Parallel Pandemics: Opioid overdoses surge during COVID-19

While public health measures have been deployed to stop the spread of COVID-19, another epidemic continues to claim the lives of thousands of Canadians. Although the ongoing overdose crisis has worsened throughout the pandemic, a new focus on societal change may bring hope for reducing overdose deaths according to a School of Public Health expert.

“After the pandemic hit, we saw a significant increase in overdose deaths across the country,” said Elaine Hyshka, assistant professor. “The public health countermeasures implemented to prevent the spread of COVID-19 led to significant disruptions in the illegal drug market. Suddenly we saw substances circulating that were even more toxic than before.”

Hyshka said that before the pandemic there was a decline in overdose deaths in Alberta. This is due in part to new initiatives Hyshka helped to roll out over the last few years expanding treatment programs and harm reduction interventions and increasing awareness.

On top of the increasingly toxic drug supply, Hyshka said the pandemic cut off people from their usual support systems as they were encouraged to stay home. One of the biggest risk factors for an overdose is using alone since no one is there to support you in case of an emergency.

“The toxic drug market is the factor that’s really driving the spike in overdoses during the pandemic. Although restrictions largely loosened up over the summer, supply disruptions have continued, which is why we continue to see high rates of overdose,” said Hyshka.

The one thing about COVID-19 that has given Hyshka hope is that the first wave demonstrated how quickly public health responses can be mobilized and how effective they can be. She feels a strong public health response to the overdose epidemic is long overdue.

“If we took a whole-society approach to the opioid epidemic, addressing its main causes and supporting those who use drugs, we could end it. I hope COVID-19 will demonstrate the value of public health expertise and approaches to Canadians. Whether it’s COVID-19 or overdose, many people are grieving the loss of loved ones. We all have a responsibility to take the necessary actions to stop overdose, and like COVID-19, deaths from overdose are preventable,” said Hyshka.

Hyshka stressed that taking concerted action to address the upstream causes of public health issues such as systemic racism, housing insecurity and income inequality is critical, whether it is in response to COVID-19 or substance use.

“As we talk about post-COVID recovery and the potential for broad societal change, I hope those social determinants of health are top of mind because meaningful action on them will not only reduce drug-related harms but a whole host of other health problems.”

Research responds

Hyshka is also encouraged by increasing support for trying novel solutions to address the opioid epidemic. She said multiple Canadian jurisdictions have received funding from Health Canada to pilot safer supply programs that connect people who use drugs to pharmaceutical-grade alternatives to reduce their reliance on the toxic illegal drug market make a connection to a healthcare provider

“At this point in the pandemic we need to be innovative and try new things,” said Hyshka who is chairing Health Canada’s Advisory Group for the Safe Supply of Pharmaceutical Alternatives and will be monitoring the results. 

Since the start of the pandemic, Hyshka’s research group has launched multiple projects designed to help people who use substances, reducing their risks of both overdose and COVID-19 infection. These include: 

• Research looking at the dual impact of COVID-19 and overdoses in provincial emergency departments and the ability of Albertans to get opioid related care in these settings.
• A Canadian Research Initiative in Substance Misuse (CRISM) project developing National Guidelines on caring for people who use substances in shelter settings and  acute care during the pandemic.
• A project comparatively analysing the COVID-19 homeless policy response in Edmonton, Toronto and Winnipeg during the pandemic. 

Hyshka receives funding for her research primarily from the Canadian Institutes of Health Research, Royal Alexandra Hospital Foundation, and the Canadian Research Initiative on Substance Misuse.

If you need support for substance use, please contact the Alberta Health Services Addiction Helpline.