Manitoba overdose deaths down, but opioids hospitalizing Brandonites twice as often as Winnipeggers: reports

Significantly fewer Manitobans died of opioid overdoses in the first half of this year than in 2016 or 2017, while Brandonites were hospitalized twice as frequently as Winnipeggers for opioid poisoning, two new national reports suggest. 

Opioids killed at least 22 Manitobans in the first six months of 2018, according to a new Public Health Agency of Canada report on opioid deaths, released Wednesday.

That compares to 68 and 36 during the same time frame in 2017 and 2016, respectively.

Neighbouring Saskatchewan saw 33 opioid deaths during the first half of 2018, the report says. There were 638 deaths in Ontario, 379 in Alberta and 754 in B.C. during that period.

A related report released Wednesday by the Canadian Institute for Health Information says people in smaller Canadian cities were hospitalized due to opioid poisoning at far higher rates on average in 2017 compared to large cities.

"We previously had thought that the opioid crisis is a big-city issue … but this analysis shows us that the opioid crisis affects smaller communities as well as bigger communities," said Roger Chen, program leader with the CIHI opioid reporting team. 

This holds true when comparing opioid poisoning and hospitalization rates between Winnipeg and Brandon.

Rate twice as high in Brandon

In the report, small communities are defined as those with populations between 50,000 and 99,000. At just shy of 60,000 residents, according to Statistics Canada, Brandon is Manitoba's only city that falls within that range.

The research suggests there were 12 serious opioid hospitalizations in Brandon last year — adjusted for age, a rate of 26 for every 100,000 people. And while there were 89 significant hospitalizations in Winnipeg in 2017, according to data provided by CIHI, that translates to a rate of about 12 hospitalizations per 100,000 people.

Provincewide, Manitoba saw just over 12 significant opioid-poisoning hospitalizations per 100,000 people in 2016-17, compared to 9.8 per 100,000 the year before, according to CIHI.

Meanwhile, there were 552 emergency response calls between January and June 2018 for suspected opioid overdoses, states the Public Health Agency of Canada.

Neither Winnipeg nor Brandon rank in the top 15 cities with the highest rates of hospitalization, though the rate in Brandon isn't far off that list.

Data sheds light on 'what,' not 'why'

Cheng said the CIHI report answers the "what" question, but doesn't necessarily provide any answers as to why rates are higher in rural or smaller communities. It could have something to do with larger cities having more developed treatment and support systems that lead to lower hospitalization rates, he said.

"This is only one out of many sources of information, and I think information or experiences or insights from front-line practitioners [and] local health authorities would greatly complement these numbers and provide better context," he added.

Opioids are commonly prescribed for pain management. While prescribed or illegally obtained oxycodone, morphine and codeine present serious community health concerns, problematic fentanyl use also continues to send shock waves through Manitoba and communities also struggle to cope with meth addiction.

The CIHI research also suggests opioid hospitalization rates have jumped 26 per cent in the past five years Canada-wide. An average of 17 Canadians were hospitalized daily between 2016-17, the report says, and during the same year, hospitalization rates skyrocketed by 73 per cent in Ontario and 23 per cent in Alberta.

More than half of of all 2017 opioid poisonings that led to hospitalization in Canada were accidental and about a third were from intentional use, CIHI reports.

Thirty per cent more men between the ages of 25 and 44 were hospitalized in 2017 compared to 2016 in Canada, representing the fastest such increase across age demographics.

CIHI researchers for the first time noted a decrease (of six per cent) in the number of hospitalizations from opioid-related drug reactions — defined in the report as an adverse effects from therapeutic use, as opposed to an accidental overdose — between 2013-17.

Some communities improved in part due to revised opioid prescribing guidelines for doctors, more supervised consumption sites, public awareness campaigns and greater availability of the life-saving overdose-emergency drug naloxone, the report states.