Toronto had 27 suspected opioid overdose-related deaths attended by paramedics in July, which the city says is the highest number of deaths recorded in a month since it began collecting such data.In a drug alert issued on Monday, Toronto Public Health (TPH) said the number is an increase from the 25 deaths recorded in both April and May.The deaths in July happened largely in the city's downtown core.According to the alert, the number of suspected opioid overdose-related deaths attended by paramedics in Toronto increased 85 per cent from March to July of this year, compared to last year's monthly average. The pandemic hit Ontario in March."The increasingly toxic drug supply, in addition to public health measures needed to prevent spread of COVID-19, continue to create challenges for people who use drugs, and for service providers," TPH said in the alert."We mourn the loss of colleagues, friends, and loved ones who are victims of a longstanding crisis and poisoned drug supply, as well as those impacted by COVID-19."Diana McNally, training and engagement co-ordinator at the Toronto Drop-in Network, said the numbers are tragic but not surprising. The network is a coalition of more than 50 drop-in centres that work with people who are homeless, marginally housed or socially isolated."The pandemic has been incredibly stressful on a lot of people. Using drugs can be a coping mechanism, especially for street-involved people like I work with," McNally said on Monday.McNally said many people who have been moved off the street and out of encampments and into former hotels are using drugs in spaces in which they are not familiar. She said they are isolated and far away from services that they were previously able to access daily. These services include overdose prevention sites."We have seen a lot of overdoses with homeless population and street-involved population, a huge spike."McNally said she thinks a majority of deaths of people experiencing homeless during the pandemic has largely been related to overdoses. Some overdose deaths have happened at the former hotels acting as shelters, she added."It's not really about COVID. It's actually overdose which is really killing people who are street-involved," she said.Toronto needs more "proactive" services such as overdose prevention sites funded by the province now because the number of people experiencing homelessness will increase when evictions start, she said.McNally added that the overdose crisis needs to be taken seriously. "These are people's lives. No one should be thrown away. Everyone's life is meaningful. This matters to people. People care. I care," she said.'Unexpected drugs of concern' being consumedThe type of drugs consumed by the people who died in July is not available, but previous drug checking data shows that the unregulated drug supply in Toronto contains what TPH calls "unexpected drugs of concern."Toronto's drug checking service, which offers people who use drugs detailed information on the contents of their drugs using lab-based technologies, says 98 samples were checked between July 18-31.Of those, a full 45 were expected to be fentanyl, 13 were expected to be methamphetamine, six were expected to be cocaine, five were expected to be crack cocaine, five were expected to be GHB and four were expected to be MDMA.Paramedics see 3 fatal suspected opioid overdoses a weekToronto Paramedic Services, for its part, said in an Aug. 7 note on the Toronto Overdose Information System Dashboard that it is collaborating with TPH to share information on calls received by paramedics for suspected opioid overdoses.The dashboard presents data on paramedic response, hospital visits, deaths and supervised injection services, while the information that paramedics share with TPH includes the number and location of cases.Since Aug. 7, 2017, paramedics in Toronto have attended 65 non-fatal and three fatal suspected opioid overdoses a week, Toronto Paramedic Services said.Pandemic making opioid poisoning crisis worse, TPH saysAt a city hall news briefing in July, Dr. Eileen de Villa said Toronto is essentially experiencing two public health crises."Unfortunately, the ongoing opioid poisoning crisis has been further compounded by the COVID-19 pandemic, and these dual public health crises are having a significant impact on our community," de Villa had said. "We know that the unregulated drug supply is having a devastating impact on people who use drugs. Too often there are unexpected drugs or contaminants in the drugs people are consuming, and this is resulting in fatal and non-fatal overdoses."Physical distancing, a public health measure promoted by TPH to reduce the spread of COVID-19, can be isolating and can lead some people who would otherwise be careful to use drugs alone, De Villa had said. The result can be deadly, she said.TPH issues drug alerts to ensure people have current information about toxic drugs circulating in the city and to promote harm reduction strategies to prevent overdose deaths.