Half of Ontario opioid deaths interacted with health-care system the month before: study
Half of Ontarians who died of an opioid overdose in the early stages of the pandemic had interacted with the health-care system in the month before their deaths, a new report shows.
And one in four had seen a doctor, gone to an emergency department or been discharged from hospital just a week prior, the research shows.
"That represents such an important missed opportunity for us to make sure that our health-care system is serving the needs of people who use drugs and helping connect them to the services that they need to help prevent these fatal overdoses," said Dr. Tara Gomes, an epidemiologist with Unity Health and investigator with the Ontario Drug Policy Research Network who co-authored the study.
The report, titled "Patterns of Medication and Healthcare Use among People who Died of an Opioid-Related Toxicity during the COVID-19 Pandemic in Ontario," was released Tuesday by Unity Health and the Ontario Drug Policy Research Network. Public Health Ontario, the chief coroner's office and ICES, the non-profit health research organization, contributed to the report.
The authors are calling for a safer drug supply, expanded access to low-barrier treatment in health-care settings, affordable, supportive housing as well as more harm-reduction services and supervised consumption sites, especially outside cities.
"The loss of lives due to opioid toxicity in Ontario has only deepened during the COVID-19 pandemic," said Dr. Dirk Huyer, the Chief Coroner for Ontario, in a statement.
"Understanding how people interact with healthcare providers, support systems, and harm reduction services will help develop policies aimed at preventing further opioid-related deaths."
The vast majority of deaths recorded between March and December 2020 -- 89 per cent -- are linked to non-prescription opioids, almost exclusively fentanyl, the report found.
Gomes said two in three deaths occurred in those with evidence of an opioid use disorder. That means about one third of people had no evidence of a substance use disorder.
"It's likely that a large number of those people are people who are just occasionally using drugs," she said.
"And they might actually be a population at higher risk of overdose from this really unpredictable drug supply because they haven't developed the same level of tolerance to these really potent drugs."
The research follows up on the group's work published in May, which showed fatal opioid overdoses were up more than 75 per cent in Ontario from March to December 2020 compared to the same timeframe the year before.
There were 2,050 people who died of an opioid-related overdose in about 10 months, compared to 1,162 from March to December 2019.
The researchers were able to link the vast majority of those deaths to other health-care data in an effort to better understand some of the circumstances.
The increasingly volatile drug supply appears to be connected to the surge, Gomes said.
"Though the role of prescription opioids has historically been focused on as the major contributor to the overdose crisis, the report shows that the unregulated drug supply is primarily responsible for fatal overdoses, with deaths predominantly driven by fentanyl," the report said.
The researchers detected a five-fold increase in non-pharmaceutical benzodiazepines in fatal opioid overdoses during the pandemic.
"It's not that people are getting prescribed anti-anxiety medication, but that the unregulated drug supply is really being contaminated by benzodiazepines," Gomes said.
The addition of benzodiazepines has further complicated the response to an overdose and subsequent treatment, she said.
"We're hearing people who are so highly sedated for the benzodiazepines in the drug supply that they can't be roused for hours and hours at a time even after administering Naloxone because that only reverses the opioid effect," Gomes said.
She said opioids mixed with benzodiazepines have been shown "to increase respiratory depression and sedation so it can make you more likely to have an overdose and a serious overdose because you're still heavily sedated and your breathing is you know, slowed even further."
The researchers also found that, when population is factored in, the opioid overdose death rate was nearly three times higher in northern Ontario compared to southern Ontario.
Meanwhile, the researchers dug into further understanding why the opioid crisis was hitting the homeless much harder than other populations, after their previous report found one in six people who died from an opioid overdose during the pandemic did not have a home.
The researchers found that population was interacting with the health-care system in similar rates as the rest of the population in the days and weeks before their deaths, but was much more likely to seek help from an emergency department than outpatient care, like a visit to a family doctor.
Gomes said they are seeing a high degree of mental health diagnoses among the homeless who died of an opioid overdose.
"Given the increasing rates of overdose among people experiencing homelessness during the pandemic, the scale-up of supervised consumption services in shelter settings and easily accessible treatment options is warranted," the researchers wrote.
This report by The Canadian Press was first published Jan. 18, 2022.
CTVNews.ca Top Stories
DEVELOPING Man sets self on fire outside New York court where Trump trial underway
A man set himself on fire on Friday outside the New York courthouse where Donald Trump's historic hush-money trial was taking place as jury selection wrapped up, but officials said he did not appear to have been targeting Trump.
Sask. father found guilty of withholding daughter to prevent her from getting COVID-19 vaccine
Michael Gordon Jackson, a Saskatchewan man accused of abducting his daughter to prevent her from getting a COVID-19 vaccine, has been found guilty for contravention of a custody order.
She set out to find a husband in a year. Then she matched with a guy on a dating app on the other side of the world
Scottish comedian Samantha Hannah was working on a comedy show about finding a husband when Toby Hunter came into her life. What happened next surprised them both.
Mandisa, Grammy award-winning 'American Idol' alum, dead at 47
Soulful gospel artist Mandisa, a Grammy-winning singer who got her start as a contestant on 'American Idol' in 2006, has died, according to a statement on her verified social media. She was 47.
'It could be catastrophic': Woman says natural supplement contained hidden painkiller drug
A Manitoba woman thought she found a miracle natural supplement, but said a hidden ingredient wreaked havoc on her health.
Young people 'tortured' if stolen vehicle operations fail, Montreal police tell MPs
One day after a Montreal police officer fired gunshots at a suspect in a stolen vehicle, senior officers were telling parliamentarians that organized crime groups are recruiting people as young as 15 in the city to steal cars so that they can be shipped overseas.
The Body Shop Canada explores sale as demand outpaces inventory: court filing
The Body Shop Canada is exploring a sale as it struggles to get its hands on enough inventory to keep up with "robust" sales after announcing it would file for creditor protection and close 33 stores.
Vicious attack on a dog ends with charges for northern Ont. suspect
Police in Sault Ste. Marie charged a 22-year-old man with animal cruelty following an attack on a dog Thursday morning.
On federal budget, Macklem says 'fiscal track has not changed significantly'
Bank of Canada governor Tiff Macklem says Canada's fiscal position has 'not changed significantly' following the release of the federal government's budget.