More than 10,300 Canadians have died of opioid-related overdoses in less than three years, according to new national data, an ominous figure that suggests efforts to curb the crisis are falling short.
The Western provinces of British Columbia and Alberta are still the hardest hit, with 1,155 and 613 deaths in the first nine months of 2018, respectively. But public-health experts point to worrying trends in other provinces, such as Ontario, where opioid-related deaths linked to fentanyl have seen a substantial jump. In 2016, 45 per cent of opioid-related overdose deaths in Ontario were linked to fentanyl. In 2018, that rose to 71 per cent.
The Public Health Agency of Canada released new figures Wednesday showing 3,286 people died of opioid-related overdoses across the country from January to September, 2018. The agency started tracking national mortality figures for opioid-related overdoses in 2016 and each year, the figures have increased. In 2018, the mortality rate was 11.8 per 100,000 – a rise from 11.1 per 100,000 in 2017 and 8.4 per 100,000 in 2016.
Fentanyl, a powerful and often deadly opioid, is linked to a majority of the deaths and is increasingly found in the street drug supply. About three-quarters of the 2018 deaths were linked to fentanyl or fentanyl-like substances.
The numbers come as jurisdictions across the country struggle to get a handle on the crisis. The provincial responses vary widely. In B.C., health officials are pushing expanded harm reduction and the idea of decriminalization of drugs to contend with the flow of illegal toxic fentanyl. In Alberta, which holds a provincial election next week, United Conservative Party Leader Jason Kenney has questioned the usefulness of supervised drug-use sites, while Ontario’s government has cut funding to some sites.
Public-health experts say the fact opioid-related deaths continue to rise shows much more needs to be done to get it under control. B.C. provincial health officer Bonnie Henry said the rising rate is “particularly worrisome” in light of some changes in provincial policy across the country.
“We are going to continue seeing people dying from the toxic street drug supply,” Dr. Henry said. “Overdose prevention sites and supervised consumption services save lives."
She said that expanding access to supervised drug-use sites and making treatment options available seem to have helped keep the rate level for opioid overdose deaths in her province. In 2018, the overdose death rate in B.C. was 30.9 per 100,000, similar to 2017, when it was 30.7 per 100,000. In Alberta, the death rate rose to 19 per 100,000 in 2018 compared to 17.5 per 100,000 in 2017.
Governments, policy-makers and public-health officials have been sounding the alarm over the opioid crisis for several years, but not enough bold measures are being taken to address the root of the problem, said Evan Wood, director of the British Columbia Centre on Substance Use. In particular, Dr. Wood highlighted the lack of a comprehensive system to treat addiction in Canada and inadequate policies to deal with fentanyl.
Dr. Wood said that in most of the country, it’s difficult for people addicted to opioids to access front-line treatment such as methadone or buprenorphine. In addition to treatment, Dr. Wood said policies need to change to reflect the fact that fentanyl is so profitable that it will likely be impossible for the police to ever get a handle on it. Instead, Dr. Wood said new policies, such as decriminalization, are needed to make the drug supply safer.
Dr. Henry has also suggested decriminalization and says it would reduce the stigma around drug use. In many cases, people who die of opioid-related overdoses use drugs alone because they fear social or criminal repercussions. Removing that can help bring them out of the shadows and connect them with social services that can help them, Dr. Henry said.
Fardous Hosseiny, national director of research and public policy with the Canadian Mental Health Association, said long wait times for addiction and mental-health treatment are major barriers that exacerbate the problem. He also highlighted the stigma associated with opioid use and said that until it’s treated as a public-health issue, not a criminal one, deaths will continue.
The Public Health Agency of Canada started tracking national opioid mortality data in 2016. There were 3,017 deaths that year and 4,034 in 2017. More than 10,300 people have died in Canada from opioid-related overdoses from January 2016 to September 2018.