An average of 13 Canadians are treated daily in hospitals for opioid overdoses, says the first national report in Canada to examine the country's growing epidemic around synthetic narcotics such as fentanyl.
The sobering data, drawn from a single year, 2014-15, was released in a joint report Wednesday by the Canadian Institute for Health Information and the Canadian Centre on Substance Abuse.
The report is the first to gauge the scope of the crisis, and the first to measure its impact on the health care system, documenting emergency room visits as well as hospital admissions from 2007 to 2015 for a wide range of prescription use and illegal drug use around the category of opioids.
"For the first time we have national figures that speak to the harms associated with opioid poisoning," said Rho Martin, the deputy CEO at the substance abuse association.
"These figures are alarming (but) they are also likely an underestimate," Martin said in a statement that accompanied the report's release online. "Overdoses that did not receive treatment in a hospital or emergency setting are not represented,"
Overdose hospitalization rates varied by province, from a high of 21 per 100,000 people in Saskatchewan to a low of 10 per 100,000 in Quebec. Manitoba saw a rate of 10.8 per cent per 100,000.
"You see the higher trends in British Columbia, Alberta and Saskatchewan and then in Manitoba, Ontario and Quebec they seem to drop off," CIHI director Michael Gaucher said in a phone interview.
"It's hard to know exactly what's happening but ... we think first it could be prescribing practices, it could be fewer higher dose opioids. We don't really know what's happening on the street," Gaucher said.
In Winnipeg, paramedics say calls to house parties for overdoses are shocking even for veterans with years on the job.
"From a front-line paramedic side, the calls with fentanyl and carfentanil, you don't know who your patients are. You have to assess everyone," said Ryan Woiden, local 911 union president. "You walk into a house party and everyone has sunken eyes. They're all very pale, they're all nodding off, walking slowly, talking slowly and you don't know how many patients there are."
"Before, when I started, or even a year ago, you'd walk into a house party and there'd be boozing, loud music, someone getting sick in a corner and you'd know who your patient was," Woiden said.
Woiden said he's taken calls to suburban house parties, including ones with young adults headed out for at night of clubbing. They start off with drugs like fentanyl or carfentanil, to get a buzz on, not realizing the dangers and in many cases, not knowing what the drugs are.
The stronger the buzz, the more deadly it is, Woiden warned.
"This is no party drug. This drug will kill you. This drug is going to depress your breathing until you stop breathing," Woiden said.
Opioid poisoning is an umbrella phrase used in the study to describe overdoses from prescription drug use and illegal street drugs for a wide range of narcotics including fentanyl, oxycodone, morphine, codeine, hydromorphone, methadone and heroin.
The rate of hospitalizations due to opioid poisoning jumped 30 per cent over the eight-year period. By 2015, opioids accounted for seven emergency visits a day in Ontario and another three in Alberta.
In those two provinces alone, the rate of ER visits between 2010 and 2015 soared 53 per cent in Alberta and 22 per cent in Ontario.
The study comes as alarm grows over carfentanil, a synthetic opioid designed for large animals that's 100 times stronger that the highly addictive fentanyl.
Fentanyl and carfentanil are the subjects of a national summit called by federal Health Minister Jane Philpott later this week in Ottawa.
"From what I've learned, each grain of carfentanil is the size of a grain of salt and it only takes three grains to kill you, just absorbed through the skin," said Roxanne Shuttleworth, an indigenous fashion designer in Winnipeg whose daughter, 31, landed in the ER a week ago after an accidental overdose of carfentanil.
She said her daughter was on the brink of death, and paramedics were able to revive her. It was touch and go for days.
Shuttleworth said her daughter told her that she and a friend took a drug together but they didn't know it was carfentanil. He tested it first, tasting it on the end of his finger and she did the same. Almost instantly he slumped and turned blue. Shuttleworth said her daughter managed to dial 911 before she also collapsed.
Shuttleworth said daughter is now recovering but her daughter's friend died.
Shuttleworth said her daughter only survived because doctors delivered doses of naxolone, the fentanyl antidote, every two hours for two days.
"That's what we're talking about. This is a killer drug," Shuttleworth said.
The report found young people aged 15 to 24 were hospitalized in ever greater numbers year over year, the highest rates among all ages. Over the course of the study, hospital rates in that age group rose 62 per cent. And over half, 52 per cent, overdosed as a result of street use, a category the study referred to as "intentional self-inflicted harm."
The report found seniors aged 65 and older, accounted for nearly a quarter of the hospitalizations, reflecting prescription habits.
"Canadians may be surprised to learn that seniors accounted for the highest rate of hospitalizations over the last eight years," said Brent Diverty, a senior executive with the Canadian Institute for Health Information.
"Although there are many reasons for (this), the report shows that Canada's seniors are particularly vulnerable," Diverty said.