Hamilton's opioid deaths during pandemic among worst in Ontario, report says

Hamilton's opioid epidemic continues to cause deaths, even during the pandemic. And a new report shows more people died from overdoses toward the end of 2020.

Hamilton's drug strategy was put on pause and deaths linked to opioids increased near the end of 2020

A person holding drugs.
Hamilton's opioid epidemic is still causing deaths during the pandemic. And a recent report shows the pandemic made matters worse. (Briar Stewart/CBC)

A new report from public health shows the COVID-19 pandemic has made Hamilton's opioid epidemic worse.

And the necessary precautions to stop the virus form spreading led to reduced access to services for people who use drugs, while fatal overdoses began to rise.

The data, set to be presented at a Friday board of health meeting, shows more work needs to be done.

"Problematic substance use continues to be an area of significant public health concern in Hamilton," says the report submitted by Michelle Baird, the city's director of epidemiology, wellness and communicable disease.

"Since March 2020, with the start of the COVID-19 pandemic, there have been a higher number of fatalities associated with opioids."

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A recent federal report from Public Health Canada shows that in the first six months of last year there were more than 2,600 opioid-related deaths. Dr. Monty Ghosh is a Calgary addiction and internal medicine specialist and advocate. He spoke to CBC News about the impact the pandemic is having on opioid overdoses

The rate of overdoses was lower in the early days of the COVID-19 pandemic, the report says. From January to June, there were 67 overdose deaths, compared to 72 during that same time period in 2019. And 2020 overall had fewer suspected overdoses than the year before, with 565 incidents compared to 596 in 2019. But as the year went on, the problem worsened. 

In all of 2020, 3,445 people visited Hamilton emergency departments for drug misuse or overdose. Among these, 42 per cent were suspected overdoses. Last year also saw 83 opioid-related deaths according to public health data, which is fewer than 2019 and 2018.

But in November, analysis by the Ontario Drug Policy Research Network showed Hamilton was one of four regions in Ontario with the largest absolute increase in opioid deaths when compared to the pre-pandemic cohort.

"While there has been a rising trend of opioid-related deaths across most regions of Ontario during the pandemic, some areas – particularly larger urban centres like Hamilton, Toronto, Ottawa and Peel regions – are exhibiting the largest increases in rates and absolute number of cases," the analysis says.

"While local governments across the province should consider how to provide adequate services and supports to people who use drugs during the COVID-19 pandemic, this need is most urgent in larger urban centres across the province."

How did the pandemic make the epidemic worse?

"COVID-19 has impacted how individuals are able to use substances safely within Hamilton," reads the report.

"Locally, there are changes to community service provision with some agencies closing to public access as a result of the provincial government guidelines."

The city's four-pronged drug strategy was paused in April to help public health manage the first wave of COVID-19. In August, one part of the strategy restarted — the harm reduction working group. 

That group is responsible for increasing the number of people revived with nalaxone, and bolstering the destigmatization of drug use. The remainder of the drug strategy will remain closed until at least the end of 2021's first quarter.

"In addition, social distancing recommendations have limited the availability of social networks and safe spaces for individuals who use substances. These changes can increase the frequency of individuals using substances alone; which increases the risk of adverse events from substance use," the report states.

The report also notes a more toxic drug supply. In October, reports of a new, dangerous pink fentanyl was flagged in Hamilton and across Ontario. In December, a "new deadly substance" was also found to be likely causing a rise in suspected opioid-related overdoses.

Hamilton opioid use in 2021

Hamilton Paramedic Services responded to 69 incidents related to suspected opioid overdoses since the start of 2021. Of those, 54 were in January, which is marginally higher than some past months.

Hamilton emergency departments have had 64 people visit for drug misuse or overdose (that includes drugs beside opioids).

There have been 715 naloxone doses distributed by public health and local naloxone expansion sites. One person has been revived.

Public health has advice for anyone who uses the substance:

  • If using the drug, do not do it alone.
  • If using the drug, ensure you have naloxone present.
  • If using the drug, start with a small amount to test the effect.
  • If someone is overdosing, use naloxone and call 911.