About the study
This study is the first to comprehensively characterize trends and patterns in opioid use, access to treatment, and opioid-related harms among First Nations people in Ontario. Importantly, our work is First Nations-led, and this project was guided by a Steering Committee made up of First Nations community members, healthcare workers, and researchers. These member’s insights have helped to inform and shape this report, and will continue to inform our future work.
We used the Narcotics Monitoring System, which includes all prescription opioids dispensed to people residing in Ontario, to complete a comprehensive analysis of opioid use for pain and opioid agonist therapy (OAT). Linkage to other administrative databases enabled us to examine how trends and patterns differ by various demographics, including age, sex, and residence within and outside of First Nations communities.
Finally, this study used the detailed records available from the coroner’s office to gain an in-depth understanding of circumstances surrounding opioid-related deaths among First Nations and non-First Nations people.
Goals & Methods
Over the past several years, the Chiefs of Ontario (COO) and the Ontario Drug Policy Research Network (ODPRN) have been collaborating to study opioid prescribing and opioid-related harms among First Nations people in Ontario. This study set out to describe trends and patterns in the following indicators of opioid use and opioid-related harms among First Nations people in Ontario:
- Prescription opioid use for pain, as well as high dose opioid prescribing and combined prescribing of opioids for pain and benzodiazepines
- Use of OAT to treat opioid use disorder
- Emergency department visits and hospital admissions for opioid-related poisoning
- Deaths due to opioid-related poisoning
Where appropriate, we also compare these indicators between First Nations and non-First Nations people in Ontario.
This study used several databases held at ICES, an independent, non-profit research institute in Ontario, to describe trends and patterns in opioid prescribing and opioid-related harms among First Nations people in Ontario.
We presented measures of opioid prescribing and opioid-related harm among First Nations people overall, and compared the measures between First Nations people residing within First Nations communities and those residing outside of First Nations communities. We also compared measures of opioid prescribing and opioid-related harm between First Nations and non-First Nations people in Ontario.
We calculated several measures of opioid prescribing, access to treatment, and opioid-related harm. We examined trends in these measures over time by fiscal year (defined as April 1 to March 31). We also examined the demographic characteristics of people who were prescribed opioids or experienced an opioid-related poisoning in calendar year 2019 (defined as January 1 to December 31), the most recent calendar year for which data were available.
An accompanying report provides recent information on the impact of COVID-19 on trends in opioid-related poisonings. Specifically, the report describes the impact of COVID-19 on hospital visits and deaths due to opioid-related poisoning among First Nations and non-First Nations people in Ontario.
Why this is important
The data in this report, and from the research to come, will provide evidence to support investment in, and implementation of, First-Nations led programs and services designed to specifically support the health and wellbeing of First Nations people across the province.