Opioid prescriptions in Southwestern Ontario among highest rates in province, report reveals

Southwestern Ontario is near the top of a list no one wants to be on.

Parts of the region — WindsorEssex, Sarnia-Lambton, ChathamKent and Elgin County — are running some of Ontario’s highest rates for opioid drug prescriptions, a new report by the Ontario Drug Policy Research Network shows.

One in seven Ontarians — that’s about 1.7 million people — were prescribed the potentially addictive drugs to treat pain last year. More than 122,000 of them live in the area of Southwestern Ontario with the highest prescription rates, a zone west of London that’s covered off by four public health offices.

“My hope is that people at the local and regional level can use this information to understand specific patterns in their areas,” said Tara Gomes, lead author of the report and a scientist at St. Michael’s Hospital in Toronto and the Institute for Clinical Evaluative Sciences.

Opioid drugs have become a deadly new scourge on the streets in many Canadian cities, but reliance on legally-prescribed opioids — which often make their way to the illegal market — is also a growing concern.

The report released Tuesday found higher rates of the potentially-addictive drugs prescribed for pain in rural and northern regions of Ontario.

The North Bay-Parry Sound and Haliburton, Kawartha, Pine Ridge health units lead the pack, with about 17 per cent of residents holding opioid prescriptions.

But Southwestern Ontario isn’t far off, the report says.

In the area covered by the Windsor-Essex health unit, 16.9 per cent of residents have been prescribed opioids for pain.

The public health agencies in Sarnia-Lambton, Chatham-Kent and Elgin-St. Thomas come in at 16.5, 16.3 and 16.2 per cent, respectively.

The Middlesex-London Health Unit ranks lowest in the five-agency region, with only 12.9 per cent of residents holding a narcotic painkiller prescription.

Despite the number of opioid prescription holders, the total volume of the drugs dispensed to patients province-wide fell 18 per cent between January 2015 and March 2017. The reduction was driven by cuts to the amount of long-acting, slow-release formulations, like fentanyl patches and some types of oxycodone, prescribed by doctors.

Of the long-acting drugs distributed to patients already using opioids for pain, the study found nearly 40 per cent were for doses higher than the 2017 Canadian prescription guidelines.

Gomes said the regional differences between opioid prescribing can be linked to a number of factors including the most common industries in each area, the potential for workplace injuries and access to non-drug interventions.

“It is possible that some of these patterns are from different patterns of treatment and access to pain management,” she said.

Gomes said she wants policymakers to use the report to steer local public health strategies. If an area is seeing high prescribing rates, coupled with a spike in narcotic-related deaths and low opioid treatment numbers, it could prompt health officials to focus more on addiction services.

“You can use the combination of information we have here, at the local level, to understand what’s happening. That may help inform better targeted policies,” said Gomes.

Those policies, said MPP Jeff Yurek, the Progressive Conservative health critic at Queen’s Park, need to include broad access to addiction treatment — not just in big cities, but in the rural areas where they’re needed most.

“There are large wait times for residential treatment,” said the Elgin-Middlesex-London MPP, a pharmacist by training. “We need to ensure some form of strategy is in place to help people recover.”

Yurek said he also wants to see expanded access to non-pharmaceutical pain management strategies like physiotherapy, a service he said could reduce the need for the long-term use of potentially-addictive painkillers.