Opioids killed more people in Ontario in the second year of the pandemic than in the first, but the province saw a drop in those deaths last March, according to newly released data.
About eight people a day were dying from opioids in the second year of the pandemic, according to preliminary data from the Ontario Office of the Medical Examiner. From April 2021 to March 2022, there were 2,790 opioid-related deaths, a slight increase from 2,727 in the first year of the pandemic.
Both were big jumps from 2019, when opioids killed 1,559 Ontarians – about four people a day.
“It’s ongoing and it’s bad and it got a lot worse during the pandemic,” Dr. Dirk Hyer, Ontario’s chief medical examiner, said in an interview.
However, the figures also show that the death rate fell by 10 percent in the first quarter of this year compared to the same period last year. The data is considered preliminary because it includes both confirmed and possible opioid-related deaths and is subject to change, Huyer said.
“Should we be celebrating the fact that we’re down 10 percent?” Huyer said. “No. We still have a lot of people dying, but, yeah, we don’t keep going up, so that’s good.”
The number of total deaths fell by 31 per cent in March 2022 compared to March 2021. Ontario lifted the most restrictions for COVID-19 this month, though Huyer said at this point it’s just a correlation, not necessarily the cause of the fall.
Overall, the death rate for opioid toxicity in 2021 was 19.5 deaths per 100,000 people – more than double the rate of 9.1 deaths per 100,000 people in 2017.
The data suggests to Huyer that the jump in opioid deaths during the pandemic was due to more people using drugs on their own because of fewer services available in their communities.
“This community is now opening up again, so there’s some support from a safety standpoint, but also support for mental wellness, and generally, things are better overall,” Huyer said.
He also said the border closure may have had an impact on drug supply.
Northern Ontario continues to be the hardest hit in Ontario and the problem is getting worse, with the region having more than twice the death rate of the province as a whole.
“Thunder Bay, Sudbury, Algoma, just significant increases,” Huyer said.
The Thunder Bay Regional Health Unit had an opioid death rate of 82.1 per 100,000 people in the first quarter, which was the highest rate in the province and more than four times the provincial rate.
Public Health Sudbury and Districts was the next highest with an opioid death rate of 57.9 per 100,000, while Algoma Public Health – in and around Sault Ste. Marie, Ont. – was third with a death rate of 52 per 100,000.
Men continue to die from opioids at a disproportionate rate, accounting for three out of four deaths in Ontario. Men aged 25 to 44 accounted for 54 percent of deaths in the first quarter of 2022.
Fentanyl remains the most common substance found in those who died from opioids, the data show. It was involved in 88 percent of deaths in 2021, up from 86 percent the year before — which was a big jump from 53 percent of all opioid deaths in 2019.
Tara Gomes, an epidemiologist at Unity Health in Toronto who studies opioid use, is cautious about the recent drop in deaths, saying the data remains preliminary.
“It’s so hard to know for sure right now, but it’s better than the alternative, which is what we continue to see during the pandemic,” he said.
“But it’s important to remember that eight deaths a day compared to four deaths a day before the pandemic is such a big change.”
Her work has focused on urban-rural disparities as well as challenges in the north.
“I think a lot of the harm reduction services that we have are really designed to work well in an urban setting, but in larger areas or rural areas, it’s a lot harder to design and manage,” he said.
Gomes said the province and federal government need to loosen rules on proven opioid treatments like Suboxone and methadone, greatly expand harm reduction and safe drug use spaces, and safe drug supply.
Her research found that opioids are disproportionately killing the homeless and unemployed population during the pandemic. It has also greatly affected construction workers, her research shows.
“We still haven’t solved that,” he said.
This report by The Canadian Press was first published on August 23, 2022.
