Opioid-related deaths doubled in Canada between 2019 and the end of 2021, with Manitoba, Saskatchewan and Alberta experiencing a dramatic jump, mostly among men in their 20s and 30s, says a new study that calls for targeted harm-reduction policies.
Researchers from the University of Toronto analyzed accidental opioid-related deaths between Jan. 1, 2019 and Dec. 31, 2021 in those provinces as well as British Columbia, Ontario, Quebec, New Brunswick and Nova Scotia, and the Northwest Territories.
Manitoba saw the sharpest rise in overdose deaths for those aged 30 to 39 – reaching 500 deaths per million population, more than five times the 89 deaths per million population recorded at the beginning of the study period.
In Saskatchewan, the death toll for that age group nearly tripled to 424 per million, up from 146 per million, while Alberta’s rate spiked more than 2.5 times to 729 fatalities per million, up from 272 per million. Ontario’s death rate reached 384, up from 210 per million.
British Columbia, which has been the epicentre of the overdose crisis, recorded 229 deaths per million for that age group in 2019, climbing to 394 in 2020. All data for 2021 from that province’s coroners service was not yet available when researchers completed their work based on information collected by the Public Health Agency of Canada.
Nationally, the annual number of opioid overdose deaths surged from 3,007 to 6,222 over the three-year study period, which researchers note coincided with pandemic public health measures that reduced access to harm reduction programs and imposed border restrictions that may have increased the toxicity of the drug supply.
“In addition, for many, the pandemic exacerbated feelings of anxiety, uncertainty, and loneliness, contributing to increased substance use globally,” they said.
The study was published Monday in the Canadian Medical Association Journal.
Senior author Tara Gomes said one in four deaths involved people in their 20s and 30s. More than 70 per cent of the overall deaths were among men.
A spokesman with the coroners service in British Columbia said 78 per cent of people that fatally overdosed in that province between 2019 and the end of 2021 were men.
The sharp surge in fatal overdoses – especially among young adults in the Prairies – suggests provinces must act quickly, said Gomes, an epidemiologist who called for more harm-reduction services including supervised consumption sites.
“Being slow and not being as nimble as we would like to be in our responses can have really devastating impacts,” said Gomes, also lead principal investigator of the Ontario Drug Policy Research Network.
Bernadette Smith, Manitoba’s minister of housing, addiction, homelessness and mental health, said the province plans to open its first supervised consumption site in Winnipeg next year and will also offer drug-testing machines so people can check if their illicit substances are toxic.
“We came out of a previous government that didn’t take a harm-reduction approach, unfortunately,” said the New Democrat, whose party defeated the Progressive Conservatives last fall.
“We’re working with front-line organizations because they have not been listened to or worked with for the last seven years in our province, which has been a real problem.”
Manitoba plans to train family doctors to treat addiction with medications including Suboxone and methadone, said Smith, noting the physicians typically refer patients to detox for care.
“We’re creating a model so that folks aren’t having to go to a bunch of different places to get different services,” said Smith.
She declined to say whether Manitobans will have access to a prescribed safer supply of drugs.
Tanya Hornbuckle of Edmonton said her son Joel Wolstenholme was 30 when he died in 2022. He became addicted to illicit substances at about age 14, starting with cannabis before shifting to methamphetamine, cocaine and other drugs that were increasingly laced with fentanyl.
He also battled a mental illness but getting help for both that issue and addiction in a single service was challenging, Hornbuckle said.
Wolstenholme tried multiple times to detox but there were never enough beds at a clinic where people had to line up at 8 a.m., she said.
“It would happen over and over and then he would call me. I went and stood in line or I drove him there and waited with him in the lineup. They wouldn’t have enough beds.”
Her son’s anxieties and addiction worsened when pandemic restrictions prevented her from entering an emergency room with him because he did not trust staff, Hornbuckle said.
On Feb. 6, 2022, Hornbuckle went to her son’s home so they could cook together. She found him dead.
The Alberta government’s strategy of focusing more on recovery and abstinence-based treatment than harm reduction, mental health and housing is the wrong approach, said Hornbuckle, noting that for a time her son slept in parks and abandoned houses after losing his vehicle and apartment to addiction.
Rebecca Haines-Saah, an associate professor of community health services at the University of Calgary, called the deaths of young people from overdose a tragedy, and said many more suffer from brain injury due to toxic substances.
“Obviously, we have the incorrect response. We do not have the approach and services available to keep people alive,” said Haines-Saah, who also called for more harm-reduction services.
“We don’t have a full-scale public health response that is required. We don’t have any plans to fund anything that relates to what we would call harm reduction.”
Much of the current approach to addiction excludes a large number of recreational drug users, said Gomes. She said between a third and half of the deaths in Ontario involved people without an opioid use disorder diagnosis.
“So, focusing on (residential treatment) alone is something that really concerns me because we really need to make sure that we have different options for different people.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
