Opioid-related deaths in Canada nearly doubled during COVID-19 pandemic

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Deaths from opioid toxicity nearly doubled in the first two years of the COVID-19 pandemic compared with the two years before, according to a grim new report from the federal government that reflects a worsening of the toxic drugs epidemic.

The research, released Wednesday by the Public Health Agency of Canada, attributes the increase in mortality to a toxic street drug supply; interruptions to health services; and feelings of isolation, stress and anxiety – all of which it says became more acute during the pandemic.

In the two years ending March, 2022, at least 15,134 people across the country died of apparent opioid toxicity, according to the report. That is a 91-per-cent increase from the 7,906 deaths that occurred in the two prior years.

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British Columbia, Alberta and Ontario continue to see the majority of opioid-related deaths. The three provinces account for about 90 per cent of them in Canada so far this year.

Carolyn Bennett, the federal Minister of Mental Health and Addictions, called the deaths “heartbreaking.”

“For every one of them, there’s a whole family and a community that is grieving not only the loss, but [wondering], could they have done something?” she said in an interview.

Early in the pandemic, The Globe and Mail reported that lockdowns, border closings and other measures implemented to slow the spread of the coronavirus had severely affected the global illicit drug trade, disrupting supply chains and wreaking even more havoc on an already volatile drug supply. Authorities theorized that producers unable to procure chemicals from usual suppliers had turned to new and unreliable sources, making the quality of drugs more unpredictable.

Safety measures, such as capacity limits in indoor spaces and public messaging that asked people to stay home and avoid others, led to a drop in the number of people using overdose prevention services, The Globe reported.

Public-health experts have called for measures to separate people who use drugs from the toxic illicit supply, such as prescribing them pharmaceutical alternatives – an intervention commonly called “safe supply.” Experts have also called for the decriminalization of personal possession of drugs and massive investments in addiction and harm reduction services.

Safe supply programs have prescribed drug users the opioid painkiller hydromorphone, sold pharmaceutical-grade fentanyl capsules and expanded access to pharmaceutical-grade heroin. The federal government has supported some of these programs in principle and with funding, but is not prepared to legalize and regulate any currently illicit substances nationally, Ms. Bennett said.

“I think we need evidence for these projects, and we also need to be able to look to the people who know how we can make sure that there is a safer supply of the drugs that people want, and that people are used to now,” she said.

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The minister added that government’s cautious approach is part of an effort to balance public health and public safety.

“We have to make sure that this is a prudent approach that doesn’t open the door to organized crime and gangs,” she said.

Drug policy experts have countered that the status quo has created the present-day crisis.

“By continuing to support the policies of drug prohibition over the last 100 years, we’ve created a large, illegal unsafe drug supply controlled and distributed by transnational organized criminal networks,” Donald MacPherson, executive director of the Canadian Drug Policy Coalition, told The Globe in 2020.

B.C. is set to become the first Canadian province to decriminalize the personal possession of illicit drugs, after being a granted a time-limited exemption from federal drug laws. Effective Jan. 31, 2023, adults will be able to carry up to a cumulative total of 2.5 grams of drugs such as illicit fentanyl, cocaine and methamphetamine without the risk of arrest or criminal charges.

Under rules established by Ottawa and the province, police will not confiscate the drugs, and people found to be in possession will not be required to seek treatment. The production, trafficking and exportation of these drugs will remain illegal.

Asked whether other jurisdictions were close to receiving exemptions, Ms. Bennett said discussions continue with Toronto, whose board of health formally submitted its application in January.

“The officials are still talking and everybody’s looking to the successful B.C. proposal,” she said. “I think it’s helping many other jurisdictions know what needs to be in there for it to be approved.”

Between January, 2016, and March, 2022, at least 30,843 people in Canada died of apparent opioid toxicity, according to separate national data that was also released on Wednesday.