COVID-19 Could Make 2020 Canada's Worst Year for Overdoses

At least 2,450 people have died of drug overdoses in Canada so far this year, putting it on track to be one of the worst years for overdoses in the country, according to data obtained by VICE News. 

Fatal and non-fatal overdoses have soared across the country since the start of the pandemic, according to the data, with Saskatchewan reporting a nearly 40 percent increase in overdose deaths so far this year, and its capital Regina reporting a nearly 1,000 percent spike in overdose calls to police.   

Drug policy and public health experts fear 2020 could be one of the worst years for Canada’s overdose crisis due to the combination of lockdown measures that have led to increased isolation and disconnection, and an even more potent and unpredictable drug supply chain.

“It’s hit us hard,” Michael Parkinson, drug strategy specialist at the Waterloo Region Crime Prevention Council, told VICE News. In his region alone, in southwestern Ontario, at least 64 people have died of suspected overdoses so far this year, up already from the 63 total deaths there for 2019. 

“The people who are paying attention are left on the sidelines to resuscitate people, attend funerals, and to grieve before moving onto the next victim,” he said.

VICE News requested overdose death data for 2020 from all 13 provinces and territories, and non-fatal overdose numbers from police services and paramedics in major cities. Other overdose figures were compiled from publicly available information. 

The data reveals a grim snapshot of the overdose crisis fuelled by non-prescription fentanyl,  mirroring similar trends in the U.S. where opioid deaths have increased in more than 40 states during the pandemic; 2019 was the deadliest year in U.S. history for fatal overdoses. 

The data shows overdose rates are spiking in the prairie provinces of Saskatchewan and Manitoba that previously had relatively low or stable overdose numbers; previously unreleased data shows more than 800 people have already died this year in Ontario, Canada’s most populous province. 

Unlike with COVID-19 metrics, it’s impossible to get real-time national overdose numbers in Canada because data collection varies across jurisdictions. Many provinces are months behind on investigating overdose deaths and making the findings public. Some jurisdictions produce data only on opioid overdoses while others include overdoses involving all drugs. The data gaps make it difficult to truly understand the scope of the crisis and roll out timely solutions, advocates say.

Saskatchewan is on track to have the highest number of overdose deaths it’s seen in a decade. There’s already been a 45 percent increase in confirmed and suspected overdose deaths so far this year—the vast majority of which involve opioids—compared to 2019. And Regina police are reporting 10 times the number of  overdose emergency calls—706 up from 68—from January to the end of August this year compared to the same time in 2019. 

The data also shows that most of the confirmed overdose deaths in Saskatchewan up until the end of June involved Indigenous peoples. It’s one of the only provinces that releases breakdowns of overdose deaths by race. 

Neighbouring Manitoba has yet to release complete overdose data for 2019 and 2020, but  rising emergency medical services overdose calls in Winnipeg suggests the overdose crisis has also hit the province. Experts say that 911 and EMS overdose calls, even if they aren’t fatal, are often the canary in the coal mine that a crisis is coming, or has already arrived.

From January to August, Winnipeg EMS responded to 785 opioid-related calls, a nearly 200 percent increase from the 263 opioid calls from all of 2019. The agency does not track how many of those calls are fatal.

“At the root of a lot of addictions are mental health issues, and those issues are compounded with the stress of the pandemic,” Winnipeg EMS Deputy Chief Tom Wallace told VICE News. “We’re attending these calls in all areas of the city—many different age demographics, socioeconomic statuses.” 

Experts are especially alarmed as these provinces had, until now, been largely spared from the massive spikes in opioid deaths seen in the epicentres of British Columbia and Ontario.

“They might actually be seeing a shift in their drug markets towards more of a predominance of fentanyl,” Gillian Kolla, a postdoctoral fellow at the Canadian Institute for Substance Use Research at the University of Victoria, told VICE News. 

Kolla said the lack of access to drug testing in the face of an increasingly toxic drug supply makes it nearly impossible for people to get rapid information about what they are consuming and how strong it might be. 

At the same time, these provinces are further behind when it comes to evidence-based harm reduction initiatives that could help curb overdoses and prepare for a worsening opioid crisis. Saskatchewan’s first and only safe consumption site is set to open next month in Saskatoon, while Manitoba does not have a sanctioned supervised consumption site, nor has the health ministry said whether it intends to open one. 

“I'm very concerned because up until now, we've had a completely piecemeal response to the overdose crisis,” Kolla said. “We’ve needed a comprehensive response for years now. That includes very low threshold access to treatments scaling up things like heroin-assisted treatment and injectable opioid agonist treatments … We need all of these options on the table for people.”

B.C. and Ontario are also reporting increases in overdose deaths that rose in the weeks following the initial pandemic lockdowns.

Previously unreleased numbers provided to VICE News show there were at least 879 confirmed and probable opioid deaths in Ontario from January to May, the most recent data available. That’s up nearly 12 percent from the 786 opioid deaths that occurred during the same time in 2019. (Ontario’s overdose numbers pertain only to opioids.)

In April, a month after the pandemic lockdowns resulted in the shuttering of many businesses and community services, there were 206 opioid deaths, an 18 percent jump from 174 during April 2019. The number of deaths continued to climb this May to 219, up 35 percent from 162 in May 2019. 

Kolla added that rising rates of overdoses had taken a toll on frontline workers who were burned out before the pandemic, and now it’s being amplified even further. “It's hard to capture just how difficult it is to spend your day resuscitating people. And how much worse this has been under COVID.”

That latest coroner’s data does not include the 27 suspected overdose-related deaths attended by Toronto paramedics this July, which prompted an alert from Toronto Public Health as it was one of the highest number of deaths ever recorded by the agency in a single month. 

“We're continuing to see similar trends that we've seen before, which is young people (between) the ages of 25 and 44 are the most significantly affected. And that fentanyl does appear to be the most common drug that is involved in the people that have died,” Dr. Dirk Huyer, Ontario’s chief coroner, told VICE News. 

“This is young people, many life years lost, many who were likely healthy and have died a preventable death.”

Overdose rates have also risen sharply in British Columbia, where there was a decline in overdose deaths earlier this year compared to previous years. In fact, B.C. had been praised for rolling out supervised injection sites and safe supply programs ahead of other provinces. 

But with the coronavirus, overdose deaths started to rise again, with  more than 900 recorded during the first seven months of the year, the majority involving non-prescription fentanyl and other opioids. In July alone 175 overdose deaths were recorded, up 136 percent from July 2019. This year B.C. is set to surpass its 995 total overdose deaths in 2019. 

Alberta has not yet released its overdose rates since the start of the pandemic in March, but experts say that they have likely spiked during that time. A June alert from Alberta Health Services said there were 16 overdose deaths linked to carfentanil in Edmonton during the last week of May and the first week of June.

While the Atlantic provinces have largely seen a reduction in overdose deaths so far this year, as well as very few cases of COVID-19, harm reduction workers there are noticing a stronger opioid supply and worry about what the future may hold.

“We're seeing more and more of that contamination of fentanyl not just being sold as fentanyl, but being sold as other things like Xanax,” Matthew Bonn, a Halifax-based program coordinator for the Canadian Association of People Who Use Drugs, told VICE News. 

There have been at least 45 confirmed and probable drug overdose deaths in Nova Scotia from January to July, according to the province’s latest numbers. That’s a decrease from the 59 overdose deaths reported during that same time last year. 

Last month, the federal government announced funding for harm reduction efforts including a safer drug supply pilot project in Toronto to provide pharmaceutical-grade opioids, such as hydromorphone, for people who are at risk of overdosing on the street supply. There’s a patchwork of these programs in various provinces, but not all local governments are supportive of the idea and it’s largely up to doctors and advocates to push for them. 

Frontline workers say safe supply programs are a good start, but are calling on the federal government to also decriminalize drug possession as a way to reduce the stigma around addiction and drug use that impedes people from accessing health services and being treated with dignity. 

Criminalization is at the root of the rising overdose rates across the country, they say. And while numerous public health officials, and even police groups, endorse the idea of drug decriminalization, Prime Minister Justin Trudeau and his Liberal government are opposed to it.

“We’ve always had drug policy that’s based on moralizing around drug use. We’ve never had evidence-based drug policy,” Kolla said. “Part of why decriminalization is so important is because you cannot continue forward with criminalizing drug use and then say in the same breath that we have a health response to drug use. It doesn't work.”

Follow Rachel on Twitter