Abstract
Objective
To compare rates of fatal drug-related overdose death (OD) cases–a major harm outcome of illicit substance use–in the two provinces of British Columbia (BC) and Ontario, and the two largest municipalities in those provincial jurisdictions, namely the cities of Vancouver and Toronto, between 1992 and 2004.
Methods
Provincial coroners’ data of drug-related OD cases for the provincial jurisdictions of BC and Ontario, and the municipal jurisdictions of Vancouver and Toronto, are descriptively presented and compared.
Results
After drastic increases in the initial part of the observation period, OD rates in BC have been declining; moreover, due to major reductions of OD cases in Vancouver, the ratio of OD cases between Vancouver and the province of BC has fallen considerably. Conversely, OD rates in Ontario have remained stable at low levels, whereas Toronto has seen a slight decline in such rates during the observation period.
Interpretation
The recent establishment and expansion of treatment and harm reduction interventions may have influenced the decline of ODs in BC, yet similar interventions in Ontario did not have a similar effect, perhaps due to different patterns of illicit drug use. OD rates in jurisdictions across Canada need to be monitored and analyzed to inform evidence-based policy development.
MeSH terms: Street drugs, overdose, mortality, public policy, Canada
Résumé
Objectif
Nous avons voulu comparer les taux de décès par surdose liés aux drogues (l’un des principaux méfaits de la consommation de drogues illicites) en Colombie-Britannique et en l’Ontario et dans les deux plus grandes villes de ces provinces (Vancouver et Toronto) entre 1992 et 2004.
Méthode
Nous décrivons et comparons les données des coroners provinciaux sur les décès par surdose liés aux drogues en C.-B. et en Ontario, ainsi que dans les villes de Vancouver et de Toronto.
Résultats
Après les fortes hausses enregistrées pendant la première partie de la période d’observation, les taux de décès par surdose en C. B. ont baissé; de plus, en raison d’importantes baisses des cas de surdose à Vancouver, la part de Vancouver dans les décès par surdose enregistrés en C. B. a considérablement diminué. Réciproquement, les taux de décès par surdose en Ontario, relativement faibles au départ, sont restés stables, alors qu’ils ont légèrement diminué à Toronto pendant la période d’observation.
Interprétation
L’instauration et le développement récents de mesures de traitement et de réduction des méfaits semblent avoir influé sur la baisse des décès par surdose en C. B., mais on ne voit pas clairement pourquoi ces effets ne se sont pas manifestés à une échelle aussi grande en Ontario, où l’on a pourtant instauré des mesures semblables. Il faudrait surveiller les taux de surdose dans les provinces et territoires du Canada pour pouvoir élaborer des politiques fondées sur des données factuelles.
Footnotes
Source of funding: The authors acknowledge research funding support from the Canadian Institutes of Health Research (CIHR) and the Canadian Centre on Substance Abuse (CCSA).
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