Overprescribed and underaddressed: Opioid mortality in Canada
Over a hundred photos are pinned to the Moms Stop the Harm Facebook page, depicting the various faces of victims in Canada’s ongoing opioid crisis. The group’s membership consists of those whose loved ones have died from drug overdoses in a crisis that has plowed through Canadian communities in recent years, unbridled by class, race, or location.
Between January 2016 and March 2018, over 8,000 opioid-related deaths were reported in Canada, and this year’s trend is no different, with similar rates at about 10 per day. In their basic form, opioids are synthetic drugs meant to treat pain, which are now so commonplace that their chemical combinations have become bizarre household names (think codeine, morphine, or oxycodone). Normally, any of these can be prescribed by doctors, but a mix of over-prescription and the addictive nature of these substances has created a wave of health concerns in both Canada and the United States. As both governments floundered over the emergency, the crisis was already underway. Rates of addiction to these drugs is even higher than the death rate, with Canadian estimates in the tens of thousands. Doctors—some of whom are partly responsible— become tangled in a paradoxical situation where cutting a patient off risks them finding a fix in even more dangerous forms.
In contrast to legally acquired opioids is fentanyl, an extremely potent opioid used by producers and dealers to lace more common narcotics (cocaine, cannabis, MDMA, or heroin). It makes them exponentially more potent while increasing risk of addiction and overdose. Buyers are often unaware that their products are tainted. It is worth noting that, for those incapable of paying high-end prices for their drugs, risks grow substantially.
British Columbia, one of the first provinces to experience this epidemic, has responded with specific measures treating overdose and opioid addiction. Some provide safe injection sites for addicts to be cared for by staff while under the influence, and others provide support for those weaning themselves off substances. These sites have recently begun offering opioid pills to be ingested on-site. B.C. also introduced a program providing free Naloxone kits which was recently mimicked in Ontario. Naloxone is a drug used by paramedics to reverse overdoses, and the kit is provided with a five-minute explanation. Montreal followed Vancouver’s method by developing safe injection sites around the city. As of June 2018, they have been visited 21,265 times. Not one has resulted in fatalities, nor did crime rates change in relation to the district.
But challenges remain, and rural areas face the greatest risks associated with opioids. Men from low-income households tend to be the most susceptible to opioid addiction, and Cardston, Alberta holds the worst overdose rate per capita in Canada at 1,449 per 100,000. Adding to their challenges, rural areas lack the population concentration to operate clinics like Vancouver’s, and emergency services face higher travel times. The solution to rural districts’ massive opioid problems will not be the same as urban locations, but the delivery of Naloxone by Canadian provinces would be an important first step.
Other critics call for decriminalization of opiates along similar lines as recent cannabis legislation. Legalisation of illegal narcotics would lead more victims to call police in the case of an emergency and allow for government regulation, curtailing fentanyl overdoses. A purely judicial response is inadequate in addressing addictive issues, but its critics omit that some of the most dangerous opioids are already legal. Oxycodone, arguably the most infamous of addictive prescriptions, has never been criminalized, yet hundreds of Canadians who were legally prescribed it remain addicted. For them, the issue isn't fear of law but the physical and mental devastation of opiate addiction.
State-side, the situation is even more devastating, particularly in working class rust belt states. Modern economic stress has caused severe psychological trauma, leading to a dependence on opiates which has not been addressed either in law or in medicine, contributing to the American decrease in life-expectancy. As usual, Canadian policy and culture is highly influenced by American issues, but following their tack on this response would be misinformed.
For those struggling with opioid use, the McGill Policy Association is aware of the following resources that may be able to provide assistance.
24 hours, with texting services