Skip to main content
SpringerLink
Log in

Drug-related Overdose Deaths in British Columbia and Ontario, 1992–2004

  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objective

To compare rates of fatal drug-related overdose death (OD) cases–a major harm outcome of illicit substance use–in the two provinces of British Columbia (BC) and Ontario, and the two largest municipalities in those provincial jurisdictions, namely the cities of Vancouver and Toronto, between 1992 and 2004.

Methods

Provincial coroners’ data of drug-related OD cases for the provincial jurisdictions of BC and Ontario, and the municipal jurisdictions of Vancouver and Toronto, are descriptively presented and compared.

Results

After drastic increases in the initial part of the observation period, OD rates in BC have been declining; moreover, due to major reductions of OD cases in Vancouver, the ratio of OD cases between Vancouver and the province of BC has fallen considerably. Conversely, OD rates in Ontario have remained stable at low levels, whereas Toronto has seen a slight decline in such rates during the observation period.

Interpretation

The recent establishment and expansion of treatment and harm reduction interventions may have influenced the decline of ODs in BC, yet similar interventions in Ontario did not have a similar effect, perhaps due to different patterns of illicit drug use. OD rates in jurisdictions across Canada need to be monitored and analyzed to inform evidence-based policy development.

Résumé

Objectif

Nous avons voulu comparer les taux de décès par surdose liés aux drogues (l’un des principaux méfaits de la consommation de drogues illicites) en Colombie-Britannique et en l’Ontario et dans les deux plus grandes villes de ces provinces (Vancouver et Toronto) entre 1992 et 2004.

Méthode

Nous décrivons et comparons les données des coroners provinciaux sur les décès par surdose liés aux drogues en C.-B. et en Ontario, ainsi que dans les villes de Vancouver et de Toronto.

Résultats

Après les fortes hausses enregistrées pendant la première partie de la période d’observation, les taux de décès par surdose en C. B. ont baissé; de plus, en raison d’importantes baisses des cas de surdose à Vancouver, la part de Vancouver dans les décès par surdose enregistrés en C. B. a considérablement diminué. Réciproquement, les taux de décès par surdose en Ontario, relativement faibles au départ, sont restés stables, alors qu’ils ont légèrement diminué à Toronto pendant la période d’observation.

Interprétation

L’instauration et le développement récents de mesures de traitement et de réduction des méfaits semblent avoir influé sur la baisse des décès par surdose en C. B., mais on ne voit pas clairement pourquoi ces effets ne se sont pas manifestés à une échelle aussi grande en Ontario, où l’on a pourtant instauré des mesures semblables. Il faudrait surveiller les taux de surdose dans les provinces et territoires du Canada pour pouvoir élaborer des politiques fondées sur des données factuelles.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. English D, Holman C, Milne E, Winter M, Hulse G, Codde G, et al. The quantification of drug caused morbidity in Australia 1995. Canberra, Australia: Commonwealth Department of Human Services and Health, 1995.

    Google Scholar 

  2. Rehm J. Situation sociale des consommateurs de drogues. In: Fahrenkrug H, Müller R, Klingemann H, Linder R (Eds.). Drogues illégales en Suisse 1990–1993. La situation dans les cantons et en Suisse. Zurich, Switzerland: Seismo, 1995;35–54.

    Google Scholar 

  3. O’Driscoll PT, McGough J, Hagan H, Thiede H, Critchlow C, Alexander ER. Predictors of accidental fatal drug overdose among a cohort of injection drug users. Am J Public Health 2001;91(6):984–87.

    Article  Google Scholar 

  4. Gossop M, Stewart D, Treacy S, Marsden J. A prospective study of mortality among drug misusers during a 4-year period after seeking treatment. Addiction 2002;97:39–47.

    Article  Google Scholar 

  5. Fischer B, Rehm J, Blitz-Miller T. Injection drug use and preventive measures: A comparison of Canadian and Western European jurisdiction over time. CMAJ 2000;162:1709–13.

    Google Scholar 

  6. Darke S, Hall W. Heroine overdose: Research and evidence-based intervention. J Urban Health 2003;80(2):189–200.

    Article  Google Scholar 

  7. European Monitoring Centre for Drugs and Drug Addiction. Annual report on the state of the drugs problem in the European Union and Norway. EMCDDA, 2002.

    Google Scholar 

  8. Garfield J, Drucker E. Fatal overdose trends in major US cities: 1990–1997. Addiction Res Theory 2001;9:425–36.

    Article  Google Scholar 

  9. Strang J, Griffiths P, Powis B, Gossop M. Heroin chasers and heroin injectors: Differences observed in a community sample in London, UK. Am J Addict 1999;8:148–60.

    Article  CAS  Google Scholar 

  10. Hembree C, Galea S, Ahern J, Tracy M, Piper TM, Miller J, et al. The urban built environment and overdose mortality in New York City neighborhoods. Health Place 2005;11(2):147–56.

    Article  CAS  Google Scholar 

  11. Coffin P, Galea S, Ahern J, Leon A, Vlahov D, Tardiff K. Opiates, cocaine and alcohol combinations in accidental drug overdose deaths in New York City, 1990–98. Addiction 2003;98:739–47.

    Article  Google Scholar 

  12. Fischer B, Brissette S, Brochu S, Bruneau J, el-Guebaly N, Noel L, et al. Prevalence and determinants of overdose incidents among illicit opioid users in five cities across Canada. CMAJ 2004;171:235–39.

    Article  Google Scholar 

  13. Ghodse M, Sheehan M, Taylor C, Edwards G. Death of drug addicts in the United Kingdom. Br Med J 1985;290:425–28.

    Article  CAS  Google Scholar 

  14. Ward J, Hall W, Mattick RP. Role of maintenance treatment in opioid dependence. Lancet 1999;353(9148):221–26.

    Article  CAS  Google Scholar 

  15. F/P/T Advisory Committee on Population Health. Reducing the Harm Associated with Injection Drug Use in Canada. Health Canada, 2001.

    Google Scholar 

  16. Cain V. Report of the Task Force into Illicit Narcotic Overdose Deaths in British Columbia. Burnaby, BC: Office of the Chief Coroner, Province of British Columbia, 1994.

    Google Scholar 

  17. Buxton J. Vancouver Drug Use Epidemiology. Report. Vancouver, BC: Canadian Community Epidemiology Network on Drug Use, 2003.

    Google Scholar 

  18. Fischer B, Rehm J, Brissette S, Brochu S, Bruneau J, el-Guebaly N, et al. Illicit opioid users in Canada: Comparing social, health and drug use characteristics of untreated users in five cities (OPICAN study). J Urban Health 2005;82(2):250–66.

    Article  Google Scholar 

  19. Haydon E, Fischer B. Crack use as a public health problem in Canada: Call for an evaluation of “safer crack use kits.” Can J Public Health 2005;96(3):185–88.

    PubMed  Google Scholar 

  20. Substance Use in Toronto: Issues, Impacts and Interventions. An environmental scan prepared for the Toronto Drug Strategy Initiative. Toronto, ON: City of Toronto, 2005.

    Google Scholar 

  21. Preventing Harm from Psychoactive Substance Use. Report. Vancouver: City of Vancouver, 2005.

  22. Single E, Robson L, Xie X, Rehm J. The cost of substance abuse in Canada. Ottawa: Canadian Centre on Substance Abuse, 1996.

    Google Scholar 

  23. Popova S, Rehm J, Fischer B. An overview of illegal opioid use and health services utilization in Canada. Public Health 2006;120:320–28.

    Article  CAS  Google Scholar 

  24. Anderson J, Warren L. Client retention in the British Columbia methadone program, 1996–1999. Can J Public Health 2004;95(2):104–109.

    PubMed  Google Scholar 

  25. MacPherson D. A Framework for Action: A four-pillar approach to drug problems in Vancouver. City of Vancouver, 2001.

    Google Scholar 

  26. Fischer B. Prescriptions, power and politics: The turbulent history of methadone maintenance treatment in Canada. J Public Health Policy 2000;21(2):187–210.

    Article  CAS  Google Scholar 

  27. Brands B, Blake J, Marsh D. Changing patient characteristics with increased methadone maintenance availability. Drug Alcohol Depend 2002;66(1):11–20.

    Article  Google Scholar 

  28. Strike CJ, Urbanoski K, Fischer B, March DC, Margaret M. Policy changes and the methadone maintenance treatment system for opioid dependence in Ontario, 1996 to 2001. J Addict Dis 2005;24(1):39–51.

    Article  Google Scholar 

  29. Sibbald B. Tighten Ontario’s methadone program states inquest. CMAJ 2005;172(3):319–320.

    Article  Google Scholar 

  30. Wood E, Kerr T, Montaner JS, Strathdee SA, Wodak A. Rationale for evaluating North America’s first medically supervised safer-injecting facility. Lancet Infect Dis 2004;4(5):301–306.

    Article  Google Scholar 

  31. Schechter MT. NAOMI-her time has come. North American Opiate Medication Initiative. J Urban Health 2002;79(2):164–165.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centre for Addiction and Mental Health, 33 Russell Street, Room 2035, Toronto, ON, M5S 2S1, Canada

    Benedikt Fischer PhD, Svetlana Popova MD, Jürgen Rehm PhD & Andrew Ivsins BA

  2. Department of Public Health Sciences, University of Toronto, Canada

    Benedikt Fischer PhD & Jürgen Rehm PhD

  3. Centre for Criminology, University of Toronto, Canada

    Benedikt Fischer PhD

  4. Faculty of Social Work, University of Toronto, Canada

    Svetlana Popova MD

  5. Addiction Research Institute, Zurich, Switzerland

    Jürgen Rehm PhD

Authors
  1. Benedikt Fischer PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Svetlana Popova MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jürgen Rehm PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrew Ivsins BA
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benedikt Fischer PhD.

Additional information

Source of funding: The authors acknowledge research funding support from the Canadian Institutes of Health Research (CIHR) and the Canadian Centre on Substance Abuse (CCSA).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fischer, B., Popova, S., Rehm, J. et al. Drug-related Overdose Deaths in British Columbia and Ontario, 1992–2004. Can J Public Health 97, 384–387 (2006). https://doi.org/10.1007/BF03405347

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03405347

MeSH terms

Search

Navigation