Sharp rise in OD deaths demands better policies for those in their 20s, 30s: study

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."

This report by The Canadian Press was first published April 15, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Camille Bains, The Canadian Press

Photo: residential treatment