Overdose deaths from prescription opiates such as oxycodone and morphine have “risen sharply” in Canada, and now account for approximately half of all drug-related deaths in this country, according to the latest report from the Canadian Drug Policy Coalition.

The increase in overdoses is a direct result of an explosion in prescriptions for opiates such as Oxycodone and morphine, the report says.

In Ontario, for example, Oxycodone prescriptions increased by 850 per cent between 1991 and 2007. Between 300 and 400 people die each year in the province from an overdose of a prescription opioid, the report says.

Currently, a true picture of overdose rates in Canada is impossible to glean due to a lack of comprehensive national data.

According to the report, the available data suggests that “rates of overdose are unacceptably high in Canada, especially since overdose can be prevented.”

Overdoses can occur even when opioids are used as prescribed, it adds.

The report’s release coincides with a review by researchers at McGill University in Montreal, who found that the number of deaths involving prescription painkillers is higher than the number of deaths from heroin and cocaine overdoses combined.

The McGill team reviewed existing research, and found that the spike in opioid-related deaths cannot be attributed to one single cause. In fact, there are at least 17 different contributing factors, they say, in particular the increase in prescriptions and sales of opioids, the increased use of strong, long-lasting drugs such as OxyContin and methadone, and the mixing of opioids with other drugs or alcohol.

The team found “little evidence” that online drug sales, or errors by patients or doctors, are significant contributors to the spike in opioid deaths.

Researchers must develop strategies to bring down overdose death rates, not just in North America, the study notes, but for future use as prescription medications become more prevalent in developing countries.

Current drug policies ‘failing’

Between 500,000 and 1.25 million people are estimated to use prescription opioids non-medically, the Canadian Drug Policy report says. In fact, non-medical use of prescribed opiates is the fourth-most prevalent form of substance use in Canada behind alcohol, tobacco, and cannabis.

The report makes a number of recommendations, including the need to collect better drug-use data and improve prescription guidelines and practices. It also calls for prescribers, patients and family members to be better educated about the appropriate use of prescription opiates.

The report goes beyond the prescription-related recommendations, calling for a broader overhaul of current federal drug policies to move away from penalizing drug users and turning focus to support and harm reduction.

Current federal drug policies are “failing” to promote health and safety amongst those who use drugs, the report says. Drugs users have to rely on a “patchwork” of provincial programs and services that are in place to help them.

“These policies, while valiant attempts to integrate and streamline services, do not always translate into meaningful changes on the front lines,” the report says.

Many people end up facing long wait times for services, in part because the provinces focus on outmoded ideas for drug use prevention, and let concerns about cost influence decision-making.

A lack of services particularly affects rural areas, women, First Nations, Metis, and Inuit populations.

Broader recommendations relate to three key areas: drug law reform, discrimination, and services and support. The report calls for:

  • The modernization of Canada’s legislative, policy and regulatory frameworks that address psychoactive substances. This includes reforming the national drug strategy to focus on health and human rights.
  • The implementation of evidence-based approaches to eliminate stigma and discrimination against people who use drugs, as well as social and health inequalities, such as access to care, that affect them.
  • An increase in comprehensive health and social services, from treatment to housing, as well as harm-reduction strategies.

Canada is “at a crossroads when it comes to drug laws and policies,” the report says. “A new direction in drug policy is required.”

Canadian Drug Policy Coalition report