Overdose deaths in Ontario surged in the months after the coronavirus pandemic was declared, with most of them involving people who were found alone at the time of their death.
A new report released Tuesday predicts at least 2,200 people in Ontario could die of opioid overdoses by the end of the year, in part due to the public health restrictions meant to curb the spread of COVID-19. This would be a 50 percent increase in opioid deaths in the province from 2019, which had 1,512 opioid-related deaths, and would make 2020 the worst year on record for overdose deaths for the province.
“It’s just devastating considering that deaths have been increasing year over year from fatal overdoses. And such a leap during a pandemic that is already so traumatic and difficult for so many people is just adding to that challenge,” Dr. Tara Gomes, an epidemiologist with Ontario Drug Policy Research Network, told VICE News. Her group is one of the authors of the 22-page report alongside Public Health Ontario and the Ontario coroner.
The spike in overdose deaths in Ontario in the wake of the pandemic mirrors similar trends across Canada and the U.S., with dozens of provinces and states reporting surges in overdose deaths since March.
The overdose death rates in British Columbia and Alberta, for example, are far outpacing the number of COVID-19 deaths.
“This increase in drug-related deaths is being driven by a combination of numerous factors, including an increasingly toxic unregulated (“street”) drug supply, barriers to access to harm reduction services and treatment, and physical distancing requirements leading to more people using drugs alone,” states the report.
The report, which provides a snapshot of 2020 opioid overdose trends in the province based on statistics from January until the end of June, notes that three out of four opioid-related deaths (around 75 percent) occurred among people who were using drugs alone or in hotels and motels during the pandemic, meaning no one was there to intervene in the event of an overdose or reverse it with the antidote naloxone.
Dr. Dirk Huyer, Ontario’s chief coroner, told VICE News there has also been a notable increase in the number of stimulants found to be contributing factors in these overdose deaths. While cocaine was found to be ingested by nearly half of the people who died, it’s difficult to determine which substance was the direct cause of death when the person died alone, he said.
“It's a terrible challenge, because if you are using alone, then you're at risk of dying, of course,” Huyer said. “Not only does it lose the opportunity to provide the answer, we also then have difficulties to fully understand the prevention opportunities… What it all means still needs to be unpacked.”
One of the largest increases in opioid-related deaths in Ontario have occurred among younger people from 25 to 44 years old, the report states. There were 289 deaths among people in this age bracket before the pandemic compared to 389 deaths during the pandemic.
The report also highlights communities that are seeing an overlap of rising overdose death rates with disproportionate COVID-19 infection and death rates.
“We observed a shift towards opioid-related deaths occurring more frequently within communities with higher concentrations of people who are recent immigrants and/or racialized,” the report states.
“This parallels recent trends in COVID-19 infection and death rates that are increasingly being concentrated in ethnically diverse neighbourhoods in Ontario, and suggests that pandemic responses are disproportionately leading to negative impacts on both COVID-19 and opioid-related outcomes among racialized communities.”
Gillian Kolla, a postdoctoral fellow at the Canadian Institute for Substance Use Research at the University of Victoria who has reviewed the report, told VICE News that another striking finding is that neighbourhoods with the lowest socioeconomic statuses are among those that have the highest overdose rates.
“For years within public health, we've been calling for a focus on the social determinants of health, and the ways in which racism within our society, the ways in which our history and current experience of colonialism, and the ways in which the dismantling of our social programs have led to increasing rates of poverty and increasing homelessness,” Kolla said.
“These are all contributing to the ongoing health crises.”
Zoë Dodd, a harm reduction worker based in Toronto who has been on the frontlines of the overdose crisis for years, told VICE News she continues to be disheartened and angry by the rising death rates. Last month was the worst on record for overdose deaths in Toronto, with city public health officials reporting 357 calls for opioid overdoses and 28 suspected overdose deaths.
“I just feel very hopeless, to be honest,” Dodd said. “Every death is an event. Every death is preventable, and that’s what we should be working toward.”
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