Algoma's opioid problem is among the worst in Ontario

In the 10 years 2006 to 2015, opioid poisoning was a contributing cause of death in 88 Algoma fatalities. That's actually better than expected, given our very high rates of opioid-related emergency room visits and hospitalizations

Algoma ranks second among 36 Ontario public health unit locations when it comes to our rate of opioid-related emergency room visits and hospitalizations, members of the local board of health learned last night.

The statistics, presented by Algoma Public Health program manager Jan Metheany, were compiled from a new interactive opioid tracking tool unveiled earlier in the day by Public Health Ontario.

The web-based tool offers more than 10 years of verified data on opioid-related emergency department visits, hospitalizations and deaths provincewide.

Opioids are drugs that have a morphine-like ability to relieve pain.

Ongoing use or abuse of opioids can lead to physical dependence.

"Opioid addiction is a very serious public health problem within our district," Metheany told last night's board meeting.

The health board believes a coordinated national and provincial approach is needed to address a "worsening opioid problem" and Metheany commended a letter written last month by board chair Lee Mason to Eric Hoskins, Ontario's minister of health and long-term care, urging "timely implementation" of opioid action plans.

Algoma Public Health (APH) reported 56.5 emergency department visits for opioid poisoning per 100,000 population in 2015, more than twice the 26.3 recorded across Ontario.

Only Niagara Region Public Health had a higher rate: 61.0 opioid-related poisonings per 100,000.

As for hospitalizations for opioid poisonings, APH chalked up 39.1 per 100,000 population in 2015, more than three times Ontario's rate of 12.7.

This was also the second-highest rate among 36 Ontario health units: only Timiskaming Health Unit had a higher hospitalization rate than Algoma: 47.0 per 100,000.

There were definite gender differences for Algoma opioid-related emergency room visits and hospitalizations.

Women dominated hospitalizations for all age groups except 65-plus.

Men accounted for more Algoma emergency department visits in the 25-to-44 and 65-plus categories, while more women presented in the 15-to-24 and 45-to-64 groups.

Interestingly, the high proportion of drug problems seen in Algoma's emergency rooms and hospital wards didn't result in as many drug-related deaths as might be expected.

In 2015, our rate of opioid-related deaths was just 6.1 per 100,000 population, ranking us 11th among 36 Ontario public health unit locations.

Metheany seemed at a loss last night to explain this anomaly.

Dr. Marlene Spruyt, Algoma Public Health's medical officer of health and chief executive officer, speculated that Algoma may have fewer addicts living on the street.

"A number of those deaths in other regions are people dying because they didn't receive any care at all. They were in some back building. They were in a park," Dr. Spruyt said. "I'm just speculating. I don't have any evidence to prove that."

In the 10 years 2006 to 2015, opioid poisoning was considered a contributing cause of death in 88 Algoma deaths.

Eight opioid drugs were tracked by the province:

codeine
fentanyl
heroin
hydrocodone
hydromorphone
methadone
morphine
oxycodone

In the nine years 2008 to 2016, oxycodone was involved in 31 Algoma fatal opioid poisonings, compared to 24 involving fentanyl, 23 involving morphine, 13 involving methadone, eight involving codeine, five involving hydromorphone and two involving hydrocodone.

Some deaths involved more than one drug.

Algoma's drug death statistics show local oxycodone involvement generally falling to just one death in 2015 from a high of seven in 2008.

Fentanyl involvement rises and falls in a sawtooth pattern with peaks of six deaths each in 2011 and 2014 - and troughs of one death in each of 2008, 2012 and 2015.

The following statement about the new opioid tracking tool was issued Wednesday by the Ontario Ministry of Health and Long-Term Care:

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Joint statement on opioid data

The following statement was issued today by Dr. Eric Hoskins, minister of health and long-term care, Dr. David Williams, chief medical officer of health and provincial overdose coordinator, and Dr. Dirk Huyer, chief coroner for Ontario:

The opioid crisis in Ontario is a growing and evolving problem, and one we are continuing to work diligently to combat.

Gathering accurate data on the impact of opioids is a key part of our Strategy to Prevent Opioid Addiction and Overdose.

As part of our commitment to openness and transparency, Ontario is now launching the interactive opioid tracker, which is a web-based tool that makes available a wide range of data on opioid-related morbidity and mortality.

As the data shows, the opioid problem is affecting people of all ages, right across Ontario.

The data shows that 412 people died as a result of opioid overdose in the first six months of 2016, compared with 371 during the same time period in 2015, representing an 11 per cent increase.

For the same six-month time period from 2014 to 2015, there was a 13 per cent increase in opioid-related deaths.

These statistics further exemplify why taking action on this issue is crucially important.

The information in the interactive opioid tracker provides over 10 years (2003-2016) of the highest-quality verified information on opioid-related emergency department visits, hospitalizations and deaths in Ontario.

It will help health care workers and policy makers across the province better understand the scope and scale of the opioid problem and support the development of targeted policies and interventions that will strengthen our response on a provincial and local level.

Ontario's opioid strategy is the most comprehensive in the country.

We are already:

providing life-saving naloxone free of charge in over 200 towns and cities
de-listing high-strength, long-acting opioids
providing support for substance use disorder treatment and supervised injection services
increasing investment in mental health supports
providing funding for 18 pain management clinics across Ontario
supporting the development of new quality standards for appropriate prescribing

We have been clear about the urgent need to address the opioid problem.

The interactive opioid tracker will help us to better understand how opioid overdose and death is affecting people in Ontario and will strengthen our strategy as we work to combat this crisis in a targeted and informed way.

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