Overdose deaths from multiple substances on the rise in Ontario

Oct 31, 2023

According to the findings of a new report published by the Ontario Drug Policy Research Network (ODPRN) and Public Health Ontario in September, there has been an increasing number of deaths linked to multiple toxic substances in Ontario since the beginning of the pandemic.

Furthermore, the report attributes this augmentation in overdose deaths to an increasingly toxic and unregulated drug supply, which leads to more complicated addictions that require nuanced treatments.

Specifically, the report findings demonstrate that there were 8,767 accidental deaths from toxic drug and alcohol use across Ontario between 2018 and 2021. In 2021, 2,886 Ontarians died from consuming a toxic substance, which translates to eight deaths per day. Furthermore, the number of deaths due to illicit substance use is five times higher compared to the number of traffic accident deaths in Ontario that year. The results of the report also showed that the number of overdose-related deaths in 2021 was also nearly double the amount in 2018.

In addition, four substances were found to be involved in the majority of the deaths—opioids, alcohol, benzodiazepines, and stimulants. The report highlights that most individuals who died of toxic substances were found to have a mixture of opioids and stimulants.

“What surprised me the most was just the complexity of it,” said Dr. Tara Gomes, a research scientist based at Unity Health Toronto and a principal investigator with the ODPRN, in her interview with CBC News. “Understanding the full complement of all these different substances that are contributing to harm and how often they’re being used together in different ways really just shed a light on how difficult it is to address this issue.”

Dr. Gomes also noted that individuals are likely to use different drugs together; however, cross-contamination may also occur. The report also shows that 96% of benzodiazepine deaths in 2021 included opioids.

“Sometimes people might use a stimulant like cocaine or methamphetamine to try and counteract the sedating effects of the opioid supply, for example,” she said.

Multi-substance overdoses can be more challenging to treat, since naloxone alone is not sufficient to reverse the drugs’ effects.

The report also revealed that in 2021, toxic substance deaths were also about three times higher in northern Ontario compared to southern regions. However, the rate of death was similar across urban and rural regions, with most deaths occurring in private residences.

As a solution to treating increasing addiction complexity, Dr. Gomes highlighted the necessity of implementation of treatment programs to address multi-substance addictions. Dr. David Marsh, vice-dean of research, innovation, and international relations at the Northern Ontario School of Medicine University, added that there is also a need for improved coordination between different parts of the system that are working to provide support to individuals suffering from addiction, such as housing, social assistance support, primary care, and addiction programs, as well as better tracking of patient outcomes in Ontario.