Internal report shows surge in Saskatoon overdoses since arrival of COVID-19

An internal Saskatchewan Health Authority (SHA) report shows the number of opioid overdoses in Saskatoon is the highest it has been since at least 2017.  

The document also shows the spike in the number of overdoses recorded in the city's emergency rooms started around the time the COVID-19 pandemic began.

The number of overdose deaths in Saskatchewan in 2020 is the highest on record to date, according to the Saskatchewan Coroners Service, which has data for the past 10 years.

The Opioid Overdoses and Methamphetamine Surveillance Saskatoon Monthly Report from September 2020, obtained by CBC through a freedom of information request, includes a series of graphs that show rising opioid overdoses in the city. 

Unlike in Regina, the Saskatoon city police service does not track the number of overdose calls it receives. 

A total of 67 opioid overdoses went to the emergency room in Saskatoon in September, the highest number since the graph begins in June 2017.

Saskatoon family doctor and addictions consultant Dr. Peter Butt said "a perfect storm" of factors are contributing to the recent surge in overdoses. 

He said he receives the internal SHA surveillance report every month and the upward trend in overdoses has continued since September.

"Part of this is clearly the ongoing and increasing availability of the more potent fentanyl or fentanyl analogues that are being distributed in Saskatchewan," said Butt.

He said Canada Emergency Response Benefit (CERB) payments from the federal government have contributed to the problem by increasing the availability of money.

The closure or reduction of support services and increased stress created by the COVID-19 pandemic are also contributing to the increase, he said.

"It's going to get worse over the winter with the social isolation and the challenges people are facing," said Butt. 

"And now, of course, with the CERB [payment] clawed back provincially, that's going to create an additional burden with regards to lack of income as they're being clawed back for repayment as well as loss of housing."

While the number of overdoses spiked, the number of admissions to Mental Health and Addictions Services (MHAS) has dropped by hundreds since the start of the year, according to the report.

"MHAS admissions decreased substantially by April and [have] not recovered to pre-COVID admissions," said the document. 

In late March, the SHA temporarily stopped taking new referrals for adult and youth programs at the Calder Centre for addictions treatment in Saskatoon, except for the youth stabilization unit.

Although opioid overdoses have increased since the COVID-19 pandemic, crystal meth remains the drug used most frequently by patients admitted to mental health and addictions services. 

The SHA report also includes a map of where opioid patients who overdosed from any substance in September resided in Saskatoon. It shows the highest number of overdoses occurred in the downtown, City Park and Pleasant Hill neighbourhoods. 

Although numbers were highest in those areas, the map shows overdose patients resided in neighbourhoods across the city. It shows cases where the patient was in a hospital emergency room due to an overdose.

Jason Mercredi is the executive director of Prairie Harm Reduction, which runs a safe consumption site in Pleasant Hill. 

He said the data shows more resources are needed for the overdose response. 

"It's a matter of priorities," said Mercredi. 

"The health authority [response to COVID-19] has shown that they are capable of incredible feats of mobilization, incredible feats of public advocacy, incredible feats of public education," he added. 

"The health authority can do amazing things when it chooses to. We just want some of that to be directed toward the overdose crisis. Same thing with the Ministry of Health."

There were 323 confirmed or suspected overdose deaths in the province as of Dec. 1.

Of those, 122 are confirmed and 201 are suspected, meaning the cause of death is still being investigated. Twenty-four of the confirmed cases were in Saskatoon and 58 were in Regina. 

In Regina, police had received 712 reports of overdoses, compared with 82 for the whole year of 2019, by early September 2020.

The police service reports that the number of overdose deaths in that city doubled from 33 to 63 in the two months of July and August, far exceeding the 21 overdose deaths recorded for the whole of 2019. 

In Saskatoon, Prairie Harm Reduction hires workers to walk the streets distributing naloxone kits, which can reverse the effects of an opioid overdose. 

Mercredi suspects higher levels of naloxone distribution in Saskatoon are the reason there are fewer confirmed deaths in that city than Regina so far this year. 

He said overdose information such as the numbers in the surveillance report should be shared publicly. The document is marked "not for distribution." 

"If there's no data available, it makes it really hard to mobilize the community so that we can we can have effective interventions," said Mercredi.

The SHA report said 424 naloxone kits were distributed to people who use drugs by both health authority services and community-based organizations in September. 

Among those people, the SHA reported an increase in the number of people using fentanyl and heroin, a trend that has been reported anecdotally by people who use drugs in Saskatoon and by support workers.

Crystal meth, which has historically been more prevalent in Saskatchewan, remained the main cause of overdose in Saskatoon until around the start of 2020. The number of opioid overdoses then started edging closer or exceeding the number from crystal meth in the months leading up to September.

Butt said availability of naloxone is a key tool in responding to the growing number of opioid overdoses, but that "continuum of care" for people who are ready and able to seek treatment is lacking and needs to be improved. 

A patient who has not been using drugs for three months is considered to be in "early remission," he said, much like a cancer patient who is in remission. They are not considered to be in "sustained remission" for 12 months.

Treatment services such as a 28-day rehabiliation do not extend long enough to support a person through even the early stages of remission, Butt said. 

"We have a lack of providers for opioid agonist therapy, the methadone and buprenorphine, naloxone that we use for opioid use disorder, and addiction counsellors to provide the support that people require," he said. 

CBC contacted the SHA for comment but did not receive a response before deadline.

The Ministry of Health said in a statement in late November it is spending more than $1.7 million to fund 28 new detox beds in Regina, Saskatoon, Moose Jaw, Prince Albert, North Battleford and "other potential locations."

More than $800,000 is going toward hiring addiction workers in Regina, Saskatoon and Prince Albert, it said.

The province has also implemented programs aimed at helping people with addictions, like Take Home Naloxone —which has already distributed more than 5,400 kits so far the year, the statement says —  along with Rapid Access Addictions Medicine program, Mental Health and Addiction Services and HealthLine 811.