Mandatory treatment? Decriminalization? As opioid epidemic rages, Canadians seek extreme measures to save lives

by David Korzinski | February 14, 2019 7:30 pm

Percentage saying opioid issue is serious or a crisis in their community has risen over past year


February 15, 2019 – With the number of opioid related deaths in this country expected to surpass 4,000 in 2018, Canadians continue to search for answers – and consider more extreme measures – to address what half call a serious problem (46%) and one-quarter (24%) view as a crisis.

The latest public opinion survey from the Angus Reid Institute finds more than eight-in-ten Canadians (85%) say they would support mandatory treatment for anyone dealing with an opioid addiction. Further, half (48%) are willing to explore the decriminalization of all drugs in Canada. Public health officials in Vancouver and Toronto[1] have recently proposed such a change in order to reduce fentanyl related overdose deaths.

But three years into a state of emergency in British Columbia, and despite $230 million in new funding to fight the opioid epidemic from the federal government, many say neither Ottawa (45%), nor their own provinces (43%) have done enough, and continue to call for more resources allocated to the epidemic.

Meantime, the prevalence of this issue continues to grow, hitting closer to home for many Canadians. The percentage who now say this is a serious problem or crisis within their own communities has risen eight points in the 14 months since the Angus Reid Institute last asked – from one-third (33%) to 41 per cent.

 

More Key Findings:

 

INDEX: 

 

Awareness, community impact rising

Opioid related deaths continue to rise in Canada, reaching record levels in Alberta[2] and British Columbia[3] and affecting huge portions of the country, both in cities and rural[4] areas. While public health officials at all levels of government try to curtail the epidemic, they do so under pressure from a Canadian public more aware of and exposed to the situation than before.

This issue scores a 73 on the Angus Reid Institute engagement index in 2019, up from 62 in early 2018.

An “average” topic would score a 50 on the index, suggesting Canadians are paying considerably higher attention to this issue than most others asked about by the Institute in 2018, and on par with awareness of marijuana legalization, which scored highest for that year.

How this story compares to other polling topics can be seen in the graphic that follows. For greater detail on the construction of the ARI Engagement Index, see notes on methodology at the end of this report.

Against this backdrop, nearly half of Canadians (46%) say this issue has become a serious problem for Canada, while one-quarter (24%) say it is a crisis. Notably, the level to which Canadians believe the problem to be serious does not change significantly based on age, gender or political preference (see comprehensive tables for more information[5]).

While the number of Canadians saying this is a crisis at the national level is statistically unchanged from November 2017, up two points to 70 per cent. However, the number who say it is a problem for their own community has increased significantly, up eight percentage points to 41 per cent:

There has been an increase in the number of residents expressing concern at the community level in every province, and most intensely in Manitoba and Alberta. The rate overall in terms of opioid deaths fell in the first six months of 2018 within Manitoba, though reports suggested it was affecting rural areas at a much higher rate[6] than larger cities.

An Alberta Health report[7] comparing the past two years found that 582 people died from fentanyl overdoses between Jan. 1 and Nov. 11, 2018, significantly higher than the 463 Albertans who did in 2017.

British Columbia has been and continues to be the epicentre of the opioid epidemic. Despite ongoing prevention efforts[8] from the provincial government, the number of illicit overdose deaths rose in 2018[9], approach 1,500, with investigations continuing. Concern is highest within that province, with 52 per cent of residents saying their community faces a serious problem or crisis.

Millions touched by opioid use

Opioid-related deaths are occurring in nearly every province and territory [10]as a result of overdoses involving prescription painkillers or illegal drugs laced with fentanyl.

Final data for 2018 has yet to be released, but as of the midpoint of last year, the total number of deaths since 2016 had surpassed 9,000[11]. In addition to deaths, an estimated 17 Canadians per day[12] were hospitalized for non-lethal opioid poisoning.

Roughly one-quarter of Canadians (24%) report having been prescribed opiates by a doctor in the last five years. However, the impact of the opioid crisis is underscored when looking at the number of people who report a personal connection to someone who has been affected. Four-in-ten Canadians (40%) say they have a friend or close family member who has been prescribed opiates, while close to one-in-five (17%) say that someone within their social circle has dealt with opioid dependence or addiction. This equates to more than six million Canadians with a personal connection to opioid abuse.

Another seven per cent of Canadians say someone in their life has experienced an overdose, with six per cent saying someone has died as a result of opioid use.

The pervasiveness of the issue is evident across the country. Approximately one-in-five residents in each region say they know someone who has dealt with opioid addiction or dependency, with the exception of Quebec, where this drops to 12 per cent.

 

Many Canadians want more from government

Provincial and federal governments have reacted to the opioid epidemic in a number of different ways. In British Columbia the province declared a state of emergency in 2016. Since then the province has increased[13] non-opiate alternatives for doctors to prescribe, support for first responders, and the number of supervised consumption sites.

The 2018 federal budget allocated $230 million to the address this issue over five years, but thousands of Canadians continue to die.

Against this backdrop, a plurality of Canadians continue to say their provincial (43%) and federal (45%) governments have not provided enough resources in response to the problem. The percentage of Canadians who want more from the federal government increased 7 points between November 2017 and now:

Notably, alongside an increasing recognition of the problem across Canada, the desire for more action from provincial governments has risen. In every region other than British Columbia, more residents now say their government should increase resources to address the opioid issue.

B.C. residents, by contrast, are most likely to say their provincial government has responded adequately (35%):

Compulsory treatment

As the opioid epidemic has grown, a number of solutions have been put forth by public health officials and organizations[14]. Some of these proposals are more controversial than others, and the efficacy of each continues to be evaluated by policy makers and medical professionals. Of the three options proposed to Canadians in this study, compulsory treatment for addiction is the most popular. More than eight-in-ten (85%) support this type of action.

*political sphere methodology at end of this report

Despite this strong support for mandatory treatment, there is an absence of evidence as to its effectiveness. A recent study reviewing compulsory programs[15] in a number of countries found little evidence of improved outcomes for individuals who are involved.

 

Supervised injection

Another option, and one that has been increasingly available in Canada in recent years is the creation of supervised-injection sites – often referred to as safe-consumption or safe-injection sites. More than two dozen sites[16] have been approved since the start of 2018 across the country. Evidence from Vancouver[17] and Montreal[18] has pointed to a sharp reduction in overdoses in the surrounding areas.

Canadian are largely supportive of supervised-injection sites, with two-thirds (66%) saying they are in favour of this type of policy response to overdose deaths. Regionally, Alberta and Saskatchewan residents are divided on this proposal, while the rest of the country leans in favour of it:

Support across age demographics remains relatively high, at least six-in-ten among each group, however, a political split emerges. Conservatives are far more likely to oppose this option, while those in the Liberal and New Democratic spheres are overwhelmingly in favour:

 

Decriminalizing all drugs

The most controversial of the three options proposed in this study is drug decriminalization. The policy itself has been adopted by Portugal, wherein, drug distribution and sale is still illegal, but possession is treated with smaller penalties and a focus on public health rather than criminal penalties.

Proponents hope that this would help to destigmatize drug use and create an environment where users are able to ask for help without fear of prosecution. Montreal, Vancouver and Toronto have called for decriminalization recently as has the Canadian Public Health Association. Opponents are primarily concerned that decriminalizing will lead to increased use, particularly among those who may have been dissuaded by criminal penalties.

About half of the Canadian population appears in favour of decriminalization. This on the heels of marijuana legalization last October. One-in-five (21%) strongly favour such a policy, while one-quarter support it more tepidly (27%). Notably, one-third of Canadians are firmly against this idea (32%), by far the highest proportion for the three options presented:

Certain pockets of the Canadian public are more likely to support decriminalization. Six-in-ten of those between the ages of 18 and 34 (59%) are in favour, while older generations lean toward opposition. Those in the Conservative political sphere are also substantially more opposed than other political persuasions:

Residents in the epicentre of the opioid epidemic, British Columbia, are most open to decriminalization. More than half of B.C. residents are in favour (56%), while this support drops below a majority is most other regions:

 

Notes on Methodology

Engagement Index

Since early 2015, the Angus Reid Institute has been asking Canadians a standardized question about how closely they are following the topics of ARI polls. To facilitate easy comparisons across disparate topics, ARI researchers have developed an Engagement Index based on respondents’ answers.

For each issue, respondents are asked to say whether they are “following it in the news and discussing it with friends and family,” “seeing some media coverage and having the odd conversation,” “just scanning the headlines,” or not seeing or hearing anything about the issue.

The index is based on the average response to this question over the years, with greater weight given to the highest level of engagement on the scale, and lesser weight given to the “having the odd conversation” and “just scanning headlines” responses. An “average” issue scores a 50 on the index, with scores higher than 50 representing above-average engagement and scores lower than 50 representing below-average engagement.

On this particular topic of Canada-China relations, roughly three-in-ten (28%) say they are “following it in the news and discussing it with friends and family.” Another 43 per cent are “seeing some media coverage and having the odd conversation.” One-in-four (24%) are “just scanning the headlines,” and just 6 per cent haven’t seen or heard anything about this story. Responses on this topic equate to a score of 60 on the ARI Engagement Index, which is the highest score recorded so far in 2019, as well as the highest recorded since ARI’s poll on marijuana legalization[19] released in September, which scored a 72 and tied for the fifth-highest score of all time.

Political Sphere

Rather than rely on respondents’ potentially faded memories regarding their vote in the 2015 federal election, ARI researchers constructed a measure of political partisanship based on willingness to vote for the main federal parties in a future election under their current leaders.

The question specifically asked respondents how likely they would be to vote for “The Liberal Party led by Justin Trudeau,” “The Conservative Party led by Andrew Scheer,” and “The New Democratic Party led by Jagmeet Singh” in a future election. The response options were “definitely support” the party and leader in question, “certainly consider” them, “maybe consider” them, and “definitely not even consider” them.

Respondents choosing either of the first two options (definitely support or certainly consider) are considered to be a party’s “sphere.” They represent potential supporters of that party, not necessarily decided voters.

It should be noted that the categories are not mutually exclusive. Respondents were asked to give an opinion on each of the main parties and had the option to say they would “certainly consider” each one.

Thus, many respondents may appear in the spheres of multiple parties.

 

The Angus Reid Institute (ARI) was founded in October 2014 by pollster and sociologist, Dr. Angus Reid. ARI is a national, not-for-profit, non-partisan public opinion research foundation established to advance education by commissioning, conducting and disseminating to the public accessible and impartial statistical data, research and policy analysis on economics, political science, philanthropy, public administration, domestic and international affairs and other socio-economic issues of importance to Canada and its world.

 

For detailed results by age, gender, region, education, and other demographics, click here.[20]

For detailed results by political sphere, click here.[21]

Click here for the full report including tables and methodology[22]

Click here for the questionnaire used in this survey[23]

Image credit: THE CANADIAN PRESS/Darryl Dyck

 

MEDIA CONTACTS:

Shachi Kurl, Executive Director, Angus Reid Institute: 604.908.1693 shachi.kurl@angusreid.org[24] @shachikurl

Dave Korzinski, Research Associate: 250.899.0821 dave.korzinski@angusreid.org[25]

 

Endnotes:
  1. Vancouver and Toronto: https://www.straight.com/news/1100301/toronto-joins-vancouver-recommending-canada-decriminalization-all-drugs
  2. Alberta: https://www.theglobeandmail.com/canada/article-alberta-opioid-overdose-fatalities-hit-record-levels-last-year-data/
  3. British Columbia: https://globalnews.ca/news/4935365/bc-overdose-numbers-2018/
  4. both in cities and rural: https://www.cbc.ca/news/canada/manitoba/opioid-poisoning-hospitalization-rates-rural-manitoba-1.4942762
  5. see comprehensive tables for more information: http://angusreid.org/wp-content/uploads/2019/02/2019.02.07-Opioids-ReleaseTables.pdf
  6. affecting rural areas at a much higher rate: https://www.cbc.ca/news/canada/manitoba/opioid-poisoning-hospitalization-rates-rural-manitoba-1.4942762
  7. Alberta Health report: https://www.theglobeandmail.com/canada/article-alberta-opioid-overdose-fatalities-hit-record-levels-last-year-data/
  8. ongoing prevention efforts: https://globalnews.ca/news/3777390/bc-ndp-opioid-spending-law-enforcement/
  9. deaths rose in 2018: https://www.cbc.ca/news/canada/british-columbia/overdose-crisis-continues-in-b-c-with-120-deaths-last-month-coroner-says-1.4960065
  10. every province and territory : https://www.canada.ca/en/health-canada/services/substance-use/problematic-prescription-drug-use/opioids/data-surveillance-research/harms-deaths.html
  11. had surpassed 9,000: https://globalnews.ca/news/4754876/opioid-overdose-canada-deaths-2018/
  12. 17 Canadians per day: https://globalnews.ca/news/4754876/opioid-overdose-canada-deaths-2018/
  13. has increased: https://www2.gov.bc.ca/gov/content/overdose/how-the-province-is-responding
  14. public health officials and organizations: https://www.cma.ca/opioids
  15. reviewing compulsory programs: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752879/
  16. More than two dozen sites: https://www.canada.ca/en/health-canada/services/substance-use/supervised-consumption-sites/status-application.html
  17. Vancouver: https://www.npr.org/sections/health-shots/2018/09/07/645609248/whats-the-evidence-that-supervised-drug-injection-sites-save-lives
  18. Montreal: https://montrealgazette.com/news/local-news/they-save-lives-montreals-safe-injection-sites-report-on-year-one
  19. ARI’s poll on marijuana legalization: http://angusreid.org/cannabis-legalization-october-2018/
  20. click here.: http://angusreid.org/wp-content/uploads/2019/02/2019.02.07-Opioids-ReleaseTables.pdf
  21. click here.: http://angusreid.org/wp-content/uploads/2019/02/2019.02.07-Opioids-ReleaseTables-PoliticalSphere.pdf
  22. Click here for the full report including tables and methodology: http://angusreid.org/wp-content/uploads/2019/02/2019.02.06-opioid-release.pdf
  23. Click here for the questionnaire used in this survey: http://angusreid.org/wp-content/uploads/2019/02/2019.01.30-opioid-questionnaire.pdf
  24. shachi.kurl@angusreid.org: mailto:shachi.kurl@angusreid.org
  25. dave.korzinski@angusreid.org: mailto:dave.korzinski@angusreid.org

Source URL: http://angusreid.org/opioid-crisis-2019/