The State of Opioid Use in Canada

Nov 4, 2016

Overdose Increase

There has been increasing media coverage on the dangers of fentanyl use Canada wide with various incidents over the past fews months of accidental fentanyl overdoses. In many of the overdose instances fentanyl was found cut into various recreational drugs without the user’s knowledge. According to a report released on October 19th by the Ministry of Public Safety and Solicitor General of British Columbia, “There were 302 illicit drug overdose deaths with fentanyl detected from January through August 2016. This is a 211% increase over the number of deaths (97) occurring during the same period in 2015”.[1] British columbia is not the only province dealing with a large increase in fentanyl use, overdoses and death relating to fentanyl are rapidly increasing across the whole of Canada. Many other countries are also seeing an increase in the drug’s use as fentanyl is a cheap and readily available alternative to other prescription or illicit opioids.

In the past few months alone there have been fentanyl overdoses in communities across Canada. The substance comes in many forms including injections, patches, lozenges, pills, powder and has recently been found in liquid form. Fentanyl is 50 to 100 times more potent than morphine and due to the potency of the substance those unknowingly taking it and those willingly taking it, are at a high risk for overdosing.[2] Many arms of the government in Canada have deemed this a health crisis and have taken measures to inform the public on the dangers of opioid and fentanyl, working towards action plans in concert with law enforcement, to get the drugs off the streets. Ontario Ministry of Health and Long Term Care[3] released an opioid strategy this October which suggested further restricting opioid prescription practices. The Ministry will be giving 17 million dollars to chronic pain clinics across the province which offers patients suffering from chronic pain alternative treatments to regular opioid pain management treatments. Similarly Alberta’s provincial government has released an opioid action plan which focuses on alternative opioid treatment and monitoring of opioid prescriptions.[4]

Opioid Crisis

Health Canada had two different news releases recently concerning opioid use in Canada. The first release was August 31st concerning the growing use of fentanyl resulting in increasing number of opioid related overdoses and deaths in Canada. Health Canada has referred to this increase as a “national opioid crisis” and has proposed restricting the six chemicals that are used in the production of fentanyl. The news release mentions an RCMP report which indicated an increase in “domestic production of Illicit fentanyl”.[5] The Health Minister announced the launch of the Opioid Action Plan which focuses on informing Canadians on the risks of opioids and to encourage better prescription practices to decrease the amount of unnecessary opioids that are being prescribed to Canadians. The second Opioid related news release[6] from Health Canada was published September 14, concerning the increase in opioid use among Canadian youth. The news release mentions the results of the 2014-2015  Canadian Student Tobacco, Alcohol and Drug Survey[7] which indicated a decrease in youth smoking rates and an increase in the use  psychoactive pharmaceutical products.

Pharmaceutical Opioids

Opioid pain relief medication is widely prescribed in Canada; according to a Globe & Mail[8] article Canada is the second largest consumer of opioids per capita in the world. As opioids are widely prescribed they have been heavily abused and have caused a large illicit opioid drug market in Canada. As legislation has been pushed through to better regulate how opioids are being prescribed in Canada, the demand for illicitly made and unregulated alternatives has grown.

White Fentanyl

The presence of ‘white fentanyl’ has also been increasing throughout Canada. White fentanyl is a synthetic substance that is thought to originate primarily in China and in recent months  has been found cut into other substances. The Globe & Mail[9] reported that the RCMP, UN and China are working together to slow the rate of fentanyl being smuggled into Canada. That same article also mentions that fentanyl is being tracked by the United Nations, meaning that the sale of the substance is being monitored internationally. The same article also reported that 20 illegal fentanyl manufacturers have been found within Canada. Clearly the production and smuggling of illicit fentanyl is both a domestic and international problem that is being addressed by many forms of government and law enforcement.

Drug abuse of opioids and other prescription medications has been on the rise in Canada, according to Health Canada’s 2012 statistics.[10] Among users of opioid pain relievers, 5.2% (or 243,000 Canadians representing 0.9% of the total population) reported abusing them. Prescription drug abuse can take the form of abusing a medication that has been prescribed to the user, stolen or illicitly bought, making detection of abuse difficult. Opioid abuse is a growing public health crisis that needs to continue being addressed by governments, workplaces and individually to ensure that rate of overdoses and deaths are reduced.