Emergency department visits for opioid poisoning higher in Alberta than Ontario

Alberta far outpaced Ontario in the rate of emergency room visits and hospitalizations due to opioid poisonings last year, says a report released Wednesday. 

The report, Hospitalizations and Emergency Department Visits Due to Opioid Poisoning in Canada, was done jointly by the Canadian Centre on Substance Abuse and the Canadian Institute for Health Information (CIHI).

According to the report, the rate of emergency department visits for opioid poisoning in 2014-15 was 57 per cent higher in Alberta than in Ontario.

During that same period, hospitalization rates in Alberta more than doubled for people aged 15 to to 44. In Ontario, rates for those same age groups increased by about one-third.

"A lot of it's being driven by synthetic opioids like fentanyl and heroin," said Paul Sajan, manager of the prescription drug abuse project at CIHI.

"Heroin is increasingly being laced with illicit fentanyl, so I think a lot of the emergency department visits in recent years in Alberta, the increase is largely due to drugs coming in from the illicit market."

Seniors aged 65 and older consistently had the highest hospitalization rates due to opioid overdoses, but accidental poisoning is cited as the main reason. 

"Seniors have the most number of health conditions. They are prescribed the most medication. They are prescribed the most opioids," Sajan said.

"When you factor in the opportunity for drug interactions causing a poisoning or an overdose, or the increased risk of accidentally taking too much medication, it's actually not surprising," Sajan said.

Opioids are a type of prescribed psychoactive drugs used to treat levels of pain ranging from chronic back pain to extreme pain following surgery.

While fentanyl remains the most commonly-known opioid, other substances such as morphine, codeine, methadone and heroin were also considered in the study.

Alberta has been struggling to stem the surge of fatal opioid overdoses in the last few years.

While there's no solution, British Columbia is the model all provinces should follow in dealing with the issue said Sajan.

That province has taken a collaborative approach involving lawmakers, public health, first responders, the health care system and even border services, Sajan said.

There were 200 fentanyl-related overdose deaths in B.C. in the first three months of 2016, prompting the province's chief health officer to declare a public health emergency.

Alberta's opioids and substance abuse report, released on Nov. 1, found that 193 of the 338 overdose deaths between January and September 2016 were related to fentanyl. The remaining 145 were related to other opioids.

Alberta has also seen a jump in the number of emergency department visits due to heroin overdoses. 

In 2010-11, heroin accounted for one per cent of opioid poisonings treated in Alberta hospitals. That rate jumped to 14 per cent in 2014-2015.

The new report found that hospitalization rates across Canada varied. The highest rate for opioid poisoning in 2014-2015 was in Saskatchewan with 21 visits per 100,000.

Quebec, on the other hand, recorded a low of approximately 10 visits per 100,000.

The study did not include the number of opioid poisonings treated outside a hospital setting, nor did it compare the detailed hospitalization rates in provinces other than Ontario and Alberta as comprehensive data was unavailable.