Unanticipated Changes in Drug Overdose Death Rates in Canada During the Opioid Crisis

Abstract

Escalating drug overdose death rates in Canada are of ever-increasing concern. To better understand the extent of this health threat, we obtained mortality statistics and population figures for the years 2000 to 2020, and examined rates of overdose deaths, coded (using ICD-10) as accidental, suicide or “undetermined intent.” The drug deemed as primarily responsible for the death was categorized as opioid, non-opioid, or unspecified. Age patterns of drug deaths were graphed. Joinpoint analysis was used to test the significance of changes in death rates. Accidental opioid and stimulant overdose death rates in Canada have climbed faster since 2011, though not as high as corresponding US rates. Unknown cause death rates have increased. However, opioid and non-opioid suicide rates have decreased significantly since 2011, and there have been fewer drug deaths of undetermined intent. Increased attention to the possibility that some suicides are being misclassified is warranted.

Substance-Related Acute Toxicity Deaths in Canada from 2016 to 2017: Protocol for a Retrospective Chart Review Study of Coroner and Medical Examiner Files (Preprint)

“…Vital Statistics data from medical certificates of death are standardized and routinely collated at the national level in Canada [25]. While this is a common source for acute toxicity mortality data [26][27], it lacks detailed information on the characteristics of those who died and the specific substances that contributed to their deaths [6,[28][29].…”

Developing a Tool to Assess the Impact of Simulated Intervention Strategies on Suicide and Suicidal Behaviours in Canada: A Dynamic Modelling & Machine Learning Approach

“…Beyond the immediate loss of life, the knock-on effects of suicide touch families [2], communities [3], and entire societies [4], often leaving wounds that time struggles to heal. Recent statistics paint a somber picture: with suicide consistently ranking among the top causes of death, Canada finds itself grappling with an issue that has not only persisted over time but has also revealed additional layers of complexity with each passing decade [5][6][7].…”

Insights from Drug Checking Programs: Practicing Bootstrap Public Health Whilst Tailoring to Local Drug User Needs

“…Overdose rates in both the USA and Canada have increased since 2000, with rates climbing faster since 2011 [18]. Overdose death rates, already high in the USA, have spiked since 2018 [19][20][21][22][23][24][25], and in 2021, more than 106,000 people died, with synthetic opioids involved in more than two-thirds of these deaths [25].…”

“…The year 2020 was the first year since 1999 that overdose mortality in the USA was higher among Black individuals than White individuals [24], with overdose mortality among Blacks rising nearly 300% over this period compared to a 60% rise for non-Hispanic Whites [27]. Fentanyl has been present in Canada since at least 2012 [28], and by the mid-2010s Canada was experiencing a drastic rise in fentanyl-related deaths [18,29]. This trend has continued, with preliminary reports indicating that the first six months of 2022 saw 3556 opioid-related deaths, of which 76% involved fentanyl [30].…”