B.C. emergency doctor worries of possible rise in opioid deaths due to COVID-19

TORONTO — An emergency room doctor in Vancouver worries the COVID-19 pandemic could lead to a resurgence in opioid overdoses.

Dr. Daniel Kalla, the head of emergency medicine at St. Paul’s Hospital in Vancouver, said community measures and safe injection sites have been effective in flattening the opioid overdose curve locally over the past few years, but since the COVID-19 pandemic, he has personally seen a rise overdose numbers.

“The pandemic itself is driving people to use more drugs (and) to be more reckless in their use of drugs,” Kalla told NewsNight by CTV News, a new show on the mobile streaming app Quibi. “We were encouraging users to never use alone, because that’s when people die of opioid overdoses, but now some our substance users are afraid to use at … the safe injection sites or even with friends, so it sets them up for a deadly situation of using alone.”

Kalla also said a lot of the resources meant for opioid treatment have been shifted to help fight the COVID-19 pandemic, meaning there are fewer services available for opioid users.

According to the Canadian Centre on Substance Use and Addiction, more than 11,500 Canadians suffered apparent opioid-related deaths between January 2016 and December 2018.

Kalla said last night his emergency room dealt with three people with apparent opioid overdoses, including one who would surely have died if someone hadn’t seen them in time.

Still, Kalla said it’s too early to tell whether any increase in opioid cases might slow as the pandemic regresses.

“We don’t know when the pandemic is going to end,” he told CTVNews.ca in a recent phone interview. “We don’t know yet how much regression has happened.”

Kalla adds, however, that the response to the COVID-19 outbreak can teach us a few things about how to better handle the opioid crisis in the future.

“I think there is opportunity here, too,” he said. “Our response to COVID was so organized and all-inclusive and focused, but I really think that if we apply that kind of energy and effort to things like opioid crisis, like mental health issues and poverty, we could really make a big dent on them as well. So maybe we can learn something from the COVID response.”

In an article recently published in Annals of Internal Medicine, Drs. William C. Becker  and David Fiellin from the Yale School of Medicine echoed Kalla’s comments and said they are “gravely concerned” that COVID-19 will lead to an increase opioid death rates based on how epidemics “disproportionately affect socially marginalized persons with medical and psychiatric comorbid conditions.”

“Besides the threat of infection to persons with (opioid use disorder), there is serious risk that system-level gains in expanding access to medication for OUD, conducting critical research, and exacting legal reparations against opioid manufacturers will all reverse,” the doctors wrote in the article. “We call for urgent action to counteract these risks.”

Among their many recommendations, both doctors are calling for relaxed regulation when it comes to methadone access in the United States, a treatment for opioid use disorder, and for a rapid expansion of methadone delivery systems.

ALCHOHOL USE ALSO ON THE RISE

It appears drug abuse of all kinds could be on the rise due to the COVID-19 pandemic.

A Nanos Research poll from last week — commissioned by the Canadian Centre on Substance Use and Addiction — shows more than 20 per cent of Canadians are drinking more frequently than usual while they self-isolate at home during the pandemic, with lack of a regular schedule (51%), boredom (49%) and stress (44%) being the most common factors.

“This data validates what we have all been saying: substance use increases during times of stress and anxiety,” Rita Notarandrea, CEO of the CCSA, said in a news release from April 15. “Providing Canadians access to information about using alcohol or cannabis in safer ways is our primary goal during this challenging situation.”

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