Indigenous Albertans died of opioid overdoses three times more frequently than non-First Nations people in a 15-month period since the beginning of last year — and they're far more likely to have been prescribed those drugs by a doctor, according to a new report.

The report compiled by Alberta Health and the Alberta First Nations Information Governance Centre found that 61 per cent of Indigenous people who died of an apparent accidental opioid overdose were dispensed the drug from a pharmacy, compared to 35 per cent of the non-First Nation fatalities.

Of the 701 people who reportedly died of apparent accidental opioid overdoses in the province from Jan. 1, 2016, to March 31, 2017, Indigenous people represented 12 per cent, or 87 people, according to the report, Opioids and Substances of Misuse among First Nations People in Alberta.

The rate of accidental overdose fatalities among First Nations people is much higher in Calgary than other parts of the province. 

Of the First Nations people who died from opioid overdoses within that the same 15-month period, 47 per cent of those cases (41 people) were in the Calgary zone, while 28 per cent of First Nations overdose deaths were in the Edmonton zone.

Higher prescription rates for First Nations

Aboriginal Albertans are also far more likely to be given prescriptions for opioids.

In 2016, the rate of opioid dispensing for First Nations patients was 276 per 100,000 compared with 150 per 100,000 for non-First Nation Albertans, the report says.

The rate of opioid dispensing from community pharmacies has consistently been about two times higher among First Nations people compared with non-First Nations people.

Dr. Susan Christenson, who works on the Blood Reserve east of Calgary, says a high percentage of First Nations people have suffered physical and psychological trauma, which in many cases prompts physicians to prescribe opioids to relieve the pain.

She says the clinical needs such patients have are very complex, and, too often, the resources needed in order to offer comprehensive care are too scarce.   

"There's very clear evidence that, the more opioids that are prescribed, the higher risk of overdose. I mean, that's just common knowledge, that's medical-evidence based knowledge," she said.

Signs of improvement

But Christenson says there are signs that the situation is getting better.

"Because of this crisis, I do think that physicians are much more cognizant of how important it is to be careful with prescribing opioids," she said.

"And I have personally seen a marked improvement in that practice in m my local medical community around here."

Christenson says physicians are increasingly being encouraged to acquire the skills needed for prescribing opioid replacement therapy instead of turning to opioids so often.

"That is one solution to me that is very important," she said.

"A patient who has an opioid addiction who goes on opioid replacement therapy has a significant improvement in their longevity and their mortality statistics."

From 2014 to 2017, the rate of emergency department visits related to opioid use and other substance misuse among First Nations people was almost six times higher than the rate among non-First Nations Albertans, and the rate of hospitalization was just over five times higher, the report found.

More female First Nations Albertans affected

It also noted that the opioid crisis is affecting female First Nation Albertans especially hard.

Among non-First Nation Albertans who died of apparent accidental opioid overdoses from Jan. 1, 2016, to March 31, 2017, roughly three-quarters were men. Among First Nations people who fatally overdosed, the breakdown by sex was almost evenly spilt.

The rate of accidental overdose fatalities among First Nations people is much higher in Calgary than other parts of the province. 

In the 15-month period the study examined, there were 137 deadly overdoses among First Nations people in Calgary per 100,000 person-years, compared with 15 per 100,000 person-years in the city's non-Aboriginal population.

In Edmonton, the disparity still tilts toward First Nation members, but much less starkly — there were 55 deaths per 100,000 person-years among First Nations versus 17 per 100,000 among non-First Nation people in that city.

Fentanyl is responsible for a higher proportion of deaths among non-First Nation Albertans, accounting for 43 per cent of the fatal overdoses in 2016, compared with 23 per cent of the accidental drug fatalities among First Nations people, for whom alcohol, codeine and benzodiazepines were more likely to be the deadly substance, the report found.