A new report on opioid poisonings reveals the rate of emergency room visits and hospitalizations is far higher in Alberta than in Ontario.
The joint report by the Canadian Institute for Health Information (CIHI) and the Canadian Centre on Substance Abuse states that in 2014-15 the rate of emergency room visits for opioid poisoning was 57 per cent higher in Alberta than in Ontario (27 versus 17 visits per 100,000 population).
The report also found that 13 Canadians per day were hospitalized in 2014-15 after taking pain-killing opioid medications like fentanyl, oxycodone and morphine. In Alberta, three people are hospitalized every day because of opioid-related emergencies.
The study also looked at the rate of opioid hospitalizations in 2010-11 compared to 2014-15. It found the rate of hospitalization in Alberta increased by 53 per cent in Alberta over that period, compared to a 22 per cent increase in Ontario.
The average length of stay in the hospital for opioid poisoning was eight days in 2014-2015.
“Over the last five years, emergency department visits for opioid poisoning increased dramatically in Ontario and Alberta,” Brent Diverty, vice president of programs at CIHI, said.
“What’s worrisome is that these numbers don’t tell the full story, since some people die before reaching the hospital. This report is a great first step, but we still don’t have the complete picture on opioid poisonings in Canada.”
Alberta has expanded access to naloxone kits and doctors are rethinking prescription practices. Still, Alberta’s associate health minister said there’s always more work that could be done.
“A lot of the recommendations coming from CIHI are recommendations that we have already taken some actions under. So in a lot of ways, that helps me to know that we are on the right track,” Brandy Payne said.
“We want to continue to expand access to opioid dependency treatment and continue to work with the College of Physicians and Surgeons around some of those prescribing practices to help ensure people are getting the medications they need but also that they have the supports that they need.”
Alberta Liberal leader David Swann doesn’t think the government is doing enough to combat the “tremendously serious epidemic of opioid use in our society.”
“It’s way beyond our capacity right now. It appears across the country, and Alberta and B.C. are kind of the epicentre of this,” he said. “We’re not getting ahead of it. We’re not providing the kind of supports for the high-risk individuals. We’re not providing the education supports.”
Swann said people at risk are waiting too long to access counselling, therapy and harm-reduction programs in order to get the support services they need.
“The lack of commitment to this over the last three years is now showing up in spades. This has been going on, doubling in numbers, over the last four to five years.”
Petra Schulz lost her son, Danny, to a fentanyl overdose in April 2014. The 25-year-old was a recovering addict and relapsed. Schulz said it’s encouraging to see that Canadians are getting a better idea of the size of the opioid crisis, but adds the study only scratches the surface.
“It is heart-wrenching to see the numbers,” she said. “But while these numbers are high, the actual numbers are still far greater… There are various situations where people overdose and in many cases they don’t make it to the hospital so they would not have been captured in these statistics.”
Schulz is a member of a group called Mothers Stop the Harm, a network of Canadian mothers who have lost children to drug misuse; or as she calls it “an elite club that nobody wants to belong to.”
Having lost a child, she focuses her efforts on harm reduction, or anything that keeps a person alive “so they have a chance to make a better decision on another day.”
While Schulz said she’s happy to see the provincial and federal governments have increased efforts to reduce drug use – in particular the Alberta government’s commitment to explore a plan to set up safe, supervised sites for opioid use – it’s coming far too late.
“The action is just coming so deeply into the crisis and there is so much catch up to do,” she said.
“If he (Danny) would have had this level of awareness of the dangers, this level of awareness of strategies that can help people stay safe, and more access to treatment options, he would be here today.”
While hospitalization rates increased across all age groups, the study found the greatest change – 65 per cent – occurred among people between the ages of 15 and 24.
“The majority of poisonings (52 per cent) among youth were intentional,” the report reads.
The report also found that seniors accounted for nearly one-quarter of all hospital admissions for opioid overdoses, most of them accidental.
“People don’t tend to think of seniors when they think about drug overdoses,” Diverty explained. “Although there are many reasons for these hospitalizations, this report shows that Canada’s seniors are particularly vulnerable and may benefit from focused interventions.”
Accidental poisonings accounted for 49 per cent of opioid-related hospitalizations in Canada. Intentional poisonings accounted for 33 per cent. Twelve per cent of hospitalizations were for unknown reasons and six per cent were attributed to therapeutic poisonings, or those that occurred when the drug was used as prescribed.
The deputy CEO of the Centre on Substance Abuse said the results of the report will help to reduce the stigma surrounding opioid use and addiction, because it’s clear that those experiencing harms are parents and grandparents, colleagues, neighbours and young adults.
“The opioid crisis has put a spotlight on the need for evidence to address pain management going forward, as well as for changes within the entire system of care for those suffering with an addiction to opioids and other substances,” Rho Martin said in a statement.
In 2014-15, there were 4,779 hospitalizations due to opioid overdoses in Canada, up from 3,357 in 2007-08.
With files from The Canadian Press.