Two people in Hamilton may have died from fentanyl- or opioid-related overdoses this weekend. Or maybe three.

If they did, that information may not be available for a year or more.

And that is a gap that needs to be fixed in Hamilton and across the province, say critics of Ontario's handling of the opioid crisis.

After a weekend of at least two sudden deaths and several reported overdoses in the city, no officials had answers about how many overdose deaths might have occurred: Not police, not paramedics, not the city's public health unit, not the provincial coroner's office, not the mayor.

Each one directed questions from CBC News to another agency.

That's not unique to Hamilton. There is no real-time tracking of overdose deaths in Ontario, with the time lag stretching out for months. The latest data available on the city's new portal for examining opioid trends shows overdose deaths from 2015 but not later.

Critics of the current system say publishing that information more quickly matters.

"You want to know that stuff, for what reason? To respond, hopefully," said Michael Parkinson, a drug strategy specialist in Waterloo Region.

It could help the public know if there's a bad batch of heroin or oxycontin laced with fentanyl.

It could reach occasional, recreational drug users who might not be part of traditional drug outreach services. It could help police target dealers of tainted drugs.

'You would want to know if there were clusters happening'

Parkinson has been calling for real-time tracking in Ontario since 2008 and said releasing rapid toxicology updates or requiring reporting of preliminary data could help public health and emergency responders respond to a spike in a particular neighbourhood, for example.

We now find ourselves in the middle of the worst drug safety crisis in Canadian history and it's not going away anytime soon. - Michael Parkinson, drug strategy specialist

"From a health and safety point of view, you would want to know if there were clusters happening."

Hamilton's mayor called an urgent summit for sharing of information related to opioid overdoses, out of which came a new surveillance and monitoring system that the city said was an effort to share information and save lives.

But that doesn't change the fact that deaths aren't tracked in anything close to real time.

"Working together with our local system partners we are monitoring and sharing our best available evidence to put the pieces of the puzzle together for a timelier and more complete picture of the opioid situation in Hamilton," said Aisling Higgins, spokeswoman for the city's public health unit.

'It's frustrating'

The lag in real-time coroner numbers showing the scope of the crisis has recently drawn sharp criticism from big-city Ontario mayors like Toronto Mayor John Tory, Ottawa Mayor Jim Watson. Tuesday, Hamilton Mayor Fred Eisenberger added his voice.

"It's frustrating — we know that it would help our first responders," Eisenberger said.

Eisenberger said there was an agreement coming out of the city's opioid summit that police, paramedics, local hospitals, addictions services, and other stakeholders needed to share anecdotal information with each other in closer to real time.

He said the sense is: "OK, we can't wait for the coroner's office, so let's do what we can to collect as much as we can on our own."

'These are slow-moving trains, and here we are in a crisis'

But Parkinson, in Waterloo, said that overdose and death information should be published online, to the public, in "near real-time" so that both healthcare workers and community members can access it.

He said the slowness of federal and provincial governments to act leaves cities like Hamilton struggling to shoulder the work of combating the life-or-death crisis.

"These are slow-moving trains, and here we are in a crisis," Parkinson said. "We now find ourselves in the middle of the worst drug safety crisis in Canadian history and it's not going away anytime soon."

'If we're serious about responding'

He said a common pushback from medical and emergency personnel is that it takes time to do conclusive blood work and testing to find out how someone died.

"I think it's ok to have preliminary results," he said. "If we're serious about responding then rapid results are what's required."

Contrast the lag of a year or more in Hamilton (and province-wide) to the city of Cincinnati, where a spike in overdose deaths on the weekend was published to that city's website and it was in the news by Sunday.

In B.C., after a state of emergency was called last year for fentanyl overdoses, real-time data began to be collected and disseminated there. They showed that there were 128 drug-related deaths in Vancouver in November. The most recent numbers available for Ontario cities are from 2015.

An overdose victim in the Downtown Eastside of Vancouver. Vancouver had 128 opioid deaths in November, but numbers for Ontario are at least a year behind. (Chris Corday/CBC)

Preliminary numbers from the Office of the Chief Coroner indicate that in 2015, 37 Hamilton residents died from opioid toxicity, and 10 residents died due to toxicity from opioids and alcohol. This is the highest number of deaths in the past 11 years of data.

Sudden deaths linked to overdoses?

Here's what we know about what happened this weekend in Hamilton.

Hamilton police investigated two "sudden deaths" this weekend.

On Saturday, police told The Spectator that three men had been doing drugs and a 51-year-old man overdosed around 4:15 a.m. Staff Sgt. Greg Jackson said that the coroner's office was investigating that death, and that it was too early to say whether the men had been taking fentanyl, even unknowingly.

Then on Sunday, police said they were investigating a sudden death of a 43-year-old man at King and James streets downtown. They said the coroner was investigating that death.

A futile search for up-to-date information

A supervisor with Hamilton's paramedics said Sunday there had been three overdoses, possibly fentanyl-related, over the weekend, but she said she couldn't immediately confirm whether anyone had died.

Asked for more detail Monday, an operations manager with the paramedics said even that much information was too specific for paramedics to give out.

"We're not the ones that should be disseminating information about opioid abuse or potential abuse," said Hal Klassen. "It's not our place," he said.

(CBC)

In part, that's because while paramedics pick up patients in distress, a definitive answer about whether they've been using substances, and which substances, has to come from blood work.

So we asked police: Were any of the three or more overdoses from the weekend deadly?

Police said Monday they were unable to confirm any overdoses over the weekend. They directed CBC News to contact the coroner's office.

But the coroner's office doesn't track suspected fentanyl misuse as a cause of death until after testing has been done to confirm it.

It takes weeks or months to do the toxicology testing to determine whether someone was using drugs when they died. The coroner's spokeswoman would only say there are 170 deaths from February in Hamilton being investigated by a coroner, but that could be for a range of causes.

kelly.bennett@cbc.ca | @kellyrbennett