Opioid poisoning a significant problem in province, study finds
A new study has found Regina and Saskatoon ranked significantly higher for rates of people landing in hospital with opioid poisoning than such megacities as Vancouver and Toronto.
Some of the most commonly prescribed opioid medications — Vicodin, OxyContin and Percocet — are used for acute pain management. But when taken outside of prescription guidelines, the drugs can be very risky because of the risk of overdose.
Opioid poisoning hospitalization rates varied across the provinces and territories in 2016-17, according to Opioid-Related Harms in Canada, a report released Thursday by the Canadian Institute for Health Information (CIHI).
Regina had a 28.3 rate of opioidrelated hospital admissions per 100,000 people, while the rate in Saskatoon was 26.7. Kelowna had the highest rate at 36.3 followed by Brantford at 31.6.
Among 34 Canadian cities with populations greater than 100,000, Regina ranked fifth for the highest rate of opioid poisoning hospitalizations — higher than Vancouver’s rate of 20.5 per 100,000 or Toronto’s rate of 7.9 per 100,000.
“It surprises people that we saw lower rates in the bigger cities,” said Michael Gaucher, CIHI’s director of Pharmaceuticals and Health Workforce Information Services.
In 2016-17, there was an average of 16 hospitalizations each day for opioid poisoning in Canada. During that time, there was a total of 244 hospitalizations in Saskatchewan — less than one per day.
The findings illustrate the opioid problem is not just in large city centres, Gaucher said.
“It’s in smaller centres, in the suburbs and in rural areas as well,” he said.
Saskatchewan has a high rate of opioid poisoning for our population, said Dr. Peter Butt, a consultant in addictions medicine with the Saskatoon Health Region and associate professor in the College of Medicine at the University of Saskatchewan.
“We don’t have the large total numbers that B.C. and Alberta have had in terms of opioid poisoning, but their populations are much bigger so proportional to the population, that rate is high,” he said. “We do have problems.”
There can be several explanations why Regina and Saskatoon had higher rates, Butt said.
One reason Saskatchewan people are getting to the hospital might be because of the increased availability of naloxone, which can temporarily reverse an opioid overdose.
“Being more proactive with naloxone might mean that people live long enough to get there rather than dying,” Butt said.
Also we might be better at identifying opioid overdoses in the medical records, he said.
“It may not be so specific in other jurisdictions,” Butt said. “It depends on the coding and whether or not they’re looking at the reason for a resuscitation, for instance. They may just code a resuscitation and not delve into the reason for that resuscitation.”
Additionally, Saskatchewan has a relatively small population.
“Small numbers can shift that significantly,” Butt said. “In some of these other jurisdictions where there are a high number of overdoses, they may not be getting to hospital — either because they die or somebody else resuscitates them and they wander off. That’s not at all uncommon unfortunately — particularly with really severe opioid use disorder.”
People in withdrawal feel compelled to go and get more opioid to mitigate the withdrawal, he said.
Overall, northern and Western Canada had higher rates of hospitalization than Eastern Canada in 2016-2017.
“Fentanyl has spread from the west to the east — probably leapfrogging from Alberta to Ontario primarily because of the size of the market and that’s where the money is,” Butt said. “I’m not trying to excuse anything because we do have an opioid challenge. Historically, in Saskatchewan, we’ve had more problems with prescription opioids than fentanyl — illicit opioids.”
The overall opioid poisoning hospitalization rate declined in Saskatchewan in the past year, according to CIHI.
“Last year, there were 275 cases and the rate was 25 and now there’s 244 and the rate is 21.7,” Gaucher said.