Limiting prescription opioids does little to curb overdose deaths, study finds

VANCOUVER (NEWS 1130) – Our current approach to the overdose crisis isn’t working, says a public health expert at UBC.

Dr. Alexis Crabtree has examined nearly 2,000 drug-related deaths as part of a study that’s now published in the Canadian Medical Association Journal, concluding despite a drop in the number of medically-prescribed opiates, the death toll in B.C. continues to rise.

“A total of 2872 deaths from illicit drug overdose occurred in BC in 2015–2017,” the study reads. “Of these, 1789 (62.3%) were closed cases with toxicology results available.”

Of the deaths examined, Crabtree and her team found 90 per cent of those who succumbed to overdoses hadn’t been prescribed opiates.

“Of cases with opioids found relevant to death, only 2.4% of cases had prescribed-only opioids found relevant in toxicology,” the study reads. A further 6.7 per cent had a combination of prescribed and non-prescribed opioids.

“Our findings highlight that overdose is more than an opioid prescribing problem and requires a multifaceted response beyond prescribing and the medical system.”

Related stories: 

• Dr. Henry told B.C. how to decriminalize drugs without Trudeau. It hasn’t.

• B.C. doubling addiction beds for youth over next three years

• B.C. monthly drug overdose deaths hit record in June

Public health officials, including B.C. Provincial Health Officer Dr. Bonnie Henry, have previously made the case for safe and clean supply of drugs.

Seeing just how much innovation, money, and effort went into the rapid health policy pivots of COVID-19, the authors of the study say it’s evident a little political will power can go a long way.

“COVID-19 has made clear that the government can act in a fast and effective way when it prioritizes a response to a public health emergency, and I would love to see that same effectiveness applied (to the opioid crisis),” Crabtree says.

“Going forward, this won’t be just a response within the medical system and it can’t be just a response within the medical system. And we will need broad public support to make that happen,” Crabtree adds.

Meanwhile, a professor with the UBC School of Population and Public Health says doctors have been slow to prescribe clean opiates under a new provincial direction given during the COVID-19 pandemic.

Mark Tyndall says overdose deaths in B.C. “are largely due to potent synthetic opioids.

“The public health response to a poisoning epidemic must be to provide a safer alternative, which must include providing a safe supply of pharmaceutical drugs, as well as decriminalization of drug use and a redeployment of resources from enforcement to social and health services,” he writes in the Canadian Medical Association Journal.

Tyndall notes Crabtree and her team highlight the importance of addressing the opioid crisis.

“I would argue that the only pragmatic and ethical way forward is to offer a regulated, safer supply of opioids, decriminalize drug use, and redeploy resources that are used for drug law enforcement into health and social programs,” Tyndall says.

He adds the emergence of fentanyl in the drug supply across North America “reveals the devastating consequences of efforts to interrupt and suppress illicit drugs.”

More than 6,000 drug-related deaths have been recorded in B.C. since 2014, according to the research team. The opioid crisis was declared a public health emergency in April 2016.