Although opioids have been in existence for decades, the 2016 overdose and subsequent death of musician Prince sent shockwaves throughout the world and brought a great deal of attention to Fentanyl and other potentially lethal opioids.

Since then, opioid use, opioid addictions and lethal overdoses from these painkillers have been steadily on the rise worldwide. Here at home, they have had a devastating impact on Canadians, with provinces such as B.C. and Ontario hit especially hard. In fact, the Government of Canada has deemed the growing crisis a complex public health emergency. So what exactly are opioids and why are there so many related deaths?

What Are Opioids?

Initially used to relieve pain in palliative patients, opioids were created to replicate the pain-alleviating properties of opium. Opiate is the term used for naturally occurring compounds such as morphine found in the opium of poppy resin. Legal opioids include codeine, morphine, fentanyl, oxycodone or hydrocodone and are doctor prescribed – even something as frequently prescribed and common as Tylenol 3 contains codeine, which is an opioid. Illegal opioids include heroin or illicitly produced fentanyl, but the line between legal and illegal painkillers remains blurry. Musician Prince was initially prescribed a painkiller by his doctor, but moved to stronger illicit painkillers, before finally taking a lethal dose of fentanyl. Not only do they relieve pain, opioids can also affect the mind, mood and mental processes and can cause a sense euphoria, or that “high” feeling, creating an even greater potential for them to be misused.

The Stats

We hear about the opioid crisis almost every day now, and yet the statistics are still rather shocking:

• In Canada, more than 11,500 opioid-related deaths occurred between January 2016 and December 2018; numbers increased steadily from 3,017 deaths in 2016 to 4,460 deaths in 2018

• In 2018, 94% of opioid-related deaths were accidental

• Fentanyl and other Fentanyl-related painkillers continue to be at the forefront of the crisis; in 2018, 73% of opioid-related deaths involved Fentanyl or its derivative

Worldwide, opioids were responsible for two-thirds of drug-related deaths in 2017.

Why Are We In Crisis?

Once the demand for opioids was recognized, they were heavily pushed and promoted. Many doctors over-prescribed the legal varieties, causing addiction and a greater tolerance for the painkiller. In turn, illegal dealers provided a more powerful, cheaper, synthetic version (fentanyl for instance), foregoing vital equipment testing and oftentimes providing product that was far stronger than what the user could manage, increasing the possibility for overdose and death. Consuming as little as a few grains of fentanyl can be fatal and without proper labeling, you cannot really know its true contents and strength.

Opioids do not discriminate. They affect people from all walks-of-life. In fact, the sad reality is that most people with acute or chronic pain will begin with a doctor-prescribed dose. However, due to the addictive nature of the drug and the steady decrease of its pain-alleviating effects over time, the user continually requires more drugs, stronger drugs, in order to relieve their pain.

Opioid Risk and How to Protect Yourself

Anyone using prescribed or illegal opioids is at risk for overdose, but there are definitely factors that can increase the risk, such as:

• Taking opioids more frequently or at a higher dose than prescribed or accustomed to

• Taking opioids with alcohol or sedatives such as sleeping pills or muscle relaxants

• Injecting the opioid

• Switching to a stronger drug

• Using drugs with an unknown purity or strength

• Having other health conditions such as liver or kidney disease or breathing difficulties

If you know someone who is struggling with addiction and needs help, encourage them to speak to their physician and refer to the following websites:

Access CAMH

CAMH Family Support

ConnexOntario

Kids Help Phone

If you believe someone to be overdosing, call 9-1-1 and administer naloxone immediately.