Assessing the Harms of Opioids

Opioid misuse is a pressing issue in Canada with rates of drug-related overdose deaths rising drastically across the country. Canada is the second largest per capita consumer of prescription opioids (1) and increasingly more patients are being treated for harms related to these drugs. Between 2009 and 2014, fentanyl, a potent synthetic opioid, was identified as a cause or a contributing cause in at least 655 deaths in Canada. (2) Despite the prevalence of this epidemic, reliable pan-Canadian data about the burden of harms associated with opioid use on Canadian hospitals is currently lacking.

A collaborative report between the Canadian Centre on Substance Abuse (CCSA) and Canadian Institute for Health Information (CIHI) fills this evidence gap. Hospitalizations and Emergency Department Visits due to Opioid Poisonings in Canada is the newest addition to CCSA’s resources on the costs and impacts of substance use. Its development is part of CCSA’s ongoing efforts to inform and support initiatives aimed at reducing opioid-related harms, including the 2013 release of First Do No Harm: Responding to Canada’s Prescription Drug Crisis.

The report provides pan-Canadian data on rates of hospitalizations and emergency department visits due to opioid poisonings. Opioid poisoning refers to the clinical code used in medical records when a patient is diagnosed with an acute toxicity due to opioids. Findings from the report show that:
• The rate of hospitalizations due to opioid poisoning in Canada increased over 30% between 2007–2008 and 2014–2015.
• Quebec had the lowest rates of hospitalizations due to opioid poisoning compared to all other provinces across all data years.
• Although seniors over age 65 represent only 16% of Canada’s population, they accounted for nearly one-quarter of hospitalizations due to opioid poisoning.
• The majority of opioid poisonings among seniors were accidental — likely due to the use of multiple medications and age-related changes to the body.
• Compared to other age groups, youth rates of opioid poisoning increased most rapidly and the majority of these were due to intentional self-inflicted harm.

This evidence was compiled to provide the first cross-Canada picture of who in each Canadian jurisdiction is experiencing opioid-related harms. This data can help inform and tailor prevention and treatment efforts in each jurisdiction. The data presented in the report could also be used to fuel future multi-sectoral collaborations between organizations in an effort to mitigate harms associated with opioids.

1 International Narcotics Control Board. (2013). Narcotics drugs: estimated world requirements for 2013; statistics for 2011. New York: United Nations.
2 CCENDU. (2015) CCENDU drug alert: deaths involving fentanyl in Canada, 2009-2014. Ottawa, Ont.: Canadian Centre on Substance Abuse.