Opioid overdoses are killing a growing proportion of people experiencing homelessness in Ontario, a new study suggested Tuesday.
Researchers from the Institute for Clinical Evaluative Sciences found about one in six people who died from opioid overdoses in 2021 were homeless, compared to one in 14 people back in 2017.
“(It’s) something that even shocked us as researchers when we first derived some of these numbers,” said Richard Booth, lead author of the study that was published in the journal Addiction.
“That is a massive increase, you know, spanning the pandemic where accidental opioid-related overdoses became a much more significant element in the lives of people experiencing homelessness,” said Booth, an associate professor of nursing at Western University in London, Ont.
The researchers examined coroner’s data and health records for 6,644 people who died from opioid overdose deaths in the province between July 2017 and June 2021.
During the first few months of that time period, 7.2 per cent of those who died were homeless. That percentage rose to 16.8 per cent in the last few months.
During the first few months of that time period, 7.2 per cent of those who died — or 26 out of 359 people — were homeless. That percentage rose to 16.8 per cent — or 97 out of 578 people — in the last few months.
Although the study results show what happened, the numbers don’t explain why, the researchers noted.
But the disproportionate percentage of overdoses among those who are homeless clearly shows that housing is a “protective” factor, Booth said.
“Housing as a social intervention is very important,” he said.
The increasing toxicity of the drug supply over the last few years led to more overdose deaths, added Dr. Stephen Hwang, a physician-researcher at the MAP Centre for Urban Health Solutions at Unity Health Toronto who was a co-author of the study.
The COVID-19 pandemic’s impact on health and social services was also likely a factor for marginalized people, he said.
“The disruption caused by the lockdown and by the real lack of availability of services caused people to change where they spend time and thus where they use drugs,” Hwang said.
“I think that contributed to people using in higher risk situations that would more likely result in death,” he said.
The study findings highlight the importance of outreach to marginalized people using drugs, Hwang said.
“We need to bring harm reduction and treatment options to people where they are on the street or in the community rather than waiting for them to come to us in clinics or hospitals,” he said.
The Ontario findings are in keeping with the harsh reality of overdose deaths in British Columbia and other parts of Canada, said Jade Boyd, a research scientist with the BC Centre on Substance Use who was not involved in the study.
“We are dealing with an overdose crisis with a poisoned toxic drug supply,” Boyd said.
She pointed to current Health Canada data, which says there is an average of 21 opioid toxicity deaths every day in this country.
Although the agency doesn’t have statistics on what percentage of people who died were homeless, Boyd said the impact is greater on marginalized people due to “lack of resources, stigma and discrimination.”
“There’s an urgent need right now to expand access to low-barrier harm reduction services,” she said. “That can be safe consumption sites, treatment options, drug checking (and) regulated drug supplies or safe supplies throughout Canada,” she said.
Preventing homelessness in the first place is another critical part of the solution, Boyd said.
That means addressing poverty, stigma around drug use and the “giant affordability issue around housing in Canada,” she said.
Increasing access to “low-barrier” housing is vital, both Boyd and Hwang said.
That means supportive housing where abstinence from substance use isn’t required to move in and an end to the practice of evicting people if they use drugs in their homes, they said.
Boyd said the fact that people are dying every day from preventable overdoses is “devastating” and “impacts all of us.”
“The toxic drug supply … is intersecting with issues of poverty, stigma and housing affordability,” she said.
“We need to remember this impacts all Canadians — even those who are housed or may be at risk of losing their housing and security.”
This report by The Canadian Press was first published Oct. 17, 2023.
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.
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