illicit opioid deaths increased most in central nova scotia health zone post-covid, research finds
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a dalhousie university research study that looked at trends in opioid toxicity mortality in nova scotia's four health zones from 2009 to 2023 showed that the central zone had the biggest rise in non-pharmaceutical opioid deaths in the province's post-pandemic period.
david bloom
data from a dalhousie university study shows a rise in non-pharmaceutical opioid deaths in the central zone of nova scotia.
the study, co-authored by cindy feng, an associate professor in dalhousie’s department of community health and epidemiology, and mark asbridge, a professor, looked at trends in opioid toxicity mortality in nova scotia’s four health zones from 2009 to 2023, with the focus on differences between pharmaceutical and non-pharmaceutical (illicit) opioid-related deaths.
feng said the data was from the nova scotia medical examiner’s service.
pharmaceutical opioids are prescribed for pain relief, and deaths often result from misuse, dependence or accidental overdose. illicit opioids are unregulated and include fentanyl and its analogues, which are often mixed with other substances.
the rate of fatal opioid overdoses in the province declined in the early years of the covid-19 pandemic but rose again after 2021 due largely to deaths linked to non-pharmaceutical opioids, according to findings by the researchers.
the numbers showed the central zone had a much greater level of illicit opioid-related deaths compared to the northern, eastern and western zones.
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the central zone, which covers the halifax regional municipality and west hants county, had 29 non-pharmaceutical opioid-related deaths in 2022-23, up 16 from 2019-21. pharmaceutical opioid deaths in the central zone rose from 50 in 2019-21 to 56 in the 2022-23 period.
“the central zone showed that the pharmaceutical toxicity rate was kind of stable during the pandemic, but what is interesting is that the non-pharmaceutical opioid death rate actually increased during and after the pandemic,” said feng. “that shows a growing situation with illicit opioids — for example, fentanyl.”
the northern zone showed a steady decline in pharmaceutical opioid deaths. in the pre-pandemic era (2009-18), the region had 93. that dropped to 12 in 2022-23. there was, however, an increase in illicit opioid deaths, from four in 2019-21 to seven in 2022-23.
the western zone showed consistently low death rates in both categories, while the eastern zone dropped in post-pandemic pharmaceutical deaths (34 to 19).
feng suggested that the regional disparity across zones might be due to several factors.
“for example, the access to illicit drugs and the different health-care services, overdose prevention sites, especially during covid, there was a huge disruption in the health-care access to treatment.”
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feng said the research was a descriptive study and didn’t include details on individual-level data. without individual data, feng said they couldn’t tell if individuals had access to the health-care system.
however, the findings underscored the dynamics of opioid type, geographic variation and pandemic-related disruptions, said feng.
the study concluded it was crucial to continue efforts to reduce opioid misuse through harm reduction and improved prescribing practices.
“the study is the first step of a broader study that we aim to conduct when we have more detailed information,” said feng. “we can give more insight into what is causing the trend in trajectory.”
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