More than 11 Canadians are dying every day on average because of opioids, according to new data from the federal government.
“The crisis is not abating,” Theresa Tam, Canada’s chief public health officer, said in an interview on Tuesday.
Canada is the world’s second highest per-capita consumer of opioids, after the United States, which has led to widespread misuse, dependence and addiction.
The report released on Tuesday from a special federal advisory committee shows that 1,036 people died from causes related to using opioids, mainly overdoses, from January to March. That brings the total number to more than 8,000 since the start of 2016. Most of the deaths were ruled to be unintentional.
The powerful painkiller fentanyl was involved in more than 70 per cent of the deaths, the report said. The rate of death is up 5 per cent from the same time period last year, and 44 per cent compared with the same time in 2016.
Prescription and illicit fentanyl were linked to 73 per cent of the deaths from January to March, an increase of 16 per cent from the same period last year and double the rate in 2016.
Western provinces have been hardest hit, but experts note that provinces such as Ontario are catching up. From January to March, B.C. had 371 deaths, Alberta 195 and Saskatchewan 12. Ontario had 287 deaths, Quebec had 82, New Brunswick had five, Nova Scotia had 16 and Newfoundland and Labrador had four. PEI had no deaths, and data were not available for Manitoba, the report said.
The advisory committee, created in 2016, includes health experts, and meets monthly to discuss harm reduction, how to improve data and surveillance of the crisis and address prevention and treatment.
Dr. Tam said it is clear much more needs to be done. Many provinces are making the medication naloxone, which can reduce the effects of an opioid overdose, more widely available. But plenty of other things could help, such as making it easier for people to get treatment, she said.
But what’s also needed is a fundamental change in perceptions, she said. Poverty and homelessness are among the chief causes of the opioid crisis, and many Canadians simply do not see its effects, she said, adding that focusing on these issues, rather than drug use, would help.
“Our general population is not necessarily seeing the impact,” Dr. Tam said.
But Meldon Kahan, medical director of the substance use service at Women’s College Hospital in Toronto, said the health-care system bears much of the blame.
“We’re not doing what we need to do,” he said.
In many parts of the country, patients who use opioids cannot get treatment or counselling, even though they often have anxiety disorders, depression or other mental-health issues, because those services are in short supply, he said. New national opioid-prescribing guidelines are also causing some doctors to rapidly reduce their patients’ doses, which may send them to the black market, he said.
“This is a failure of the health-care system,” Dr. Kahan said.
The federal government also released highlights of a national study on opioid-related deaths. Researchers interviewed coroners and medical examiners who investigated such deaths and found that many people who died had a history of mental illness, substance use and a lack of social support. They were also often alone when they died, meaning they had no access to life-saving treatment.
Dr. Tam also voiced support for supervised consumption sites, saying there is good evidence to show they can play an important role in the opioid crisis because they can immediately help people who overdose.
“From our perspective, safe-consumption sites work and they save lives,” she said.
Earlier this summer, the Ontario government put a freeze on plans to open new overdose-prevention sites.
The Globe and Mail, September 18, 2018