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Ontario: Half of opioid deaths interacted with health care system a month earlier: Study

One in four had seen a doctor, went to an emergency department or had been discharged from hospital a week earlier, research shows

TORONTO — Half of Ontario people who died of opioid overdoses in the early stages of the pandemic had interacted with the health care system in the month before their deaths, a new report shows.

And one in four had seen a doctor, went to an emergency department or had been discharged from hospital a week earlier, research shows.

“This represents such a significant missed opportunity for us to ensure that our health care system is meeting the needs of the people who use drugs and to help connect them to the services they offer.” They are needed to help prevent these fatal overdoses,” said Dr. Tara. Gomes, an epidemiologist with Unity Health and investigator with the Ontario Drug Policy Research Network, who co-authored the study.

The report, titled “Patterns of drug and health care use among people who died of opioid-related poisoning during the COVID-19 pandemic in Ontario,” was released Tuesday by Unity Health and the Ontario Drug Policy Research Network. Public Health Ontario, the Chief Coroner’s Office, and ICES, the non-profit health research organization, contributed to the report.

The authors are calling for safer drug supplies, less barrier treatment in health care settings, affordable, supportive housing as well as more harm-reduction services and expanded access to supervised consumption sites, particularly in outlying cities.

“The loss of life due to opioid poisoning in Ontario has only deepened during the COVID-19 pandemic,” Ontario’s chief coroner Dr. Dirk Heuer said in a statement.

“Understanding how people interact with healthcare providers, support systems and harm reduction services will help develop policies aimed at preventing further opioid-related deaths.”

The majority – 89 per cent – of the deaths recorded between March and December 2020 are linked to non-prescription opioids, almost exclusively fentanyl, the report found.

Gomes said two out of three deaths occurred in people with evidence of opioid use disorder. This means that about a third of the people had no evidence of a substance use disorder.

“It’s likely that a significant number of those people are people who are sometimes using drugs,” she said.

“And they may actually be a population at greater risk of overdose from this unpredictable drug supply because they haven’t developed the same level of tolerance for these really potent drugs.”

The research builds on the group’s work, published in May, showing that fatal opioid overdoses were up by more than 75 percent in Ontario from March to December 2020, compared to the same time frame a year earlier.

Opioid-related overdoses killed 2,050 people in about 10 months, compared to 1,162 from March to December 2019.

Researchers were able to link the vast majority of those deaths to other health care data in an effort to better understand some of the conditions.

Gomes said the increasingly volatile drug supply appears to be linked to growth.

The report states, “Although the role of prescription opioids has historically been focused as a major contributor to the overdose crisis, the report suggests that unregulated drug supply is primarily responsible for fatal overdoses, primarily with fentanyl-driven deaths,” the report said.

Researchers traced a five-fold increase in fatal opioid overdoses to non-pharmaceutical benzodiazepines during the pandemic.

“It’s not that people are being prescribed anti-anxiety drugs, but that unregulated drug supplies are actually being contaminated by benzodiazepines,” Gomes said.

The addition of benzodiazepines further complicated the response to overdose and subsequent treatment, he said.

Gomes said, “We are hearing people who are so sedated to benzodiazepines in the drug supply that they cannot be woken up for hours and hours after administering naloxone, because it can only reverse the opioid effects.” gives,” Gomes said.

She added that opioids mixed with benzodiazepines “have been shown to increase respiratory depression and sedation, so it can make you more likely to overdose and have a serious overdose because you’re still too sedated.” And your breathing, you know, has slowed down even more.”

The researchers also found that, when population is taken into account, the death rate from opioid overdose was nearly three times higher in northern Ontario than in southern Ontario.

Meanwhile, the researchers further sought to understand why the opioid crisis was hitting the homeless more difficult than other populations, as their previous report found that one in six people who died from an opioid overdose during the pandemic One did not have a home.

The researchers found that the population was interacting with the health care system at similar rates to the rest of the population in the days and weeks before their death, but more likely to seek help from an emergency department than outpatient care, such as a Visit a family doctor.

Gomes said he is seeing high levels of mental health diagnoses among homeless people who have died from opioid overdoses.

“Given the increasing rates of overdose among people experiencing homelessness during the pandemic, the scale and easily accessible treatment options of supervised consumption services in shelter settings are warranted,” the researchers wrote.

This report by The Canadian Press was first published on January 18, 2022.

Liam Casey, The Canadian Press

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