Opioids in Canada: One-in-eight have family or close friends who faced addiction

by David Korzinski | January 10, 2018 7:30 pm

Nearly 20 per cent of Canadians say they themselves have been prescribed opioids in the last five years


January 11, 2018 – The thousands of deaths across Canada as a result of opioid use and addiction has been a dominating public health, public safety, and public policy issue for more than two years.

Beyond the headlines and the grim statistics, a new public opinion poll from the Angus Reid Institute finds this nationwide epidemic striking close to home for a significant number of Canadians. One-in-eight (12%) – the equivalent of nearly 3.5 million Canadian adults – say they have close friends or family members who have become dependent on opioids in the last five years.

The issue opioid dependency rises to the level of a “crisis” in the eyes of more than one-in-four Canadians (26%), and a further four-in-ten (42%) say it is “a serious problem” for Canada today.

But while relatively few are of the opinion government is responding appropriately to the situation, most offer strong majority support for safe-consumption sites for drug users (67% support them) and mandatory treatment programs for those who overdose (85%).

 

More Key Findings:

 

INDEX:

 

Introduction

The opioid epidemic in Canada – as in the United States and elsewhere – begins with the proliferation of prescription opioids[1] such as oxycodone and hydromorphone, among others, in the 1990s and early 2000s. At that time, with notable prodding from drug companies[2], doctors on both sides of the border started to embrace these drugs as a treatment for pain.

Increased opioid use led to increased opioid addiction, and when prescriptions ran out, black markets stepped in.

Today, despite concerns about physicians over-prescribing opioids, data from provincial health authorities continues to show[3] the number of such prescriptions rising. And, at the same time, illicit drugs are increasingly being laced with synthetic opioids such as fentanyl, causing a surge in overdoses among street users as well.

Opioid use is a massive and complex problem in Canada today, and while this survey sheds light on some of the most important elements of this problem, there are many other important areas of inquiry related to opioids in Canada that could be addressed in future research.

 

Part 1: Measuring the problem

Millions have a personal connection

Nearly one-in-five Canadians (19%) report having been prescribed opiates by a doctor in the last five years, and recent research[4] from the Canadian Centre on Substance Use and Addiction suggests that roughly 2 per cent of Canadians who use opioid pain relievers do so for non-medical purposes.

The impact of the opioid crisis becomes even clearer when looking at the number of people who report a personal connection to someone who has been affected. Roughly one-in-eight Canadians (12% – the equivalent of more than 3 million people) say they have a close friend or family member who has been dependent on or addicted to opiates:

These personal connections to opioids and opioid addiction are not limited by age, gender, or social standing. Canadians of all income brackets and education levels are roughly equally like to have been prescribed these drugs, and to have a close friend or family member who has been addicted to them (see comprehensive tables for greater detail[5]).

Notably, B.C. residents – despite the severity of the crisis in that province, which will be discussed later in this report – are no more likely than those who live in other regions to report having been prescribed opiates or become addicted to them, nor are they significantly more likely to say they know someone who has:

Though data suggests that the number of opiate prescriptions doctors are writing has not declined, a substantial number of Canadians seem to be worried about an over-correction.

Indeed, a small majority (56%) agrees with the statement “Because of this opioid problem, it’s now too hard for legitimate pain sufferers to get the drugs they need.” This view is fairly consistent across all age groups except those under age 25, who are divided almost evenly on the statement:

How serious is it in the eyes of Canadians?

Opioid-related deaths are occurring in every province and territory[6] as a result of overdoses involving prescription painkillers and those involving illegal drugs laced with fentanyl.

“No area of Canada is necessarily safe from this crisis,” said Dr. Theresa Tam, Canada’s chief public health officer when announcing the 2016 statistics[7]. “Everybody needs to be prepared.”

Canadians may or may not feel prepared to deal with opioids in their communities, but this poll finds most recognizing the problem as a serious one – at least at the national and provincial level, although less so in their own communities:

The high number of Canadians who regard this situation as either a crisis or a serious problem is at least partially a product of their high degree of awareness of the issue. Fully seven-in-ten Canadians (71%) say they have been seeing either “some” (38%) or “a lot” (33%) of media coverage of the opioid epidemic – a total rate of awareness that ranks among the highest[8] the Angus Reid Institute has recorded for a non-election topic.

This pervading awareness of the opioid problem and belief in its severity is reflected in Canadians’ responses to a pair of statements about the issue: First, that the issue “is going to get worse before it gets better” (77% agree with this statement), and second that it would be receiving even more attention if it were a more traditional public health crisis (71%).

Views on the “more attention” statement are fairly consistent across demographics (see comprehensive tables[9]). The other statement elicits a more varied response:

The fact that younger Canadians seem to be less concerned that the opioid epidemic will worsen mirrors a lower degree of concern they express about the severity of the epidemic in the first place. Canadians under age 35 are more likely than those in older age groups to see opioid use as one problem among many, and less likely to see it as a serious problem or a crisis, as seen in the following graph:

 

The regional picture: Concerns highest in British Columbia

Canada’s opioid epidemic has been most acute in its westernmost province. British Columbia became the first province in Canada to declare a public health emergency[10] after a surge in overdoses – many related to the synthetic opioid fentanyl – between 2013 and early 2016.

Since the declaration in April 2016, the number of overdoses in B.C. has continued to rise. A total of 982 people died of overdoses[11] in the province in 2016, and the 2017 total topped 1,000[12] in just the first eight months of the year.

Opioids have become a problem in every province in recent years, but British Columbia remains the region with the highest rates[13] of opioid-related deaths and hospitalizations per 100,000 people.

Perhaps as a result of their province’s central role in the national discussion on opioids, British Columbians are more likely than residents of other regions to report paying close attention to this issue in the news and discussing it with friends and family. Nearly half (49%) say they have followed the story this closely, compared to 36 per cent or fewer everywhere else:

Relatedly, B.C. residents are more likely to describe opioid use as a “crisis” than those living anywhere else.

To further excavate regional differences in views on this issue, the Angus Reid Institute asked these same three questions of a larger national sample – one that allows for comparisons between specific metro regions.

The urban story closely mirrors the provincial one: Residents of Metro Vancouver tend to be more likely than residents of other large metro areas to see a crisis nationally, provincially, and locally, and residents of Alberta’s two big cities are next-most-concerned about the issue in their province.

Residents of Halifax are notable outliers on the seriousness of opioid use in Canada today. Nearly four-in-ten there see the opioid issue as a national crisis, but only one-in-20 would describe it as a crisis for Nova Scotia or their local municipality:

Perhaps unsurprisingly, concern at the local and provincial level is highest in the metro areas that have the highest rates of hospitalization for opioid poisoning: Vancouver, Edmonton, and Calgary topped the list[14] in terms of the raw number of such hospitalizations between March 2016 and March 2017:

Part 2: Addressing the problem

Are governments doing enough?

Both Canada’s federal and provincial governments have developed strategies for responding to the opioid epidemic. At the federal level, one of the most notable changes has been a loosening of restrictions[15] on supervised consumption sites – facilities in which drug users can consume opiates and other substances with staff on site to monitor for and respond to overdoses.

In addition to this and other changes aimed at reducing the harm that comes from opioid use, the federal government’s strategy has included efforts to improve addiction prevention and treatment, as well as improve enforcement of opioid-related laws. The progress of all of these efforts is detailed on the government’s opioid crisis response website[16].

That said, critics have described[17] the federal response so far as insufficient, and relatively few Canadians see the federal government responding “appropriately” to the issue. Fewer than one-in-four (23%) say this, while nearly four-in-ten (38%) say “too few” federal resources have been allocated to the epidemic. Almost one-in-three (32%) are unsure how to characterize the federal response.

Provincial governments’ responses to this issue have been varied, but Canadians views of them are – in aggregate – similar to their views of federal efforts:

Removing those who are unsure and looking only at responses from those who offer an opinion paints a clearer picture of the decided opinion on this question. Nearly half (49%) of those with an opinion see their province’s efforts coming up short, and a small majority (55%) feel the same way about the federal government’s response, as seen in the following graph:

As might be expected, assessments of provincial government responses vary depending on the province in question. Manitoba is the region most inclined to say its government has put “too few resources” toward the problem (45% do), but the percentage saying “too few resources” outnumbers the percentage saying “too many” across all regions.

It should also be noted that a significant number of respondents in each region are unsure how they would assess their provincial government’s response, as seen in the table that follows.

*small sample size

 

Strong support for safe-injection sites, mandatory treatment

This survey also asked Canadians to weigh in on a pair of responses governments have proposed to the opioid epidemic. Two-thirds (67%) say they are in favour of supervised-injection sites, and an even larger majority (85%) support compulsory treatment programs for people who overdose or are otherwise found to be abusing opioids.

Notably, compulsory treatment programs – which are being considered[18] in several U.S. states – are much more likely than supervised-injection sites to elicit strong support from the Canadian public:

The percentage supporting supervised-injection sites is consistent across age and gender groups, as seen in the graph that follows.

The biggest differences on this question are political: Those who cast ballots in 2015 for the Conservative Party – which imposed significant limitations[19] on the opening of new supervised-injection sites while in government – are divided on the issue, while past supporters of the federal Liberal and New Democratic parties are each in favour of safe-injection sites by a roughly four-to-one margin:

Regionally, B.C. and Quebec have the highest percentage respondents who say they are “strongly in favour” of such measures (34%). That said, overall support is identical to the national average in B.C. (67%), while Quebec is an outlier with nearly eight-in-ten (78%) supporting safe-consumption sites:

For their part, mandatory treatment programs for those who overdose are less controversial with the Canadian public. At least 80 per cent are in favour of this approach across all major demographic groups, with support topping 90 per cent among residents of Saskatchewan and Manitoba and among those who voted for the Liberal party in the 2015 federal election (see comprehensive tables[9]).

Compulsory treatment is already on the books in most provinces for people with mental health issues, but such programs have faced criticism[20] for overuse, and for infringing on patients’ civil liberties.

 

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.

 

Summary tables follow. For detailed results by age, gender, region, education, and other demographics, click here[21].

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

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

 

MEDIA CONTACTS:

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

Ian Holliday, Research Associate: 604.442.3312 ian.holliday@angusreid.org[25]

Endnotes:
  1. proliferation of prescription opioids: https://www.thestar.com/news/canada/2017/04/25/an-epidemic-within-an-epidemic-why-opioid-use-in-canada-keeps-rising.html
  2. prodding from drug companies: https://www.vox.com/policy-and-politics/2017/6/7/15724054/opioid-companies-epidemic-lawsuits
  3. continues to show: https://www.theglobeandmail.com/news/national/prescriptions-for-painkillers-still-rising-in-canada-despite-opioidcrisis/article34431838/
  4. recent research: http://www.ccdus.ca/Resource%20Library/CCSA-Canadian-Drug-Summary-Prescription-Opioids-2017-en.pdf
  5. see comprehensive tables for greater detail: http://angusreid.org/wp-content/uploads/2018/01/2017.11.21_OpioidsReleaseTables.pdf
  6. every province and territory: https://www.canada.ca/en/public-health/services/publications/healthy-living/apparent-opioid-related-deaths-report-2016.html
  7. when announcing the 2016 statistics: https://www.theglobeandmail.com/news/national/opioid-related-overdose-figures-show-grim-reality-of-canadian-epidemic/article36257932/
  8. among the highest: http://angusreid.org/ari-awareness-issues-tracking/
  9. see comprehensive tables: http://angusreid.org/wp-content/uploads/2018/01/2017.11.21_OpioidsReleaseTables.pdf
  10. a public health emergency: https://news.gov.bc.ca/releases/2016HLTH0026-000568
  11. died of overdoses: http://www.huffingtonpost.ca/2017/11/09/opioid-crisis-over-1-100-people-have-overdosed-and-died-in-b-c-in-9-months_a_23272693/
  12. topped 1,000: https://www.theglobeandmail.com/news/british-columbia/number-of-overdose-deaths-in-bc-has-surpassed-2016-total-coroners-service/article36571265/
  13. highest rates: https://www.theglobeandmail.com/news/national/opioid-related-overdose-figures-show-grim-reality-of-canadian-epidemic/article36257932/
  14. topped the list: https://www.theglobeandmail.com/news/national/opioid-related-overdose-figures-show-grim-reality-of-canadian-epidemic/article36257932/
  15. a loosening of restrictions: https://www.theglobeandmail.com/news/british-columbia/streamlined-conditions-for-supervised-injection-sites-become-law/article35055553/
  16. opioid crisis response website: https://www.canada.ca/en/health-canada/services/substance-abuse/prescription-drug-abuse/opioids/federal-actions.html
  17. critics have described: https://www.theglobeandmail.com/news/british-columbia/critics-say-federal-governments-moves-to-curb-canadas-opioid-crisis-are-just-a-start/article37013902/
  18. are being considered: http://www.wmur.com/article/bill-would-allow-opioid-users-to-be-involuntarily-committed/9104496
  19. significant limitations: http://www.cbc.ca/news/canada/british-columbia/supervised-injection-hurdles-1.3733942
  20. have faced criticism: https://www.ctvnews.ca/health/forced-treatment-orders-sparks-growing-controversy-1.2793886
  21. click here: http://angusreid.org/wp-content/uploads/2018/01/2017.11.21_OpioidsReleaseTables.pdf
  22. Click here for the full report including tables and methodology: http://angusreid.org/wp-content/uploads/2018/01/2018.01.11-opioids.pdf
  23. Click here for the questionnaire used in this survey: http://angusreid.org/wp-content/uploads/2018/01/2018.1.10-Opioids.pdf
  24. shachi.kurl@angusreid.org: mailto:shachi.kurl@angusreid.org
  25. ian.holliday@angusreid.org: mailto:ian.holliday@angusreid.org

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