Rate of opioid use second highest in province: study
By Jenn Watt
Published Nov. 29, 2016
Haliburton County has the second highest rate of opioid use among those accessing the Ontario drug benefit program out of 49 regions, according to a study by the Ontario Drug Policy Research Network.
In 2015, the county had 1,810 opioid users, the report shows, with 81 opioid maintenance therapy users. Hospital admissions in 2014 related to opioids had the county ranked 13th in the province with less than five admissions and ranked 12th in emergency department visits with seven.
The county was near the bottom of the ranking when it came to opioid-related deaths in 2013 with none.
However, numbers can be deceiving, says scientist Tara Gomes of St. Michael’s Hospital, particularly when it comes to areas with small populations.
“One of the issues we run into in the smaller regions is that there can be no deaths in a given year or a very small number,” she told the Echo. “That can make it appear … as though your rank would be very low because there were no deaths in 2013.”
However, when the county is examined over five years, its rank leaps to third in the province for deaths. Again, Gomes notes the population size when interpreting the numbers.
“There were only six deaths, but because of the small population size, the rate at which those deaths occurred is higher,” she says.
However, six deaths is still quite high, which the researcher says “highlights the fact that those high prescribing rates might also be leading to this increased risk of overdosing and dying.”
Opioid prescribing is a national problem. The powerful painkillers are incredibly effective, but can also easily be abused and are addictive. Public health officials have been warning of the dangers of the medication. In particular, those patients who are prescribed a high dose of the medication have a real risk of overdosing, because the body acclimatizes to the drug, which can lead to increasing doses over time.
“Studies conducted in Ontario and elsewhere have demonstrated that rates of opioid prescribing in general – and high dose opioid prescribing in particular – are on the rise,” the study reads. “Furthermore, the rising prevalence of abuse, misuse and addiction related to opioids has driven concerns regarding accidental opioid overdoses that may lead to hospitalizations for toxicity and sometimes death.”
Looking at the statistics for Haliburton County in particular, Gomes sees a hopeful trend in the number of people seeking addiction services, which is accounted for in the opioid maintenance therapy.
“I think that’s a positive sign because we know that there are people who have become addicted to these drugs across the province and there have been concerns around the ability to access addiction services, so rises in the use of opioid maintenance therapy are a positive sign,” she said.
Opioids in the county are overwhelmingly “immediate release combination agents” – acute pain drugs such as Tylenol 3s. These are typically a short-term drug, she says, and aren’t typically associated with overdoses.
“Instead, it’s the longer acting drugs that are more concerning [for overdose],” she says.
The purpose of the study was to show the degree of variation across the province in opioid usage and is geared to health professionals and agencies.
Gomes said people in Haliburton should note from her research that there is a high rate of opioid prescribing that could indicate some work needs to be done.
“I think for Haliburton County we know there aren’t a huge number of people who are dying of opioid overdose … which I think is reassuring, but at the same time the fact that opioids are being prescribed at such a high level – and that we do see a fairly high rate of emergency department visits for opioid overdoses as well – should perhaps point to some underlying issue in the community that there may be some overprescribing. There may be some addiction issues that might need more resources in the community to properly address,” she says.