A new report says the number of opioid-related deaths rose alarmingly in all parts of Ontario during the pandemic and suggests public health restrictions designed to protect residents from COVID-19 likely contributed to the increase.
The report was prepared for the Ontario Drug Policy Research Network, the Office of the Chief Coroner of Ontario, Ontario Forensic Pathology Services, and Public Health Ontario.
It is a follow-up of a previous report released last November that noted a 38 per cent increase in opioid-related deaths from the onset of the pandemic to June 2020. This report compiled statistics from March to December of last year.
In 2019, there were 4,000 opioid-related deaths across Canada, and 94 per cent were accidental. In Ontario, there were 1,517. Overall, in 2020, there were 2,426 in the province, an increase of 62 per cent.
Public health units across the province reported increases in opioid-related fatalities, but in 15 the rate more than doubled. Lambton Public Health was among those that had among the most statistically significant increases. Chatham-Kent Public Health also reported double the number of deaths compared to before the pandemic, along with Middlesex-London and Windsor-Essex County.
Not included in the study, but related, the Windsor-Essex Community Opioid and Substance Strategy issued four alerts regarding high incidents of overdoses in a one-month period.
Although increases were found in rural and mid-sized communities, the largest jump was in larger urban centres.
The overwhelming majority of fatalities were in private homes, a statistic that did not change much with the pandemic, but the number of people experiencing homelessness at the time of their death almost doubled from 135 to 323. There was also a shift in the location of overdose deaths for that population. More were outdoors, in a rooming house, and in shelters, including hotels and motels where guests were staying so they could physically distance themselves from others.
More alarmingly, the report indicated more people who passed away were taking an unregulated drug. There was a ten-fold increase in the use of non-prescription benzodiazepines. One in four deaths were related to those compared to one in 20 before the pandemic. Three types of benzodiazepines were commonly detected post-mortem. Etizolam, flualprazolam, and flubromazolam are not approved for use in Canada. It indicates the supply of opioids has been contaminated and is increasingly unreliable. Those drugs also complicate resuscitation efforts. Naloxone will reverse the effects, but not the extreme sedation related to benzodiazepines.
The prevalence of cocaine and methamphetamine also rose, while fentanyl continued to be a problem. However, the proportion of deaths related to methadone declined.
The report's conclusion reinforces the importance of safe, affordable housing, requiring immediate attention from all levels of government. It also emphasizes the need for widespread integration of harm reduction services and healthcare providers in the shelter and supportive housing systems. The expansion of harm-reduction strategies, lower barriers to treatment for addiction, and a safer supply of regulated drugs are other urgent requirements in addressing the higher death count.
