Alberta health officials declined to participate in a major national opioid study earlier this year that looked into the demographics of overdose victims, an absence that was conspicuous and underscored continuing gaps in the tracking of opioid deaths.
Researchers from the Public Health Agency of Canada were looking to draw deeper insights into the national opioid crisis when they interviewed dozens of medical experts from across the country who examined the more than 8,000 Canadians who have died from opioid-related overdoses since January, 2016. Alberta was the only major province not to participate.
First responders give aid to an overdose victim in a Downtown Eastside alley in Vancouver, Dec. 21, 2016.Rafal Gerszak/The Globe and Mail
The opioid crisis has taken a heavy toll on Alberta, which has suffered the second-highest per-capita death rate among provinces. Two Albertans are now dying daily from opioid overdoses, according to the provincial government.
Despite criticism in the past over the province’s failure to release timely data to the public as the opioid crisis worsened, provincial officials say they did not have the resources to participate in the interviews with the federal agency’s researchers.
In a statement, Alberta’s chief medical examiner said a “resource allocation decision” made by that office, as well as Alberta’s Ministry of Health, meant they could not help Ottawa’s study. Instead of the national initiative, the province is undertaking its own provincial “deep-dive objective study” looking into the demographic factors involved in the opioid-related deaths of Albertans, according to the examiner’s office. Because both studies were happening simultaneously, Alberta did not have any coroners or medical examiners to spare for the national effort.
While Newfoundland and Labrador as well as Prince Edward Island did not participate in the national study, Alberta’s absence was noted in the federal study as having an impact on the results: “One province that has been heavily impacted by the opioid crisis did not participate.”
According to the federal agency, the study was meant to look beyond the raw numbers on opioid deaths – where people have died and how many – and instead request data and interviews with coroners and medical examiners to pinpoint the circumstances surrounding the deaths of opioid users.
“Some coroners and medical examiners have gained considerable insight on changes over time from investigating overdose deaths for many years,” the report, which was released in September, noted in its findings.
As part of the study, 36 interviews were held between December, 2017, and February, 2018, with coroners, medical examiners and toxicologists.
British Columbia, which has suffered the most opioid-related deaths of any Canadian province, has been in a state of public-health emergency since April, 2016. The province also releases monthly data on the number of deaths from overdoses. Alberta’s health officials have not gone so far as to declare an emergency in their province, and only release data every quarter.
Deena Hinshaw, Alberta’s deputy chief medical officer of health, says the province needs time to review the data before it can be released. “It takes time to verify and validate the information that is collected. So what we’ve done is looked at the balance between a timely response and ensuring we have confidence in the data we’re releasing,” she told The Globe and Mail.
Petra Schulz, co-founder of the advocacy group Moms Stop the Harm, said there was an air of frustration at an opioid conference in Edmonton during the first week of October as people have grown angry with the increasing number of fatalities due to overdose and government inaction, especially in Ontario where a new Progressive Conservative government has put a stop to opening new overdose-prevention sites.
Petra Schulz holds a picture of her son Danny who she lost to an accidental Fentanyl overdose, in Edmonton, Alta., March 27, 2018.JASON FRANSON/The Globe and Mail
While Ms. Schulz said Alberta has done a better job of collecting data in recent years, the province’s data don’t delve deep enough into what interactions people have with the health-care system before their deaths – the kind of questions being asked by the federal study.
“Alberta is doing better on data but there’s a lot of room to improve. The data is very focused just on opioids and we need different types of data. They need to do more on follow-ups. If someone comes to an ER because of an overdose and is discharged, what happens afterwards? Do they go for other types of treatment? Do they get help?” asked Ms. Schulz, who lost her son Danny to fentanyl and is now part of the Alberta Health Minister’s opioid response commission.
According to Dr. Hinshaw, the data gaps highlighted by Ms. Schulz are exactly what Alberta is looking to address with the province’s study into opioid deaths. “We want to understand the specifics about what exactly is going on around those deaths. We feel there are different levels of analysis required and those deeper levels will take some time," she said.
Alberta’s study is not expected to be released until sometime in 2019.