More than 600 Ontarians died of opioid-related causes in 2013 with opioid prescribing and overdose varying widely across the province
There were 638 opioid-related deaths in Ontario in 2013, approximately one death for every 20,000 Ontarians. Nearly 13 per cent of those deaths involved suicide, according to a new report by researchers at the Institute for Clinical Evaluative Sciences (ICES), St. Michael’s Hospital and the Ontario Drug Policy Research Network (ODPRN).
“One important finding is the dramatic variation in opioid prescribing and opioid-related adverse events across the province,” says Tara Gomes, lead author, a principal investigator of the Ontario Drug Policy Research Network (ODPRN), and a scientist at both ICES and in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital.
The highest rates of opioid-related emergency department (ED) visits and hospitalizations were seen in the northern LHINs (North East, North West) and western LHINs (Erie St. Clair, Hamilton-Niagara-Haldimand-Brant) in Ontario in 2014. In particular, the North East LHIN had the highest number of opioid-related hospital admissions and ED visits (2.4 admissions and 4.4 ED visits per 10,000 residents) in 2014 and the second highest rate of deaths in 2013 (1 death per 10,000 residents), rates approximately double the provincial average.
“These findings highlight the massive societal toll of opioid-related morbidity and mortality," says one of the report's co-authors Dr. David Juurlink, a senior scientist at the ICES and head of the Division of Clinical Pharmacology and Toxicology at Sunnybrook Health Sciences Centre. "Prescribed with care, opioids can help some people, but it’s essential that patients and doctors recognize the potential harms associated with use of these drugs.”
The researchers also found there were 3,200 opioid-related ED visits in Ontario in 2014, with about half of those patients being admitted into hospital.
The report, published today, evaluated the rates of opioid prescribing, opioid-related hospitalizations and ED visits and opioid-related deaths, broken down by Ontario’s counties and LHINs.
When looking specifically at Ontario’s 49 counties, Thunder Bay District and Timiskaming District had the highest rates of opioid-related death in Ontario, approximately 4-fold higher than the provincial average. Algoma District displayed the highest rates of opioid-related ED visits (6.2 visits per 10,000 residents), third-highest rate of opioid-related hospital admissions (3.1 admissions per 10,000 residents) and among the highest rates of prescription opioid use and opioid-related deaths.
“This report illustrates the considerable variation in both prescribing and adverse events across the province. This information can be used to identify regions with the highest need for programs and services to address opioid addiction and overdose such as addiction services, safe injection sites and access to naloxone,” adds Gomes.
The researchers note a limitation of their report is that estimates of opioid use are restricted to individuals eligible for the Ontario Drug Benefits Program (OBDP). This means that areas where more people are on ODBP may have higher numbers of opioid-related healthcare encounters and/or deaths. Individuals can also access prescription opioids through private insurance, cash payments, or the federal public drug program (Non-Insured Health Benefits for indigenous populations), and these are not reflected in the report.
“Opioid use and related adverse events in Ontario: report” was published today on the ODPRN website.
Author block: Diana Martins, Simon Greaves, Mina Tadrous, Michael Paterson, Dana Bandola, Samantha Singh, David Juurlink, Muhammad Mamdani, Tara Gomes.
The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care 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, follow us on Twitter: @ICESOntario
About St. Michael’s Hospital – St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Center, 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.
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