Patterns of medication and healthcare use among people who died of an opioid-related toxicity during the COVID-19 pandemic in Ontario

Key findings from this report are available as an infographic here.In Ontario, the COVID-19 pandemic has exacerbated the ongoing opioid overdose crisis, leading to a significant rise in unintentional deaths due to opioid-related toxicity. Specifically, between February 2020 – the month before Ontario declared a State of Emergency due to COVID-19 – and December 2020, there was a 79% increase in the number of opioid-related deaths across the province. There are a multitude of reasons for this rapid acceleration in opioid-related deaths, including the increasing unpredictability of the unregulated drug supply, reduced access to healthcare services, limited access to community based-programs that support people who use drugs, and increased social isolation, which led to more people using drugs alone. Furthermore, the pandemic has had a disproportionate impact on opioid-related death among people experiencing homelessness, with 1 in 6 opioid-related deaths occurring within this population during the first eight months of the pandemic.

There is an urgent need to better understand patterns of healthcare use among people who died of an opioid-related toxicity during the pandemic, particularly amid the pandemic-mandated disruptions to healthcare services and increasing rates of opioid-related death since the onset of the COVID-19 pandemic. This information will help identify policy- and program-related interventions to improve access to healthcare and other supportive services for people who use drugs, with the ultimate goal of reducing the loss of life due to overdoses in Ontario and beyond. To help address this need, this report describes the characteristics of people who died of an accidental opioid-related toxicity in Ontario prior to the pandemic (March to December 2019) and during the first two waves of the pandemic (March to December 2020). We also report patterns of healthcare use prior to death and compare these characteristics and patterns to people who died of an opioid-related toxicity prior to the pandemic. In addition, this report will focus on describing these same characteristics and patterns of healthcare use among people who were experiencing homelessness in order to inform supportive approaches that can be tailored specifically for this population.