Omar Ali
With the coronavirus pandemic and the ruling elite’s “profits before lives” strategy exacerbating the already terrible social and health care crisis across Canada, the number of Canadians dying of opioid overdoses has risen dramatically over the past year. While some provincial data is still being compiled, 2020 will likely emerge as the deadliest year on record to date.
Estimates put total opioid-related deaths at approximately 16,000 since 2016 nationwide. The steady stream of tragedies was underlined this week by reports of two overdose deaths within two days in the small southern Ontario town of Owen Sound.
Virtually every province recorded increases in 2020. In British Columbia (BC), the number of deaths almost doubled to 1,716 from 984 in 2019. Saskatchewan experienced a per capita rate comparable to BC, with its death rate doubling in 2020. In Ontario, 50–80 people are dying each week, according to the chief coroner’s office. The year 2021 is following on the same path, with the City of Toronto breaking its monthly record for deaths this January. The previous record had been set in December 2020, which in turn had eclipsed record figures in October and November. Alberta and Nova Scotia have also seen significant spikes in opioid deaths.
Several factors have been cited as contributing to the sky-rocketing death-rate. The pandemic has disrupted the drug supply due to the effects of border controls, leading to more-unpredictable products and homemade concoctions being more widely used. Increasingly more-powerful opioids are found to be responsible for overdose deaths including fentanyl. In 2017, 50 percent of samples tested by Health Canada contained fentanyl. Now, samples are being found to contain the synthetic opioid carfentanil, which is 100 times more powerful than fentanyl and 10,000 times more powerful than morphine.
Social distancing measures have left users isolated and without access to help in the event of an overdose. A study last year by the Canadian Institutes of Health Research found that in three-quarters of the cases they reviewed, victims were alone at the time they overdosed. The pandemic has also resulted in reductions of treatment beds and safe-injection sites. The latter, already few in number, have seen large increases in wait times as a result. The study also recorded significant increases in deaths among males, recent immigrants and visible minorities.
Another report by the Ontario Drug Policy Research Network noted that younger age cohorts are being hit harder than before the pandemic. The opioid epidemic, it adds, is increasing in both large cities and small towns. A southeastern Ontario nurse and harm reduction coordinator told CTV News, “I’ve been doing this for 11 years, and I’ve never seen numbers like this.”
The temporary lockdowns imposed by provincial governments, which together with the federal Liberal government have refused to provide adequate financial and social support for working families while doling out hundreds of billions of dollars to the banks and big business, have also coincided with the deteriorating mental health situation across the country. There have been significant drops in self-reported mental health since the pandemic began. Use of alcohol, tobacco and cannabis—which may serve as barometers for stress and other mental-health related issues—have shot up since March of last year. The combined use of opioids with other narcotics, especially alcohol, methamphetamines and cocaine can increase the risk of death.
The rise in deaths has come on the heels of an already devastating epidemic of opioid deaths. One report found that in 2018, each day saw 13 Canadians die from opioid overdoses. While there was some improvement in 2019, the situation drastically reversed in 2020. In the trough between the pandemic’s first and second waves, many regions were seeing more deaths from opioids than from COVID-19.
Calls are growing for the decriminalization of possession of opioids and other narcotics, particularly in small quantities. This measure has received support from the country’s chief medical officer and the head of the Canadian Association of Chiefs of Police. Proponents argue that this would encourage users to seek treatment without fear of legal consequences.
Researchers point out that the United States and Canada are alone among industrialized nations in suffering a pronounced epidemic of opioid use. The commercialization of health care in both countries is one of the leading culprits. The two nations are the largest consumers of prescription opioids. Japan, by contrast, has an opioid usage rate 5 percent that of Canada’s. Disingenuous marketing has contributed to a dramatic rise in over-prescription of opioids for pain since the late 1990s. Once restrictions on the dispensation of these drugs were strengthened, users were forced to seek black market alternatives. This has in part contributed to a more than five-fold increase in opioid deaths compared to 30 years ago.
Like their counterparts in the United States, Canada’s governments have made much fanfare of their belated efforts to rein in the large pharmaceutical corporations that profited off the death of thousands. Purdue Pharma, controlled by the venal Sackler family who have thus far escaped criminal prosecution, is the subject of provincial lawsuits totaling tens of billions of dollars. But it remains to be seen what will be recovered, as the company has sought bankruptcy protection.
While much has been made of the impact of social distancing and other pandemic-related measures on the opioid epidemic, less media coverage has been devoted to the ongoing social crisis that has only been exacerbated by COVID-19.
Before the pandemic, one study of hospitalizations due to opioid poisoning found levels of education and income were negatively associated with risk. In the midst of a nationwide housing crisis that has witnessed dramatic increases in homelessness, the study found that the percentage of income spent on housing was positively predictive of hospitalization as well. The occupations most associated with hospitalization were working class jobs that are physically demanding, often resulting in injury, and poorly compensated, including manufacturing and manual labour jobs. The prison population and the indigenous population are also disproportionately affected by the epidemic.
Funding at all levels of the health care system has been stripped bare, and paramedics and firefighters who are on the frontline of the epidemic are heavily overstretched. The offender-in-chief in this regard is the Trudeau Liberal government, which has reduced health transfers to the provinces during its more than five years in power. The official 3 percent annual “increase” of these transfers does not even keep pace with inflation, never mind the increased costs placed on health care by both a growing and ageing population, the demands of the opioid epidemic, and now, above all, the COVID-19 catastrophe. No such restrictions have been placed on the lavish budget increases for the military and its weapons of war, which is set to increase by more than 70 percent by 2026 compared to 2017 levels.
Before the pandemic, a group of researchers wrote in the Lancet what it would take to tackle the problem, explicitly comparing it to an outbreak of an infectious disease. They explained that “the current opioid crisis in Canada would require systematic identification and protection of an estimated population of as many as 1 million users at risk from toxic opioid products, through provision of a safer opioid supply.”
A poll released late last month by the Angus Reid polling agency further demonstrates the deep scars left by the epidemic. Five percent of Canadians know someone who has died from opioid use, including 10 percent of British Columbians. As a result, a clear majority in the country support broad decriminalization of narcotics and the increase in availability and funding for safe-injection sites. Residents of nearly every province felt their governments were not doing enough to address the crisis. The lowest satisfaction rating went to British Columbia’s New Democrat Premier John Horgan. Horgan had to apologize last year for remarks he made comparing COVID-19 to the opioid crisis, in which he stated that the pandemic had claimed innocents while those who died of an opioid overdose had made a “choice” to take the substance.
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