St. Catharines-Niagara ranked fourth in the report by the Canadian Institute for Health Information (CIHI) that zeroes in on how the opioid crisis, whose death toll has prompted some cities including London to set up supervised drug consumption sites, is playing out nationwide.
Why Southwestern Ontario is so implicated in high rates of hospitalization for use of the highly-addictive drugs isn’t clear, officials say, but economic factors such as poverty and unemployment can’t be ignored, they note.
“(Addiction) is a problem that affects all strata of society, but a big part of it follows the economic problems that our region has faced,” Dr. Chris Mackie, the medical officer of health for London and Middlesex County, said Wednesday.
Opioids are a class of narcotics that include illegal drugs such as heroin, prescription painkillers and synthetic drugs such as fentanyl, often the source of deadly overdoses and warnings by police and health authorities about the hidden dangers in street drugs.
In its latest report Wednesday, the CIHI, an independent national medical organization, found communities with populations of between 50,000 and 99,999 have the highest per-capita opioid overdose hospitalization rates in the country – more than double those in Canada’s largest cities.
The wider Brantford area, which includes both the city of 135,000 and parts of Brant County, ran second only to Kelowna, B.C., with an opioid poisoning hospitalization rate of 41.2 per 100,000 people in 2017, more than double the rate in Vancouver.
St. Catharines-Niagara’s rate was 27.1.
The wider London area, which includes St. Thomas and Strathroy-Caradoc, had a hospitalization rate of 22.5 per 100,000 people.
Other large cities in Southwestern Ontario were further back in the pack, but still high for a national survey, with Windsor 22nd on the list for opioid poisoning hospitalizations in 2017 and Kitchener-Waterloo-Cambridge 26th.
The Brantford area’s ranking near the top of the list isn’t a surprise, medical officer of health Dr. Malcolm Lock said, but it’s a distinction officials there are working hard to shake by the time next year’s report is released.
“We knew, even at the beginning of 2017, that we were heading into an issue here,” Lock said. “We were early adopters of naloxone. We’ve got a rapid-access addiction medicine clinic now in Brantford and that’s been . . . formed since we started to see some of these changes.”
The city has an opioid strategy and strong partnerships with police and first responders, Lock said. From January to October of this year, 2,550 naloxone kits – an antidote that blocks the effects of opioid overdoses – have been distributed in the community, the health unit said.
Over that same period, the area public health office has reported 40 per cent fewer opioid overdoses compared to 2017.
In the CIHI study, opioid poisoning refers to overdoses from legally or illegally-obtained drugs or adverse reactions from opioids taken with another prescribed drug or alcohol.
Across Canada, opioid poisoning hospitalization rates have increased by 27 per cent over the last five years, the report said.
Opioids have been blamed for more than 9,000 deaths across Canada from January 2016 to June of this year.
More work needs to be done to understand why some communities are affected more than others by the opioid crisis, project lead Roger Cheng said.
“Our report is very good at answering the ‘what’ question,” he said. “This one source of information, the numbers, needs to be interpreted in conjunction with other lines of information to address the ‘why’ question.”
A report released by Statistics Canada in October examining the demographic details of people across Canada sent to hospital for opioid overdoses found hospitalization rates between 2011 and 2016 were highest among people who were unemployed and people younger than 65 who were not in the labour force.
The labour force participation rate – the percentage of working-age people employed or looking for jobs – has been a chronic issue in the London area. It can’t be understated when it comes to understanding drivers of substance abuse issues in communities, Mackie said.
“When people don’t have a meaningful thing to do with their lives, when they don’t have a good reason to get out of bed and be productive, then they fill their day with other things,” he said.
Mackie said the lCIHI report also highlights the importance of dealing with the crisis in a more constructive and cost-effective way.
“Housing with supports is a more efficient way of supporting people with addictions. We need more investment in evidence-based treatment models like methadone maintenance and suboxone,” he said.
“(Hospitals are) not a good place to deal with this problem. We want to be dealing with this problem at its root, in a more efficient way.”
2017 opioid poisoning hospitalization rate
By census metropolitan area, per 100,000 population:
1. Kelowna, B.C. – 52.8
2. Brantford – 41.2
3. Thunder Bay – 34.7
4. St. Catharines-Niagara – 27.1
5. Abbotsford-Mission, B.C. – 26.7
6. London – 22.5
7. Regina, Sask. – 21.4
8. St. John’s, Nfld. – 21.0
9. Vancouver, B.C. – 20.4
10. Hamilton – 20.2
Source: Canadian Institute for Health Information
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