During 2016 and 2017 in Canada, approximately 16 Canadians were sent to hospitals per day due to opioid abuse. The highest rates of opioid abuse-related hospitalizations in Canada were found to be in cities with populations under 225,000, including nine of the top ten Canadian cities. In 2016, the Canadian Institute for Health Information (CIHI) stated that 2,816 people died from an opioid overdose in Canada. Two factors continue to be prominent issues every year: the rising presence of fentanyl and the over-prescription of pharmaceutical opioids. Over the past decade, CIHI found that the rate of hospitalization has risen to 54 percent, although rates can vary widely depending on the province or city. An example of this variance is in Toronto, Ontario, where ten times more people are sent to the hospital for opioid poisoning, compared to the much smaller city of Brantford located 100 km west of Toronto, with a population of 100,000. The rate of hospitalization, however, is much greater in Brantford, with 32 hospitalizations per 100,000 compared to 7.9 per 100,000 in Toronto.
Michael Gaucher of the CIHI noted, “The population may reflect more seniors and more chronic use of opioids, it could just reflect more availability of drugs on the street.” Suzy McDonald, of Health Canada’s Opioid Response Team, stated, “There’s been a huge focus on large cities, and indeed we’re doing more and reaching out more to figure out how we can do a better job of facilitating harm reduction services in smaller cities.”
Knowing which areas in Canada are more affected and/or vulnerable to the opioid epidemic provides insight into practices that can help improve public health policies and initiatives in a way that effectively addresses the pathway to various opioid abuse. It is already apparent through media that the opioid crisis has had a significant impact on large cities in Canada, and that it particularly affects marginalized Canadians. The extent of the crisis in smaller cities, where there are the highest rates of opioid hospitalizations, shows the importance of continuing to develop strategies, such as raising further awareness. Harm reduction programs, as indicated by McDonald, are an important part of effective crisis intervention. The lack of harm reduction programs like Vancouver’s Insite, a safe injection facility, as well as other resources in smaller communities across Canada, is a major obstacle to addressing the crisis.
There is a pressing need to assist communities greatly affected by the opioid crisis with programs that address the reason behind people’s tendency to follow a path that puts them in danger of opioid abuse and overdosing. The implications of the continued crisis include the further loss of life and injury to Canadians and their families. To address the human cost of the opioid crisis, the impact on smaller cities, where the crisis is in some ways much more extensive than in major Canadian cities, is essential. A cohesive and comprehensive plan must be designed to combat the opioid crisis, then implemented and promoted.