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A team of researchers with Health Sciences North Research Institute is looking into why northeastern Ontario has some of the highest rates of opioid-related death in the province.

Dr. Kristen Morin, a professor at NOSM University in Sudbury, studied more than 130,000 people from across the province over an eight-year period to understand who stays on treatment for opioid addiction.

• READ: Only 4 per cent of opioid overdose patients were prescribed drugs to manage addiction in week after hospital visit: Ontario study

“Opioid agonist treatment (OAT) is the most effective treatment for opioid use disorder,” the hospital’s research arm said in a social media post Friday morning.

“But in the north, many people -- especially young women living in rural areas or facing homelessness -- struggle to stay in treatment.”

• READ: Ontario eyes involuntary addiction treatment for people in jail, on parole, probation

The goal of the research is to highlight the unique regional challenges contributing to the drug crisis and help identify ways to improve care and support.

“Actually, women have been excluded from studies,” Morin said.

“So, some of the medical treatment isn’t necessarily targeted towards vulnerable people and … so that may be playing a role.”

The cohort study, which Morin conducted along with three of her NOSM colleagues, set up data that can be used in further research and helps identify the issues for specific populations.

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“We’re just sort of tracking people over time to really understand like who’s … accessing treatment and who has opioid use disorder …. where do people live and those kinds of things,” Morin said in a Zoom interview Friday afternoon.

“We also found that, of course, people who are unhoused also have worse outcomes.”

Disproportionately affected

“Between 2016 and 2023, Canada faced a severe public health crisis with over 40,000 deaths attributable to the toxic drug supply,” Morin’s cohort profile said.

“Ontario alone accounted for approximately 25 per cent of these fatalities, with 10,900 deaths reported during this period. Northern Ontario, despite representing less than 10 per cent of the population, experienced about 15 per cent of these deaths, totalling 1,411 fatalities.”

The research scientist said the study’s data confirmed rates of opioid use disorder are going up along with related outcomes such as emergency room visits, overdoses and overdose deaths.

Recent data released by public health shows Sudbury’s opioid-related deaths are nearly quadruple the provincial average and slightly higher than the northern Ontario average.

Opioid-related death rates:

• Ontario average - 15.9 deaths per 100,000 people/year
• Northern Ontario average - 56 deaths per 100,000 people/year
• Sudbury average - 61.1 deaths per 100,000 people/year

Methadone vs. Suboxone

The results of the study found differences in the preferred medicinal treatment of addiction between the northern and southern parts of the province.

More than half of the participants from southern Ontario started on methadone while patients in northern Ontario, 62.7 per cent, favoured buprenorphine/naloxone (Suboxone).

“This medication is really given to people to relieve their withdrawal symptoms,” Morin said.

“When people are using opioids and they’re physically dependent on opioids, once they stop using the drug, they’re incredibly sick. They have, like, physical symptoms. It can be a really … dangerous situation when they’re withdrawing from the drug.”

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With the widespread use of increasingly potent drugs like fentanyl, withdrawal symptoms come on quickly and intensely, so people feel the need to use it more often.

• READ: FDA approves painkiller designed to eliminate the risks of addiction associated with opioids

Need region-specific strategies

For treatment to be effective, people struggling with addiction need to be able to access the medication every day at the beginning of the day until they are stabilized.

It also must be overseen by a pharmacist, physician or nurse practitioner, which may make it harder for people who live in rural and remote communities.

“The findings highlight regional disparities in OAT delivery and emphasize the need for region-specific strategies, particularly in rural areas, to improve retention and reduce mortality,” the study concludes.

Morin said just like any other chronic disease, such as diabetes, staying on medication for as long as possible will help stabilize the person’s health.

Medication is just one part of the collaborative effort required across the whole system of care, which she said includes health care, criminal justice and social services.

“The key is really to like use this to you know better inform a more holistic approach to addressing the opioid crisis,” Morin said.

Once the physical need for the drug is no longer there, patients can start to focus on other things in their lives like taking care of themselves, going back to work and connecting with family.

Next steps

Some of the next factors the research team is hoping to use the data to explore are why unhoused people are having a harder time with the opioid agonist treatment than those who are housed and some of the gender differences in access.