Opioid deaths in Canada increased by 592% over 17-year period, University of Waterloo study indicates

The number of people who died from opioids in Canada increased by 592 per cent between 2000 and 2017, a new University of Waterloo study indicates.

Using data from the Public Health Agency of Canada (PHAC), researchers in the university's school of pharmacy found there were 20 opioid deaths per million people in 2000. That rose to 118.3 deaths per million people in 2017.

The study was published online on June 25 in Addiction, the journal for the Society for the Study of Addiction.

"After 2015 … things exploded. So we had huge increases between 2015 and 2017," Wasem Alsabbagh, a pharmacy professor and lead author of the study, said in an interview. "But before that, it was happening gradually and we did not [pay] a lot of attention to it."

Alsabbagh said other studies have looked at media stories on the opioid epidemic, but it wasn't really reported on before 2013.

"We were not seeing how many people were dying increasingly in all Canadian provinces over the years from 2000 to 2013," he said.

"This just did not make it to the headlines unfortunately."

Hospitalizations rose 'significantly'

The researchers said it was important to look at data from 2000 because assessments on opioid-related deaths, hospitalizations and emergency department visits in Canada "have relied mainly on provincial databases, while national assessments generally do not provide information before 2016."

Hospitalizations rose "significantly" between 2000 and 2012, from 159.7 opioid hospitalizations per million people in 2000 to 325.3 hospitalizations in 2012, the study indicates.

Visits to the emergency department also rose by 188 per cent, from 280.6 per million people in 2000 to 810.1 in 2012. Alsabbagh said the researchers are still waiting for updated numbers for post-2012 hospitalizations and emergency department visits.

Increased overdoses and deaths

Suspected opioid overdoses and deaths remain high across the country.

In Waterloo region, paramedics said they responded to 39 overdoses from June 27 to July 3, 2021, with 11 of those calls on July 2. As of June 4, the region had reported 49 suspected opioid-related deaths.

On Tuesday, the Wellington Guelph Drug Strategy reported three deaths in the past month were suspected to be from opioid overdoses, and there had been seven suspected overdoses in the previous five days.

A news release from the drug strategy pointed to red fentanyl, which is "believed to be especially toxic."

In B.C., on average, six people die each day of opioid use, and the province is on track to record more than 2,000 deaths this year. They include a 12-year-old girl from Vancouver Island who died in April. Her family said her death happened during her fourth overdose.

The pandemic may also be playing a big role in increased opioid overdoses and deaths. A national report last October found the overall health of Canadians deteriorated during the first eight months of the pandemic and showed more people turned to drugs, alcohol, tobacco and screen time rather than physical exercise to cope with the stress.

In the report, front-line workers told PHAC that social restrictions led to people using opioids alone, "decreasing the chance of intervention if they overdose and contributing to the increase in overdose-related fatalities."

CBC Kitchener-Waterloo reached out to federal Health Minister Patty Hajdu for comment on the University of Waterloo study, and asked what the government would do to address the opioid epidemic, but did not receive a response.

In April, Hajdu announced $1.7 million in funding for projects led by Community Addictions Peer Support Association and Moms Stop the Harm to help them combat stigma related to substance use to help people impacted by a family member living with an addiction.

In May, Hajdu also announced funding to expand the safe supply program in Guelph. 

"We have to do more to reach those most at risk," Hajdu said in a news release about the Guelph safe supply program.

Post-overdose support

Alsabbagh said the researchers also noted that between 2000 and 2011, the number of people dying for any reason in the year after they were discharged from the hospital for treatment for an opioid-related reason rose from 3.9 per cent to 7.4 per cent.

He said this shows there's a need for support for people who survive opioid-related hospitalizations.

"What is happening to those people, we don't know exactly, but we know that we should offer them more care, more support, more linkage to programs to help them with the opioid-use disorder."

It's a complex issue, he noted, with many medical and social aspects to it, so there needs to be a multi-disciplinary team that works together to help the person. That can include pharmacists who can work with patients and the people prescribing medications, to ensure opioids are only prescribed when necessary, Alsabbagh said.

He added the opioid epidemic doesn't just hurt the individual — it can hurt the community.

"No one is immune to the opioid epidemic. We tend to think this only happens to marginalized people … well, it is happening everywhere."