Dr. Tara Gomes, Li Ka Shing Knowledge Institute Scientist

By Jennifer Stranges

Ontario saw a 79 per cent increase in opioid-related deaths during the pandemic with marginalized populations – including people experiencing homelessness and unemployment – particularly impacted, according to a new report that details the circumstances of opioid-related deaths in the province.

The report suggests that limited access to in-person supports for people who use drugs due to the pandemic, as well as an increasingly toxic unregulated drug supply, contributed to hundreds of additional deaths across Ontario during the pandemic. Non-prescription benzodiazepines, a drug that is particularly dangerous when mixed with opioids, were detected in nearly half of opioid-related deaths during the pandemic, compared to only 30 per cent before the pandemic.

The report, released May 19, offers insight into the 2,050 lives lost to opioid-related overdose in Canada’s most populous province from March 16, 2020 to December 31, 2020, and is an update to preliminary data released last November, which examined opioid-related deaths in first three months of the COVID-19 pandemic.

The report found that during the pandemic:

  • There was a 79 per cent increase in opioid-related deaths, which was driven by an increasingly volatile unregulated drug supply during the pandemic.
  • One in six opioid-related deaths occurred among people experiencing homelessness. The number of deaths in this population more than doubled during the pandemic compared to the same period the year prior.
  • There were large shifts towards opioid-related deaths among people experiencing homelessness occurring in hotels; in particular those designated to provide pandemic-related shelter or isolation services.
  • More than half of opioid-related deaths occurred among people who were unemployed at the time of their death.

“The COVID-19 pandemic has not only worsened the existing overdose crisis in Ontario, but is disproportionately impacting people who are vulnerably housed and who are attempting to navigate risks of COVID-19 infection and an increasingly volatile drug supply,” said Dr. Tara Gomes, a Scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and a Principal Investigator of the Ontario Drug Policy Research Network (ODPRN).

“We are losing hundreds of lives to this crisis every month in Ontario, and the situation continues to worsen. These data reinforce the urgency of the overdose crisis in Ontario, and the need for a rapid, coordinated response by all levels of government to provide emergency funding and support for community-based harm reduction programs throughout the province,” said Dr. Gomes.  

The report was led by the Ontario Drug Policy Research Network (ODPRN), housed at St. Michael’s Hospital of Unity Health Toronto, the Office of the Chief Coroner for Ontario and Public Health Ontario.

“The increased number of opioid-related deaths during the COVID-19 pandemic is a stark reminder of the breadth and reach of the overdose crisis in Ontario.” said Dr. Dirk Huyer, Chief Coroner for Ontario. “Family, friends and communities are losing loved ones and we are working to understand how to respond to the crisis in the most effective way.”

The report also found:

  • Some of the largest increases in opioid-related death rates occurred among northern and rural parts of the province, such as North Bay, Sudbury, Thunder Bay and Timmins.
  • Men accounted for 76 per cent of opioid-related deaths, rising from 71 per cent the year before.
  • People aged 25 to 44 accounted for 1,109 opioid-related deaths during the pandemic, an increase of 501 deaths before the pandemic.
  • Of those who were employed, approximately one-third of opioid-related deaths occurred among people in the construction industry.
  • No one was present to intervene for 73 per cent of opioid-related deaths.

The report was funded by the Government of Ontario and the Canadian Institutes of Health Research (CIHR).

About St. Michael’s

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.

About Public Heath Ontario

Public Health Ontario is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. Public Health Ontario links public health practitioners, front-line health workers and researchers to the best scientific intelligence and knowledge from around the world. For the latest PHO news, follow us on Twitter: @publichealthON.

About the Office for the Chief Coroner

Together the Office of the Chief Coroner/Ontario Forensic Pathology Service (OCC/OFPS) provide death investigation services in Ontario serving the living through high quality investigations and inquests to ensure that no death will be overlooked, concealed or ignored. The findings are used to generate recommendations to help improve public safety and prevent further deaths. In Ontario, coroners are medical doctors with specialized training in the principles of death investigation. Coroners investigate approximately 17,000 deaths per year in accordance with section 10 of the Coroners Act. The OFPS provides forensic pathology services in accordance with the Coroners Act. It provides medicolegal autopsy services for public death investigations under the legal authority of a coroner. The OFPS performs approximately 7,500 autopsies per year. For more information, visit mcscs.jus.gov.on.ca.

Media contacts:
Jennifer Stranges, Communications Advisor, Unity Health Toronto

Stephanie Rea, Issues Manager, Office of the Chief Coroner