern Ontario city and its surrounding area has the highest per-capita accidental opioid overdose death rate in the province, at 22.7 per 100,000 people, according to the latest available data from Public Health Ontario.

Thunder Bay’s detox facility is so overcrowded that 8,000 people had to be turned away in the past year.

The city is on the front lines of Canada’s opioid crisis, but its first responders and health-care workers say they are dealing with a disproportionate share of the burden. Local officials say provincial and federal governments seem to be forgetting about their struggle as the spotlight remains on Canada’s large urban centres.

“The money kind of goes where the votes go,” Thunder Bay paramedic Brian Schenk told CTV News. “It's politically expedient to be spent in big cities where there's lots of opiates. And we got lots of opiate but not as many voters.”

On a recent ride-along with the paramedics, CTV News got a first-hand look at the growing drug crisis in Thunder Bay.

Just before dawn, an ambulance was called to a derelict downtown building where a man had taken cocaine laced with an opioid.

“He thought he was going to get high on cocaine and instead he wakes up like ‘Whoa! What the heck's going on? Who are you guys and why are you here?’” Schenk said.

Whoever supplied the man with cocaine also gave him the opioid overdose-reversing medication naloxone to counter the high.

“At least they didn't want to kill him but they did want to steal what he had,” Schenk said.

The City of Thunder Bay hands out thousands of life-saving naloxone kits for free, but paramedics say they sometimes give drug users a false sense of security.

Many users self-administer naloxone and don’t bother waiting for an ambulance, either because they’re scared of getting caught with drugs or feel like they’ve recovered – even when that feeling is only temporary.

“They'll have gotten up and left. Two, three hours later we may go back and it may be the same patient who is relapsed,” Andrew Dillon, deputy chief of the Superior North Emergency Medical Services, told CTV News.

Dillon said opioid-related emergency calls have quadrupled in two years. On average, a Thunder Bay EMS team rushes to one of those calls every 21 hours.

First responders are overwhelmed and strained, and so are the region’s treatment centres. There’s only one safe injection site in the city and not enough hospital beds.

“We’re playing catch-up in many respects with what the need is and what the demand is,” said Juanita Lawson, CEO of NorWest Community Health Centres, which operates the consumption and treatment site.

Between July 2017 and June 2018, there were 1,337 confirmed opioid-related deaths in Ontario, and the majority of them were accidental.

Although the highest number of those deaths -- 291 -- occurred in Toronto, the highest per-capita rate was recorded in the Thunder Bay District Health Unit.

Thunder Bay’s opioid crisis is fuelled by an infiltration of gangs from Toronto, Ottawa and Winnipeg. Gang members saw a lucrative drug trafficking opportunity in the area when the supply was low.

‘TO ME, THAT'S MURDER’

Ken Bailey is among those who lost a loved one in Thunder Bay’s drug crisis.

He’s still haunted by the call he got from his ex-wife last summer, telling him that his adult son Mark had died.

“She said, ‘I just phoned to tell you that we got bad news: Mark's dead,’” Bailey recalled in an interview with CTV News. “And the whole world stopped.”

Mark Bailey took his last breath in a motel room. An autopsy determined the cause of his death was fentanyl toxicity.

His father is calling for tougher penalties for dealers who sell fentanyl-laced drugs.

“I got a beer on the floor here. If you came along and put some arsenic on that beer and I drank it and died…I died from what you did. That's the same thing they did with his cocaine,” Ken Bailey said.

“To me, that’s murder.”

The Ontario Provincial Police have ramped up their investigations into opioid-related deaths and have laid nearly three dozen serious criminal charges in 13 fatal overdose cases since 2016.

The OPP said in a news release in September that 20 manslaughter and 12 criminal negligence causing death charges have been laid so far. Those include charges laid in connection to eight opioid-related deaths this year alone.

“The OPP is not the only police service to lay charges of this nature,” the release said. “Other police services across the province are collectively sending the same message -- there is no excuse for selling, distributing or trafficking drugs such as fentanyl when the deadliness of this drug is very well-known.”

Meanwhile, those on the front lines in Thunder Bay are calling for more resources on the ground.

“Maybe there’s a chance,” Schenk said. “I gotta hope there is, because the way it’s going, we’re just going to start finding more bodies.”

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