Men make up the majority of N.L. opioid deaths and one expert isn't surprised

Newfoundland and Labrador, along with the rest of Canada, is grapplingwith an overwhelminggender imbalance in itsopioid-related deaths,and one expert at Memorial University says it's a complicated issue, with a complicated explanation.

• Where do the drugs go? N.L. has country's highest rates of drug losses from pharmacies

• Last year, 25 people in Newfoundland and Labrador died after taking drugs

A new report from Statistics Canada highlights that 70 per centof accidental apparentopioid-relateddeathsin the province in 2017 were men, a figure in line with the national average of 78per cent.

British Columbia had the highest percentage of men dying, at 83 per cent, while Saskatchewan's was the lowest at 56 per cent, although P.E.I. and the territories' data werenot included in the report.

"None of this was particularly surprising to me," said Christopher Smith, a professor of social workand author of the book Addiction, Modernity, and the City.

Among thenumerous factors at play in the gender gap, said Smith, one stands out.

"Men are far less prone to talking about mental health," he said."So a lot of men are self-medicating withopioidsfor undiagnosed mental health issues. That's my feeling."

Smith said while doctors are prescribing fewer and fewer opioids overall, the trade in illicit street drugs is brisk and those self-medications of choice are easy to come by.

Talk about it

Smith calledforincreased efforts to endthe stigma surrounding mental health among men, such as morepublic education, awareness campaigns and individuals encouraging mento talk about their mental health.

"If we candestigmatizethe issue of mental health among men, and get men more comfortable talking about their psychological well-being, we can get more people into treatment earlier," he told CBC's St. John's Morning Show.

"[Then] they won't be self-medicating [or] self-compensating on their own, and then develop habits that really aren't aboutopioidsso much as masking other underlying issues."

• Fentanyl in Newfoundland: Timeline of a powerful killer drug

Alberta, incarceration factors

The well-trodden path to work out west also contributes to the gender imbalance, Smith said.

"Men disproportionately make up this robust migratory labour population moving between Atlantic Canada and places like FortMcMurrayor Grande Prairie," he said.

None of this was particularly surprising to me.- Christopher Smith

Drug testingon construction sites favoursthe abuse of opioids, crack and cocaine, which are undetectable after three days, versus cannabis that can linger longer.

"We're seeing a lot of men move to these harder drugs, this migratory labour population, and bringing these drug habits back to Newfoundland," said Smith.

Another overwhelmingly male population is also a target for opioid deaths: inmates. However, Smith said, the fatalitiesoften come just after men who did not receive adequate counselling or methadone programs are released from jail and seek out their old lifestyles.

"When you come out you have no tolerance, but often people use the same amount that they used before they went into jail," he said, calling statistics around thenumber of people who overdose within 48 hours of release "astounding." He said anywhere from one-quarter to one-third of opioiddeaths in Canada can be attributed to suchmen.

N.L. 'ahead of the curve'

For Smith, there is a small silver lining to these discouraging statistics:in Newfoundland and Labrador, the provincial government has focused a lot of effort on fatal overdose prevention.The province announced in 2016 it was distributing Naloxone kits containing a lifesaving antidote tooverdoses to prisons and organizations dealing with mental health and addictions.

"[This] is one instance where they are ahead of the curve. They have done really good work in this area," said Smith.

• Naloxone on Wheels training program launches in St. John's

About 1,200 kits have been distributed so far.

"They actually give Naloxone overdose prevention kits to prisoners upon release, which I think is brilliant," he said.

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