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Accidental drug and alcohol-related deaths nearly doubled in Ontario during pandemic


A new report from The Ontario Drug Policy Research Network and Public Health Ontario shows the number of accidental drug and alcohol toxicity-related deaths grew to alarmingly high levels in Ontario during the COVID-19 pandemic.

There were almost 9,000 accidental deaths from substance-related toxicities in the province from 2018-2021 – reaching an unprecedented rate that was five times higher than the number of deaths due to motor vehicle collisions in Ontario.

The report found that the annual number of substance toxicity deaths nearly doubled in Ontario during this time, reaching nearly 3,000 deaths in 2021, with an average of eight deaths occurring every day that year.

“This report shows the extent to which substance-related harms have worsened during the pandemic,” says senior author Dr. Tara Gomes, a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and ICES, and a principal investigator of the ODPRN.

“During the pandemic, for the first time, the number of deaths involving multiple substances surpassed deaths from one substance alone, highlighting the increasing complexity of this issue and the types of responses required to prevent these avoidable harms.”

Deaths linked to multiple substances

The report found over 80% of alcohol, stimulant, benzodiazepine deaths during this time also involved opioids, which can lead to higher fatality rates, suggesting the need for more responsive healthcare, community-based and harm reduction interventions that address the complex needs of people who use multiple substances.

Gomes says that many of these patterns are driven by the growing opioid overdose crisis that has worsened in the pandemic, but the rising trends aren’t restricted to opioids – with stimulant-related deaths rising and remaining elevated since 2020 as well.

Although much more uncommon than deaths from opioids and stimulants, the report also found there were almost 300 deaths from alcohol toxicities in Ontario in 2021, the majority of which involved another substance. Only 25 of these deaths involved only alcohol.

“These patterns of alcohol-related toxicities in part reflect how risks of harms from alcohol use can be mitigated by the regulation of its sale, in contrast to illicit drugs where supplies are highly unpredictable which can increase the risk of unintentional, fatal overdoses,” Gomes says.

“What is clear across all four of the substances that we studied is that these accidental deaths are occurring across all ages, both men and women, and in all parts of the province, meaning that responses and services need to be made accessible and tailored to these various populations.”

The researchers analyzed data from ICES and the Drug and Drug/Alcohol Related Death Database (DDARD), which contains records from investigations completed by the Office of the Chief Coroner/Ontario Forensic Pathology Service.

About St. Michael’s

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future healthcare professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About the Ontario Drug Policy Research Network

Established in 2008, the Ontario Drug Policy Research Network (ODPRN) is a research program based out of St. Michael’s Hospital that brings together researchers, people with lived experience, clinicians, and policy-makers to generate evidence to inform effective drug policy development in Ontario.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education.

About Public Heath Ontario

Public Health Ontario is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. Public Health Ontario links public health practitioners, front-line health workers and researchers to the best scientific intelligence and knowledge from around the world. For the latest PHO news, follow us on Twitter: @publichealthON.

About the Office for the Chief Coroner

Together the Office of the Chief Coroner/Ontario Forensic Pathology Service (OCC/OFPS) provide death investigation services in Ontario serving the living through high quality investigations and inquests to ensure that no death will be overlooked, concealed or ignored. The findings are used to generate recommendations to help improve public safety and prevent further deaths. In Ontario, coroners are medical doctors with specialized training in the principles of death investigation. Coroners investigate approximately 17,000 deaths per year in accordance with section 10 of the Coroners Act. The OFPS provides forensic pathology services in accordance with the Coroners Act. It provides medicolegal autopsy services for public death investigations under the legal authority of a coroner. The OFPS performs approximately 7,500 autopsies per year. For more information, visit Office of the Chief Coroner and the Ontario Forensic Pathology Service | ontario.ca

About ICES

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, visit www.ices.on.ca.

For more information, please contact:

Misty Pratt
Senior Communications Associate, ICES
[email protected]


Contributing ICES Scientists

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