COVID-19 and the spike in opioid-related deaths
Opioid-related deaths (ORDs) have been on the rise at both the local and national level over the past decade. The emergence of the COVID-19 pandemic this year has further exacerbated this rise. A recent report prepared by the Ontario Drug Policy Research Network showed that in the 15 weeks following the state of emergency declaration on March 17, ORDs increased 40% in comparison to the 15 weeks prior (1). The same report also projects that there will be 2271 ORDs by the end of the year, representing a 50% increase from 2019 (1). At the local level, the story is similar: it took only 4 months for London to reach 50% of its total ORDs from 2019, primarily driven by a spike in deaths in March and April (2).
There are many possible reasons behind the pandemic's impact on the spike in ORDs this year. For one, COVID-19 has resulted in increased barriers for people suffering opioid addiction to access key services and treatments. Social distancing measures have necessarily reduced the capacity of pharmacies, patient clinics, and overdose prevention and harm reduction sites involved in helping people with opioid addiction. The pandemic has also resulted in the rise of street-level prices of crystal methamphetamine, driving individuals towards highly potent opioids, including fentanyl, a cheaper but more deadly alternative. Consequently, during the pandemic, fentanyl has accounted for a substantially greater proportion of ORDs compared to before (1). In London, social distancing has also made it more difficult to hand out naloxone kits, used to reverse the effects of opioid overdose. Naloxone kit distribution fell from 600 a month to 400 at the start of the pandemic (3). As case counts continue to rise, the outlook of COVID-19 is becoming increasingly sombre in the coming winter months. With the evident spike in ORDs as a direct consequence of the pandemic, it is imperative that local, provincial, and federal governments take action sooner rather than later.
Since the start of the pandemic, fentanyl has accounted for a greater proportion of ORDs, possibly owing to an increase in street price of crystal methamphetamine. Figure taken from Public Health Ontario report (1).
Ontario Drug Policy Research Network. (2020, October). Preliminary Patterns in Circumstances Surrounding Opioid-Related Deaths in Ontario during the COVID-19 Pandemic. https://www.publichealthontario.ca/-/media/documents/o/2020/opioid-mortality-covid-surveillance-report
Bieman, J. B. (2020, August 31). Opioid overdose deaths rise as pandemic drives up crystal meth prices. London Free Press. https://lfpress.com/news/local-news/opioid-overdose-deaths-rise-as-pandemic-drives-up-crystal-meth-prices
Butler, C. (2020, September 14). Drop in London naloxone distribution during pandemic raises concerns. CBC. https://www.cbc.ca/news/canada/london/naloxone-london-ontario-pandemic