Fewer hospital visits does not mean fewer overdoses: health unit

Orillia had the most hospital visits related to overdoses in the region last year; 'I't’s not that overdoses have decreased. It’s that not as many people are going to hospital'

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Statistics show there were fewer overdose-related hospital visits during the first few months of 2020 compared to the same time last year, but they might not tell the whole story.

The Simcoe Muskoka District Health Unit reports, with the exception of January, emergency department visits due to opioid overdose up until July have been slightly fewer than 2019 numbers. However, the COVID-19 pandemic could have played a role.

“There was probably some avoidance (of the emergency department) because of the pandemic,” said Mia Brown, program manager with the health unit’s substance use and injury prevention program. “It doesn’t mean that people weren’t using or weren’t overdosing in the first few months of COVID.”

It’s possible more people were using in the presence of those who had naloxone, which temporarily reverses the effects of an overdose.

Brown also noted the Office of the Chief Coroner for Ontario reported an approximately 25 per cent increase in opioid overdoses from March to May over the same time last year.

The health unit is working on a document that will address how the pandemic has affected the vulnerable population as a whole, and it is also looking at “death data” related to overdose.

“We’ll get a better sense of whether there was an increase in deaths at the same time we saw a decrease in emergency department visits,” Brown said.

The number of overdoses in Orillia has been alarmingly high in recent years.

According to preliminary data from the health unit, the crude rate (per 100,000 population) of hospital visits due to opioid overdose in Orillia was the highest in the region last year, with 67 visits working out to a crude rate of 200.2. Midland had the second-highest crude rate, at 184. The provincial rate was 71.8.

Brown also noted some community resources have had a decreased capacity to assist those in need during the pandemic. The health unit is working to address those gaps and ensure an adequate supply of naloxone, methadone and suboxone.

While the latest data isn’t in yet, the health unit has heard from some of its community partners that there has been a high number of overdoses and that poorer quality of opioids being distributed during the pandemic could play a part.

It’s a concern shared by Sarah Tilley, harm reduction co-ordinator with the Gilbert Centre in Barrie.

“There are all sorts of issues with the drug supply,” Tilley said. “We’re noticing there are a lot more things like benzodiazepines that are being put in drugs.”

Benzodiazepine, she noted, kicks in later and combines with fentanyl to cause overdose.

“As people are displaced and isolated, those connections to better drugs might not be available,” Tilley said.

In June, the Gilbert Centre teamed up with the Canadian Mental Health Association to do outreach in Orillia in response to a spike in overdoses during the pandemic.

Tilley said Brown’s comment about the most recent data possibly not reflecting the real number of overdoses is “100 per cent what we’re seeing.”

“It’s not that overdoses have decreased. It’s that not as many people are going to hospital,” Tilley said.

The local outreach is still happening every Tuesday and Thursday from 11 a.m. to 2 p.m., when representatives walk around various parts of the city, including downtown and the waterfront, to offer assistance to those in need.

They also visit hotels where the homeless are being temporarily housed. Part of the outreach includes distributing supplies, naloxone kits and, when needed, clean needles.

“When we’re able to build relationships with people, that’s when they will start to come to us,” Tilley said.

Orillia Soldiers’ Memorial Hospital did not have anyone available to comment for this article.

More information about opioids in the region can be found here.