Despite decreases in opioid-related deaths province-wide, northern Ontario communities continue to suffer the devastation of the ongoing opioid epidemic, according to the Quarterly Update on Opioid-related Deaths in Ontario compiled by the Office of the Chief Coroner.
Data covering the first two quarters of this year shows the opioid toxicity mortality rate of 25.8 per 100,000 recorded in North Bay is the fourth-highest in Ontario over that time period. Five of the top six census subdivisions in the province (population greater than 30,000) with the highest opioid toxicity mortality rates per 100,000 — including the top four — are in northern Ontario.
Using the province-wide rate of 8.5 deaths per 100,000 as a benchmark, the four locations that top the list — Thunder Bay (42.4/100,000), Greater Sudbury (29.0), Timmins (28.6) and North Bay (25.8) — all register at least triple the provincial rate. Sault Ste. Marie, sixth on the list, has a rate of 24.1.
According to the two most recent years of data available, spanning July 2020-June 2021 and July 2021-June 2022, the North Bay Parry Sound District Health Unit has seen a slight increase year-over-year to 42 deaths per 100,000 from 39 in opioid toxicity mortality rate by Public Health Unit region.
Examining just the first quarter of the year, Thunder Bay District Health Unit had an opioid death rate of 82.1 per 100,000 people in the first quarter — the highest rate in the province and more than four times the provincial rate. Public Health Sudbury and Districts registered the next highest with an opioid death rate of 57.9 per 100,000 while Algoma Public Health was third with a death rate of 52 per 100,000.
Although the number of opioid-related deaths in Ontario is down in the period from January to June of this year in comparison to 2021 — all figures cited include both confirmed and probable opioid-related deaths, and are preliminary and subject to change, according to the Office of the Chief Coroner — the total number of deaths continues to hover around double those reported and verified prior to the onset of the COVID-19 pandemic in March 2020.
In 2021, the mortality rate for opioid toxicity in Ontario was 197 per 100,000 population, more than double the rate in 2017. In 2022 (up to Q2), the preliminary mortality rate decreased by 13 per cent compared to 2021 yet remains 55 per cent higher than the mortality rate in 2019. The preliminary number of Ontario opioid-related deaths in the most recent quarter with data available (April–June) indicates a 5 per cent decrease from 654 deaths to 624, as compared to the previous quarter (January–March).
According to the OCC, Fentanyl continues to contribute to the majority (85 per cent) of opioid toxicity deaths and stimulants (such as cocaine and methamphetamine) are involved in three in five opioid toxicity deaths.
Three in four deaths have been among males since the start of the pandemic and the 30-59 age group continues to be the most impacted, accounting for 71 per cent of deaths in Q2 2022. Relative to Q1, deaths during Q2 decreased among ages 20-49, down 13 per cent, and increased 44 per cent among those 60 and up.
In Ontario, the average number of opioid-related deaths per month has risen each year from 126 in 2018 to 130 in 2019, 205 in 2020, to 243 in 2021. In the first half of this year, the average dropped to 213.
In a Canadian Press report from August, Tara Gomes, a researcher and epidemiologist at Unity Health in Toronto whose studies of opioid use have included a focus on the challenges caused by the epidemic in northern locales said, "I think that a lot of the harm reduction services that we have are really designed to work well in an urban setting, but in larger areas or rural areas, it's a lot more difficult to plan and manage."
Gomes is a proponent of relaxed government rules on "proven opioid treatments like suboxone and methadone that vastly expand harm reduction and safe spaces to use drugs, as well as a safe supply of drugs."
Sudbury's drug-related death rate has been among the highest per capita in the province for years now. In May, PHSD revealed that more than 100 people had died from opioid-related overdoses in 2021.
In North Bay–Parry Sound, approximately 50 have died from overdoses in each of the past two years, according to a combination of established and preliminary findings from Public Health Ontario.
"Over the past months, a local task force comprised of community partners has been assessing the feasibility of establishing a safe consumption site for North Bay," the local health unit said. "Unfortunately, the lack of funding to support the start-up and long-term operation and staffing of a safe consumption site has to date prevented us from being able to move forward. Community partners are committed though to continuing to seek funds and work on other initiatives that are known to prevent and reduce overdoses."
According to the City of North Bay's Community Safety and Well-Being Plan, adopted in June 2021, health sector partners, addictions services providers, and the Health Unit received a one-year window to establish and implement harm reduction recommendations while the North Bay Police Service and OPP are to "explore the implementation of a safer opioid supply program," with a timeline of one to three years.