A southwestern Ontario community is dealing with what its public health officials call an "opioid problem" that has left them scrambling to figure out the extent of the issue and what can be done to solve it.
The rate of opioid-linked deaths in the Windsor, Ont., area was more than double the provincial rate in 2015, according to a recently released report from the Windsor-Essex County Health Unit. The county's rate of opioid-related deaths per 100,000 members of the population was 10.7 that year, compared to 5.1 for the province, the report said.
The report shows 43 opioid-related deaths were recorded in the county in 2015, compared to 32 the year earlier. The 2015 figures are the most recent ones available.
"The opioid problem here worries me," said Dr. Wajid Ahmed, associate medical officer of health with the Windsor-Essex County Health Unit. "It's about time that we as a community need to come together to try to do something locally."
The report comes as communities across the country are paying increasing attention to opioid overdoses, particularly those linked to the potentially deadly painkiller fentanyl.
The Windsor-Essex County report analysed data from emergency department visits, hospitalizations, prescriptions and deaths related to opioids, which include fentanyl, heroin, codeine, hydromorphone, methadone, morphine, and oxycodone.
"One thing that stood out to us is our rates are high in almost every category that we looked at compared to the province," said Ahmed.
The health unit found Windsor-Essex County had a total rate of opioid users that was 18.9 per cent higher than the provincial rate in 2015.
Men aged 20 to 44 years old accounted for nearly half of all opioid-linked emergency department hospital visits, it found.
The unit also analysed opioid use in the Ontario Drug Benefit program, which represents provincial health card holders 65 years old and older or if they meet certain criteria such as low socio-economic status and receiving disability support.
There were nearly 115,000 Windsor-Essex County residents eligible for the program, of which opioids were dispensed to nearly 28,000 people. More than 10,000 of those individuals were younger than 65.
"The illicit opioids sold on the street, we have little control," Ahmed said. "But as physicians, we can control prescriptions. We need to better understand whether someone really needs an opioid for the pain they are experiencing."
In 2015, according to the report, 1,260 residents received long-acting fentanyl, which is up to 100 times more potent than morphine and 20 times more toxic than heroin.
The report also said there were 1,315 individuals in the area who received opioid addiction treatment in 2015, a 47 per cent increase from 2011.
Ahmed said the report is a start, but noted there are many gaps in the data. For example, he said, prescription data from the Ontario Drug Benefit program only captures a fraction of overall prescriptions. He also lamented the "lag problem" with the data, namely that the most recent statistics available come from 2015.
"We still don't know what happened last year," Ahmed said.
So, he said, area health officials are moving quickly to tackle the issue.
"What can we do, at least at the local level?" he said. "Is there any other way we can capture local data that is more recent, from prescribing patterns to emergency department use and all those other pieces. Maybe we can go directly to the pharmacists."
Those are the questions Ahmed said he and other community groups hope to answer going forward.