About 13 people a day in Canada died as a result of opioids in 2018, according to a new report that shines a spotlight on preventable poisonings.
Released on Thursday, the report by Parachute, a Canadian charity dedicated to injury prevention, and the Injury Prevention Centre at the University of Alberta’s School of Public Health focused on poisoning — the toxic effects of substances such as medication, cleaning products or gas vapour — on the body.
The report found that in 2018, opioids were responsible for 4,614 deaths in Canada, equating to about 13 lives lost per day, based on data from the Public Health Agency of Canada. It breaks down the top 10 pharmaceutical and top 5 non-pharmaceutical causes behind cases at Canada’s five poison control centres.
“We know that the vast majority of these are preventable,” said report co-author Pamela Fuselli, president and CEO of Parachute.
The numbers are stark, Fuselli said, with nearly half of all opioid-related poisoning deaths occurring in those aged 30 to 49, primarily men.
Pamela Fuselli, president and CEO of Parachute, a Canadian charity dedicated to injury prevention, says what sends people to hospital for poisoning varies by age group and can include over-the-counter medications such as acetaminophen, alcohol, prescription drugs, including opioids, and cleaning products. (Kelda Yuen/ CBC)
“We’re losing people who can contribute to Canada and [losing] lives … that don’t need to be lost.”
Individuals using illicit substances can be at increased risk of poisoning despite using their usual amount because of the growing degree of contamination of the drug supply with fentanyl and other ultrapotent opioids, the report said. Respiratory arrest and death can result.
The report recommends steps to prevent the loss of a family member and the “heartache” that follows, such as:
Harm reduction to reduce the negative effects of stigma surrounding people with a substance use disorder.
Offering treatment and rehabilitation services for those with substance use disorders and associated mental health disorders.
Expanding safe consumption sites where people can access safe needles and receive medical attention and support, including conversations on accessing treatment and rehabilitation services.
Clamping down on illegal drug production and trafficking.
Providing educational campaigns to inform people of the risks associated with use of substances.
Looking at what leads people to take drugs in the first place.
Providing naloxone to prevent deaths among people who take opioids.
Locking up medications and cleaning products to keep them out of reach of young children.
Getting rid of any medications that are no longer needed.
Fentanyl detected in majority of illicit drug deaths
Co-author and epidemiologist Kathy Belton, associate director of the Injury Prevention Centre at the U of A, said Western Canada has been hit hard, with British Columbia seeing 1,542 deaths related to illicit drug use in 2018. Of these, fentanyl was detected in 87 per cent.
When both Fuselli and Belton crunched the numbers, they said they were surprised to find that twice as many people now die of unintentional poisonings than traffic-related injuries — the leading cause of unintentional injury deaths for children and teens for nearly 20 years.
“It just jumped out at you on the page,” Belton said.
She also pointed to a 2018 study in Alberta that showed the increase in death and disease accompanying the opioid crisis was largely due to unintentional poisoning rather than intentional self-harm or suicide by poisoning.
‘Long road to go to solve poisoning’
“An overdose is really the wrong term,” Belton said, because people taking opioids to get high aren’t intending to die.
“If we start looking at that’s not the intended outcome, then we look at this whole issue of poisoning and opioid poisoning differently,” she said. “Maybe they would stop blaming the individual because addiction is a disease just like any other disease.”
Jason Mercredi, executive director of Prairie Harm Reduction in Saskatoon, says he thinks the report underestimates the scale of hospitalizations from opioids and would like to see an expansion of harm-reduction services across Canada supported with long-term funding. (Don Somers/CBC)
Jason Mercredi, executive director of Prairie Harm Reduction in Saskatoon, was not involved in writing the report, but he said he thinks it underestimates the scale of hospitalizations from opioids given how busy paramedics are in Saskatchewan.
“I think the most frustrating part of my job is when I get a call from somebody’s mom whose kid died, and they’re calling and asking what they can do to support us,” Mercredi said. “That’s backwards. It should be the opposite relationship, but they have nowhere to go to and they don’t feel like they’re being listened to.”
Mercredi said he would like to see an expansion of harm-reduction services across Canada supported with long-term funding.
There has been an unprecedented spike in opioid overdoses in Canada during the COVID-19 pandemic, with a 25 per cent increase in Ontario and a 39 per cent increase in British Columbia. 1:59
Fuselli said when it comes to other types of poisoning deaths, people may think that the problem of poisoning slowed with the introduction of child-resistant caps and blister packs for medications, but that’s not the case.
“We actually have a long road to go to solve poisoning,” she said.
What sends people to hospital varies by age group and can include over-the-counter medications such as acetaminophen, alcohol, prescription drugs, including opioids, and cleaning products, depending on how much is ingested, Fuselli said.
Belton said that as a scientist, it’s important to get more information on the circumstances surrounding an event to find out what’s the best point to intervene and stop injuries from happening.
A pair of shoes representing a life lost hangs on the Burrard Street Bridge in Vancouver as part of an art display on International Overdose Awareness Day in August. (Ben Nelms/CBC)
But that data is not collected in the same database in Canada. Instead, the report was compiled based on 2008 to 2018 data on deaths and hospitalizations in all provinces except Quebec, as well as emergency department visits in Alberta and Ontario.
The authors recommend setting up a national phone number that would allow health professionals to connect seamlessly with a poison control centre. They would also like a database similar to what’s in the U.S. and European Union to look for signs of contaminants, which could also help inform health-care providers when exposures occur.
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.
