Quebec is “not immune to a tragic setback” in the opioid crisis, even if its situation is less alarming than other Canadian provinces, recalls a new report from the National Institute of Public Health (INSPQ ) published Tuesday. The organization invites the authorities to keep a “broad-spectrum watch” on the phenomenon.
The said document reveals the results of an analysis coordinated by the INSPQ and the regional public health directorates. The whole thing was carried out with more than a thousand drug users in Quebec.
The research “found the presence of an opioid in urine in 27% of 655 study participants in 2021 and in 24% of 1,068 participants in 2022,” the report reads.
According to the Institute, the situation “testifies to the extent of opioid consumption among certain drug users” in the province, as well as “the impact of inequalities in this problem”.
Several trends are evident, including firstly, an over-representation of the homeless population among individuals who have had an involuntary overdose of opioids in the last six months in Quebec. The INSPQ also argues that the homeless are “considerably under-represented among people with a naloxone kit, which necessarily makes them more vulnerable to death by opioid overdose.”
Five deaths per week
According to the most recent data, the opioid mortality rate “is lower in Quebec than the average of Canadian provinces”, but it is still increasing steadily. In fact, their numbers more than tripled between 2000 and 2020, going from just under 100 to more than 300 during that time.
In recent years, the Quebec average is approximately “five deaths per week directly attributable to opioids,” maintains the INSPQ. In Montreal, especially, the situation is getting worse over time, according to several organizations and stakeholders.
In terms of hospitalizations, an increase in their number was clearly evident for the whole of Quebec between 2007 and 2016, notes the Institute, which however observes a “slight decline” in the phenomenon between 2017 and 2021.
Currently, there is an average of around fifteen opioid-related hospitalizations per week. On an annual basis, this represents between 700 and 800 hospitalizations linked to the phenomenon, year after year, for more than ten years already.
However, everything indicates that the increase is accelerating. According to the most recent figures from federal Public Health, Ontario is the province with the highest number of deaths linked to opioid poisoning in Canada, with approximately 2,500 in 2022. All things considered, this however gives a rate of approximately 16.6 deaths per 100,000 population, good for fourth behind British Columbia (44), Alberta (33) and Saskatchewan (19.7).
With 541 deaths linked to this phenomenon last year, Quebec is still far behind this ranking, with a rate of 6.2 deaths per 100,000 inhabitants.
Why is Quebec doing better?
Many factors can explain the fact that Quebec is doing better than elsewhere, despite the acceleration of the public health crisis. From the outset, notes the INSPQ, “Quebec doctors would generally prescribe fewer opioids, and when they do, they would do so in lower quantities.”
The report also argues that “the marketing practices of the pharmaceutical industry are better regulated in Quebec than they are elsewhere in Canada and the United States.” “These campaigns also take place mainly in English, which could prevent or delay, in certain cases, the adoption of these products in a French-speaking context,” we add.
Still, it is crucial to continue efforts, maintains the group of researchers, who recall that “already in 2019, experts indicated that Quebec is indeed not immune to a tragic setback, given that a destabilization of the illicit drug market […] could have significant negative repercussions on the health of users.
“The recent context of the pandemic seems to have validated these fears since an increase in overdose deaths was observed in the months following the start of it,” adds the research group.
“We are facing a lasting phenomenon in constant transformation, hence the importance of broad-spectrum monitoring. Opioids are neither the first nor the last drug to enter the drug market. […] Other psychoactive substances will appear, others will return,” concludes the Institute.