Waterloo researchers discover a nearly six-fold increase in opioid-related deaths between 2000 and 2017
A new study looking at national opioid mortality, hospitalization and emergency department visits in Canada has found a nearly six-fold increase in opioid-related deaths between 2000 and 2017.
The study by University of Waterloo researchers is the first publication to assess the growth of Canadian opioid-related deaths during this time period at a national level. Researchers used comprehensive national databases and discovered two distinct trends in opioid-related mortality. First, the number of Canadians dying because of opioid use steadily increased from 2000-2015. Second, after 2015, opioid-related mortality increased rapidly.
“In 2016, the Public Health Agency of Canada began collating data on opioid-related mortality,” said Wasem Alsabbagh, a pharmacy professor at Waterloo and lead author on the study. “We had some understanding of trends at the provincial level prior to 2016, but no comprehensive picture of trends across the country. Our research fills this gap in Canada’s opioid mortality reporting by examining trends nationally from 2000 to 2017.”
The researchers looked at death databases maintained by Statistics Canada. They used data from all provinces and territories, examining all opioid-related death. In addition, opioid use that led to hospitalizations or emergency department visit were captured using data from the Canadian Institute of Health Information. Alsabbagh and the research team analyzed the data using computer modelling to identify patterns.
Twenty Canadians died of opioid-related causes for every million people in 2000. By 2017, that number increased to 118.3 and there was a rapid growth of 52 per cent between 2016 and 2017. Current estimates from the Public Health Agency of Canada lead the researchers to suspect that the number of deaths per million Canadians is much higher today, especially given the COVID-19 pandemic.
The study identified significant regional variations both in opioid mortality rates and hospitalizations. British Columbia and Alberta had the highest mortality rates and hospitalizations, followed by Ontario, Nova Scotia, Manitoba and Saskatchewan. The lowest were observed in New Brunswick, Quebec, Newfoundland and Labrador and Prince Edward Island. The study also links information from numerous databases, allowing for new observations about trends in specific circumstances.
“We saw a significant increase in the percentage of all-cause mortality – dying from any cause – in those discharged after an opioid-related hospitalization,” said Alsabbagh. “Between 2000 and 2011, the percentage of all-cause mortality went up from 3.9 per cent to 7.4 per cent one year after being discharged from an opioid-related hospitalization. This tells us we need to provide more robust substance use disorder treatments for those who survive opioid-related hospitalizations.”
The large scope of the project – examining nearly 20 years of medical administrative data – required an interdisciplinary team, which included Alsabbagh, Feng Chang, Martin Cooke, Susan J. Elliott and Meixi Chen. The study was published in the journal Addiction.
