Non-medical opioid use, harms, and interventions in Canada – a 10-year update on an unprecedented substance use-related public health crisis

Abstract

This commentary follows up on previous examinations on the state and evolution of opioid use, related harms, and interventions since the early 2000s in Canada. Since the most recent commentary, there have been distinct yet heterogeneous developments on these fronts. Policy and intervention systems have become notably more active in regards to what is now popularly dubbed ‘the opioid crisis,’ including a widely expanded array of prevention and treatment interventions; however, these have been limited in overall reach and impact. While population-level opioid dispensing and exposure have overall plateaued, or selectively decreased by province, in recent years, key indicators of opioid morbidity, but especially mortality and its related population health burden have continued to substantially increase across Canada. The latter developments have been associated with the devastating impact of recent increases in the availability of potent illicit opioid products following increasingly restricted medical opioid supplies for which direct intervention measures have been largely amiss. Key surveillance indicators are improved yet continue to include major gaps. More than a decade into this unprecedented public health problem, Canada continues to search for a comprehensively effective and integrated strategy combining prevention and treatment measures towards effectively reducing the burden of opioid-related population health harms.

Keywords:

• Opioids
• non-medical use
• public health
• surveillance
• policy
• Canada

Note

Acknowledgements

Dr. Fischer acknowledges research support from the endowed Hugh Green Foundation Chair in Addiction Research, Faculty of Medical and Health Sciences, University of Auckland.

Ethical approval

Not required as this manuscript reports on secondary data only.

Disclosure statement

The authors have no conflicts of interest to declare.

Notes

1 ‘Prescription opioids’ are pharmaceutical-grade opioids dispensed through the medical system which however may be used medically or non-medically.

Additional information

Funding

This work was partly supported by funding from Canadian Institutes of Health Research (CIHR) specifically grants [#SMN-139150 and #SAF-94814]. None of the external funders had any direct involvement in the content of this the present work.