Pandemic increases number of opioid-related deaths, APH reports

The ongoing opioid crisis in the Sault and Algoma district has worsened as a result of the COVID-19 pandemic.

A presentation entitled ‘The Perfect Storm: COVID-19 and the Opioid Crisis’ - delivered by Algoma Public Health (APH) officials at the health unit’s most recent board meeting (held Oct. 27) included numbers highlighting that fact.

The report, presented by Allison McFarlane, public health nurse, Amanda Perri, epidemiologist and Kristy Harper, manager of community wellness and chief nursing officer, showed:

• From April 2020 to March 2021, there was a 96 per cent increase in opioid-related deaths compared to the previous year
• From January 2021 to August 2021, a total of 56 suspected drug-related deaths were reported (compared to 53 from January 2020 to August 2020)
• In Algoma, fentanyl was found in 87 per cent of opioid-related deaths in 2020
• From January to August 2021, the number of naloxone kits dispensed from pharmacies, APH, and community agencies increased and surpassed the total amount distributed in 2020.

The report showed there were 44 opioid-related deaths in Algoma in 2020, compared to 14 in 2019.

There were 35 opioid-related hospitalizations in the region in 2020, compared to 21 in 2019.

There were 172 opioid-related emergency department visits in Algoma in 2020, compared to 112 in 2019.

The increases in opioid-related deaths during the pandemic in northern Ontario have been mostly in the 25 to 44-year-old age group, followed by those aged 45 to 64 and people below the age of 25.

The percentages of opioid-related deaths among males and females were almost equal between those three age groups. 

Connections between the COVID-19 pandemic include physical distancing and isolation.

Stay at home orders increased stress, anxiety, and depression among many, but the APH report stated literature shows increased drug and alcohol use related to social isolation and stay at home orders.

Border and travel restrictions have also played a role in the  opioid crisis.

Border closures disrupted drug supply chains. Those disruptions in supply led to people turning to unknown sources, increasing the risk for opioid-related harm and deaths.

Job losses and changes to income caused by COVID-19 lockdowns and business closures have also been a factor.

The APH report found daily routines and schedules affected by pandemic-related job loss increased stress and anxiety, poor coping skills having led to increased substance use or, for some in recovery, re-use of substances.

While Allison McFarlane, APH public health nurse, reminded the board “no single individual approach or organization can effectively address this crisis alone,” APH officials and board members agreed the health unit will continue to battle the opioid crisis with the help of its community partners, such as the Canadian Mental Health Association (CMHA), as well as drawing on advice from those who have experienced and made it through the struggles of opioid use.

The report said addressing socio-economic factors that worsen the opioid crisis must be addressed.

While those factors are not quickly and easily fixed and require enormous political will, those factors include the need for better education, childhood development, access to health care, improvement of certain neighbourhoods, addressing unemployment and wage inequality, food insecurity and removing the stigma attached to problematic drug use (thereby encouraging people who use drugs to step forward and seek help).

“Unfortunately, not everyone has the same opportunities to be healthy. People who have limited access to supports and resources are likely to be less healthy than those who have greater access and resources to maintain a healthy lifestyle. Health inequities are the differences in health outcomes between population groups that are unfair, avoidable, related to social inequality and disadvantage, and are beyond the individual’s control. In fact, 50 per cent of health outcomes are directly related to social and economic conditions. These conditions are collectively known as the social determinants of health,” said Allison McFarlane, APH public health nurse in an email to SooToday.

“Because of the unique characteristics and needs in northern Ontario (such as geography, isolation, transportation and accessibility), equitable access to health care is a challenge. Addictions treatment in northern Ontario must be prioritized so that those living in northern Ontario with addictions and/or mental illness have a variety of diverse, accessible and appropriate treatment care options. This will ensure individuals living with addiction in northern Ontario can transition through the continuum of care and receive the right care, at the right time based on their level of need,” McFarlane wrote.

Changing the language typically used amid the opioid crisis must be changed so that the barrier of stigma is taken away and people who use drugs seek the help they need, McFarlane stated.

Recommended changes in language, McFarlane wrote, include:

• Avoiding ‘addict, user, drug abuser, drug user,’ choosing instead to use ‘people who use drugs,’ ‘person with a substance use disorder’ and ‘someone with lived experience’  
• Avoiding ‘former drug addict’ or referring to someone as being ‘clean’ or ‘dirty,’ choosing instead to use ‘people who have used drugs’ or ‘person in recovery’
• Avoiding ‘substance/drug abuse’ or ‘substance/drug misuse,’ choosing instead to use ‘substance/drug use,’ substance use disorder, problematic drug use or dependence

McFarlane emphasized consulting with people who have overcome drug use is important in battling the opioid crisis.

“Service providers across all sectors (and levels of government) need to honour the voices of people with lived experience(s). Resources, tools and approaches to substance use should be developed with ongoing engagement of people with lived experience(s) to ensure that their perspective, insights and needs inform the implementation of actions,” McFarlane wrote.