Nova Scotia

Nova Scotia doctor says opiate overdoses biggest health crisis facing Canada

A Nova Scotia doctor says opiate overdoses are Canada's greatest public health crisis — and the situation is no less severe in Nova Scotia than other parts of the country.

'I don't think we can relax on this, I think we need to acknowledge it's a significant problem'

Dr. David Milne said opiate overdoses are a significant problem. (Zak Markan/CBC)

A Halifax doctor says deaths from opiate overdoses are the biggest public health crisis facing Canada right now, and the situation is no less severe in Nova Scotia than other parts of the country.

David Milne is a physician and associate chair of Dalhousie University's department of anaesthesia and pain management.

He's also one of the participants in Friday's leadership committee meeting aimed at crafting a response to opioid deaths in the province, following 49 deaths so far this year.

Milne told CBC's Information Morning that although the issue might seem less serious than that faced by provinces like British Columbia, where 488 people have died from overdoses, Nova Scotia's rate is not far off B.C.'s on a per capita basis.

"I don't think we can relax on this, I think we need to acknowledge it's a significant problem."

'Staggering' death rates

Milne said the problem with opiates is twofold.

First, hospitals have noticed an increase in the number of opiate-tolerant patients, meaning those who take between 50 and 90 milligrams of morphine or morphine equivalents a day.

"Those patients were incredibly complicated to deal with when they were coming in for surgery," he said. "They had more complications and they were spending more time in the hospital."

Milne said the issues persisted, and in many cases worsened, once those patients went home.

"They also had a significant amount of complications after they left the hospital," he said. "The death rates we saw with these opiate-tolerate patients were staggering."

Milne said the high volume of opiates prescribed by physicians gives people a false sense of security.

"If physicians are prescribing large numbers of prescription pills, then there's a sense that it must be safe, there must not be a risk." 

That risk is especially pronounced when people take pills they've not been prescribed, or which have been bought and sold illegally, because those pills are often mixed with dangerous drugs, including fentanyl. 

Milne said over-prescribing opiates has given people a false sense of their safety, especially when illicit versions of the drugs are often mixed with fentanyl and other dangerous substances. (Canadian Press)

Change in prescribing habits

Milne said doctors have an important role to play in addressing the crisis.

"I think we've got to take a really hard look at our prescribing habits," he said.

Doctors should not only standardize prescribing, so that patients don't end up taking multiple opiates at once, but also give patients explicit warnings about the risks of opiates, he said. 

Milne said that warning should extend to those taking medication that they've not been prescribed. 

"The other thing is we need to be aware from a public advocacy perspective is that [our] kids are at increased risk of consuming illicit medications.

"If there's any sense that they may be safe, we should really go out of our way to have the conversation with our kids that it's not the case."


  • There have been 488 overdose deaths in B.C. so far this year. An earlier version of this story contained an incorrect number. This version has been corrected.
    Oct 28, 2016 12:12 PM AT

With files from CBC's Information Morning