Local opioid death rate fourth highest in Ontario
The city and county had the fourth highest rate of opioid-related deaths in Ontario, a recent study revealed.
Peterborough had an annualized rate of 9.2 opioid deaths per 100,000 people. The outcome was based on 39 opioid-related deaths between July 2013 and June 2016.
The information stems from the new Ontario Drug Policy Research Network study released last week. It compared all 36 public health units.
Thunder Bay, Sudbury and Temiskaming health units in Northern Ontario had higher rates of opioid-related deaths.
The study also revealed that Peterborough had one of the highest rates for percentage of population being prescribed opioids at 16.6 per cent of the population.
The report didn’t say whether the deaths were connected to people who were prescribed the drug or to those who bought it on the street.
The high prescription rates didn’t surprise Donna Rogers. She’s the executive director at Fourcast, an addiction treatment organization.
Opioids are most often prescribed to treat pain.
With a large senior population, Rogers said pain is likely to be more prevalent in the community.
“We have an aging demographic so it’s going to make sense that we going to have high rates,” Rogers said.
Eighty-five per cent of opioids prescribed in Peterborough were pain-related. Smaller amounts were used to treat coughs and addiction.
Dr. Rosanna Salvaterra, medical officer of health for Peterborough Public Health, agreed with Rogers that higher prescription rates could be due to the area’s older population.
Salvaterra noted that the average age for an opioid prescription for pain is 55.
She also pointed out that the study showed people living in rural areas have a higher rate of being prescribed opioids than in urban areas.
“Half our population is rural,” Salvaterra said.
The medical officer wasn’t sure why rural residents are prescribed more opioids than urban dwellers.
“That I don’t understand. That definitely needs more research,” she said.
So far this year, city police have responded to 102 overdoses in the area. Forty-one were suspected to be opioid overdose. Naloxone, an opioid antidote, was used in half those overdoses. Of those 41 overdoses, eight people died.
In 2015, there were 13 opioid-related deaths.
Though it might seem like there could be a connection between the area’s high prescription rates and the high number of opioid related deaths, it’s not that simple, Rogers said.
“Trying to distinguish one from the other is fairly complex,” Rogers said.
Rogers and Salvaterra agreed that doctors cutting back on prescribing opioids isn’t the answer.
“The last thing we want doctors to do is to suddenly stop prescribing opioids to someone who has become dependent or who is addicted to opioids, that is going to throw the person into crisis,” Salvaterra said.
What doctors need to do is start prescribing them at the proper dosage, Salvaterra said. Forty per cent of patients taking opioids are on too high a dosage, above the recommended guidelines, she said.
“There’s definitely work to be done to help doctors prescribe more safely,” Salvaterra said.
New prescription guidelines were released this year. To make sure local doctors are up to speed, there’s workshop is happening in October for doctors and dentists.
While physicians may have some work to do, Peterborough is a bit ahead of the curve in other areas as far as the opioid crisis is concerned.
It was one of the first communities in Ontario to pick up the Patch for Patch program, where patients return their used fentanyl patches. The city’s hospital was among the first hospitals the province to provide Naloxone kits in the emergency department. And city police were the first force in Ontario to have officers carrying the antidote.
“Certainly there has been an interest in those kind of harm reduction strategies in this area that is probably further ahead that many other communities,” said Rogers.
What Rogers would like to see is improved access to appropriate pain management, therapies, clinics and interventions.
Currently family doctors are the ones managing patients’ pain.
Salvaterra said Peterborough needs a chronic pain network, either a pain clinic or consultants that can help family doctors.
“We need better treatment of pain locally,” Salvaterra said.
A positive note in the recent study was that a high rate of opioids was prescribed for treatment of people who have an addiction, such as methadone, Salvaterra said.
“Peterborough has a notably higher rate of treatment, so that’s encouraging for me to see that,” she said.
Salvaterra also pointed out that the volume of opioid prescription in Ontario is on its way down. The total volume of opioids prescribed to treat pain is down 18 per cent since January 2015.
“That’s good to see,” Salvaterra said.
Meanwhile, in an open letter to Premier Kathleen Wynne on Monday, more than 700 doctors, nurses, harm reduction workers and academics called on Ontario to declare opioid overdoses and deaths an emergency, as British Columbia did last year.
Our legislation differs in Ontario, though, Salvaterra said. Municipalities are able to declare emergencies and it’s left up to the mayor or warden to decide.
What Salvaterra said she thinks petitioners are after is more transparency from the government.
“I think the province could be doing better in communicating how we’ re doing with the opioid crisis and what resources are being brought to play,” Salvaterra said.
Regardless, Salvaterra said opioid overdoses have been on the rise for more than a decade, so a quick fix won’t be the answer.
“We’re not going to solve it overnight,” she said.
As for street-drug users, Salvaterra thinks kid gloves are in order to handle the problem.
“What we need to do is apply a much more humane approach to treating substance disorders and recognizing that people need help, they don’t need to be turfed out,” she said.
NOTE: On Thursday, International Overdose Awareness Day, there’ll be three locations offering information on opioids and handing out free naloxone kits. Stop by the Silver Bean Café or Peterborough Square (outside George and Simcoe streets) between 11 a.m. to 1 p.m. or One Roof Community Diner on Brock street between 1 to 3 p.m.