Opioid deaths skyrocket, mental health suffers due to pandemic restrictions, new federal report says

The COVID-19 pandemichas wreaked havoc on Canadians suffering from mental illness,opioid addictionand othersubstance abuse problems, saysa new study released today by the Public Health Agency of Canada (PHAC) which confirmsanecdotal reports warning that the pandemic'shealth consequences extendwell beyond the novel coronavirusitself.

Efforts to curb the spread of COVID-19through social distancing and shutdowns havekept the Canadian caseload relatively low compared to other jurisdictions globally. But the overall health of the population has deterioratedover the last eight months,with more people turning to drugs, alcohol, tobacco and screentime over physical exercise to cope with the stress.

"This year's annual report describes the heavy toll that the COVID-19 pandemic has had on Canadian society, both directly and indirectly," Chief Public Health OfficerDr. Theresa Tamsaid Wednesday as shereleasedher agency's annual report.

"These findings are more than just uncomfortable facts about our country during this pandemic. They're the lived realities of countless Canadians."

One pandemic, different levels of risk

Confirming what hasbeen well-documentedalready, PHAC found that long-term care (LTC)homes have been the epicentre of COVID-19-related deaths because "pandemic preparedness did not extend into these settings." The report saidLTCfacilities' limited supplies ofpersonal protective equipment, old infrastructure, poor ventilation and chronic understaffing ledto more infections.

People of colour in Canada also have been far more likely to contract the virus, PHAC found. The report saysArab, Black, Middle Eastern, Latin American, South Asian and Southeast Asian Canadiansaccountedfor more than 80 per cent of the cases in Toronto, despite collectively making up slightly more than half ofthe city's population.

While the reasons for this minority/majority split in the caseload numbersare unclear, PHACsuggested thatpre-existing health disparities, the stress of racismand the preponderance of low-wage work in high-risk places could be to blame.

Beyond the COVID-19 pandemic, Canada is still in the grips of an opioid crisis a crisis that is now much worse than it was just a year ago. With travel and border restrictions in place, the local opioid supply has grown more toxic and dangerous, PHAC said.

While Canada made meaningful progress in reducing the rate of overdoses in 2018-19, the number of deaths has increased significantly since the start of this year.

A surge in opioid deaths

In B.C., there were more than 100 "illicit drug toxicity" deaths per month for six consecutive months from March to August 2020, and more than 175 such deaths each month in May, June and July, according to data compiled by PHAC.

B.C.'s highest monthly opioiddeath toll, in June2020, was 181, up from 76 in June2019. First Nations people account for a disproportionate number of these deaths they were nearly six times more likely to die from an overdose than other B.C. residents.

In July, B.C. paramedics responded to a record high number of overdose calls a 75 per cent spike in calls compared to the same month last year. Paramedics in B.C. also responded that monthto an average of 87 overdose calls a day, or 2,706 calls in total.

Last week, the B.C. Coroners Service said 1,202 people have died offatal overdoses so far this year, compared to just983 deaths in all of 2019. The death toll in B.C. in September was more than double the 60 fatalities recorded in the same month last year.

Preliminary data from Ontario also showthat the number of confirmed and probable deaths from opioid-related causes has increased by almost 50 per cent, from 148 deaths in January to 220 deaths in May.

Alberta also experienced a dramatic increase in opioid-related deaths in the three-month period from April to June 2020 302 deaths, up from the previously recorded high of 211 deaths in a three-month period in 2018.

PHAC heard from frontline workers who said that, because of social restrictions, many more people have been using opioids alone, "decreasing the chance of intervention if they overdose and contributing to the increase in overdose-related fatalities."

Physical distancing measures at safe-consumption sites designed to prevent the spread of COVID-19 also resulted in more opioid-related deaths.

At least one supervised consumption site in Ottawa did away with physical distancing measures after several clients overdosed while waiting in line to get in.

We're drinking and smoking more, moving less

Meanwhile, manyCanadians have increased their use of alcohol, cannabis and tobacco during this pandemic.

By early summer, based on surveys by Statistics Canada,close to one in five Canadians (19 per cent) said their consumption of alcohol had increased, cannabis use jumped 8.3 per cent and tobacco smoking rates were up by 3.9 per cent overpre-pandemic levels.

CBC North has documented a surge in alcohol and substance abuse in Canada's northern territories thanks in part to more bootlegging and access to cash through the Canadian emergency reliefbenefit (CERB) and other relief supports.

WATCH: Dr Theresa Tam says pandemic exposed existing inequities in Canadian society

Dr. Theresa Tam says pandemic exposed existing inequities in Canada

4 years ago

Duration 1:11

Canada's Chief Public Health Officer Theresa Tam says some groups in Canada have been disproportionately affected by the COVID-19 pandemic.

The pandemicand its resulting restrictions on social and economic life havehad a lasting impact on mental health.

PHAC found that, due toshelter-in-place restrictions, more women have had to staywith abusive partners and LGBTQ kids have been confined to homes with homophobic and transphobic parents and caregivers.

Child welfare agencies are reporting a drop in abuse or neglectreports but they fear it's because fewercases arebeing reported now thatmore school-age children arestuck at home without access to school or sports.

"This may be the result of fewer detection opportunities, as children are likely to be isolated at home and without community involvement," PHACsaid.

But it's not just the vulnerable and marginalized among us who have seen notable drops in mental wellness.

Canada has gone from one of the happiest countries in the world ninth out of 156 countries according to a 2019 UN report to one that is noticeably less so.

Less happy, more anxious

In 2018, 68 per cent of Canadians age 15 years and older reported excellent or very good self-perceived mental health. This figure dropped to 54 per cent in late March and early April 2020 before going lower still to 48 per cent in early May, according to Statistics Canada data.

Indigenous people, the disabled and low-income Canadians alsohave reported experiencingmore suicidal thoughts since the outbreak, PHAC found.

With strict social distancing measures and limits on social gatheringsin place, many Canadians feel isolated and are worried about the state of their friendships and familial relationships.

Watch:We can't "arrest our way out" opioid crisis: Dr. Tam:

We can't "arrest our way out" opioid crisis: Dr. Tam

4 years ago

Duration 1:06

Chief Public Health Officer Dr. Theresa Tam says Canada needs to have a discussion about decriminalizing the simple possession of drugs as a way to address the opioid crisis.

Seventyper cent of Canadians who responded to a recent Statistics Canada survey said they were concerned about maintaining social ties, while54 per cent of respondents with kids said they were very or extremely concernedabout their children's loneliness or social isolation.

While thousands of Canadians have died from COVID-19 nearly 80 per cent of themin long-term care homes, as of August there were also more deaths in general this year than last.

"Alberta, British Columbia, Ontario and Quebec all showed increased numbers of deaths compared to the same time period over the past five years. Some of these additional deaths are directly related to COVID-19, however contributions from other causes not directly linked to COVID-19cannot be excluded," PHAC concluded.

Hospitals have seen a drop in walk-in patients for other maladies in emergency rooms. Surgeries have been cancelled or postponed due to capacity restraints, and health professionals fear that people may be avoiding necessarymedical carebecause of pandemic-related worries.

With gyms closed in many jurisdictions and recreational sports leagues on pause, some Canadians are less active.Those who weren't particularly active before March 2020 lockdown reported being even less so in the months that followed.

More than 60 per cent of Canadians reported spending more time using the internet and watching TV during the pandemic in early April.

"Limited physical activity as a result of public health measures to physically isolate may also have an impact on mental health. Research has demonstrated that people who were able to engage in physical activity outdoors were more likely to report excellent or very good mental health," PHAC said.