Toronto

5 people are hospitalized because of opioid poisoning every day in Ontario

Between April 1, 2016 and March 31, 2017, 494 people in Toronto had to be hospitalized for opioid poisoning - the highest number of cases in the province.

New report shows a troubling rise in opioid-related hospitalizations, emergency room visits

White fentanyl pills are partially crushed.
Fentanyl, a dangerous opioid, has been a growing concern across Canada. (CBC)

Over the past year in Ontario, about five people a day had to be hospitalized because of opioid poisoning, according to a new report released Thursday by the Canadian Institute for Health Information (CIHI). 

Between April 1, 2016 and March 31, 2017, 494 people in Toronto had to be hospitalized. That's the highest number of cases in the province, but when adjusted for population, it's the city of Brantford, Ont. that's hardest hit. 

Brantford experienced 32 cases per 100,000 people, whereas Toronto had eight.

According to the report, the rate of hospitalizations nationwide increased 53 per cent over the last 10 years to 15.6 per 100,000 people. By comparison, the hospitalization rate for driver injuries in motor vehicle collisions is 25 per 100,000. (CIHI)

The report also looked at the number of emergency room visits in the province due to opioid poisoning, which is another term for overdosing.   

During the same time period, about 13 Ontarians had to visit the emergency department each day, an almost 50 per cent increase from four years ago. 

Again, Toronto had the highest number of cases with 1,465, but Brantford remained the highest when factoring in population — about 99 compared to Toronto's 23 per 100,000 people.

This graph shows the amount of emergency department visits caused by opioid poisoning by city between 2016-2017.

To Paul Sajan, manager of prescription drug abuse at CIHI, the numbers show the opioid crisis is worsening.

"There's been a lot of attention on the opioid crisis over the last couple of years, and what this data shows is that harms, whether measured by hospitalizations or by emergency department visits, continue to increase across Canada, in fact some of the strongest growth we've seen is just in the past three years."

Sajan said the growth in opioid poisoning numbers is being driven largely by two types of drug: heroin, and synthetic opioids such as fentanyl. (CBC)

"This is a major public health crisis in Canada," Dr. Theresa Tam, Canada's chief public health officer, said in the report. 

"Tragically, in 2016, we estimate there were about 2,500 apparent opioid-related deaths in Canada, fwhich is greater than the number of Canadians who died at the height of the HIV epidemic in 1995."

Young people 15 to 24 hardest hit

The fastest-growing population impacted by opioid poisoning are 15 to 24 year olds. 

"I think in large part this reflects what's happening in the illegal market," Sajan said. 

"Over the past decade, the availability of illegal opioids, or what are often referred to as counterfeit opioids, has increased dramatically on the streets ... sadly, in many cases youth are purchasing recreational drugs such as ecstasy, and they don't realize that illegal opioids such as fentanyl are being laced into their recreational drugs."

Peter Saunders, a 24-year-old from Toronto, has overdosed on opioids three times.

Twice he was saved by nearby naloxone, a drug used to reverse the effects of opioids, but the third time, he ended up in hospital. 

Saunders told CBC an overdose "doesn't really feel like anything. When you overdose you have no idea. You do your shot, you feel your rush and then it's black. It's just dark." He's one of thousands who have visited the emergency department after an overdose. (CBC)

"When you're younger you think you're invincible," he said. "I know I used to. I would take anything. It didn't matter the amount. We used to play games, who can do a bigger amount. We weren't thinking about overdoses ... but as you get older life really becomes a reality. People start dying around you. People start going to jail. People start losing their minds."

To fix the problem, Saunders said underlying problems being dealt with by young people, such as mental health and trauma, need to be addressed.

According to the report, 44 per cent of opioid poisoning hospital visits nationwide from youth are considered intentional, meaning they were the result of "purposely self-inflicted harm." 

Strained health care system

The report also makes note of the average length of time someone suffering from an opioid poisoning spends in hospital.

The national average for a hospital stay, according to Sajan, is approximately five days. For an opioid poisoning, it can be up to about 15 days, he said.

"It's put increased pressure on the resources at the local level for many emergency departments and for hospitals," Sajan said.

"It is requiring more resources. It is something that a lot of hospitals are dealing with, but many of them are working very diligently to provide the care that's necessary." 

Saunders, who's now attempting to stay clean, said there's one element of that care missing for young people: many of them prefer to stay out of the hospital even if they're experiencing an overdose because they feel judged.

"Generally when I go to the hospital I'm turned away," Saunders said. "Once they see that I'm prescribed methadone or they see my track marks or I have to tell them my veins are bad when they're trying to give me an IV, your level of care goes down."

His advice for a fix is simple: "Humanize them. Treat them like you would any other patient."

With files from Katherine Brulotte