Income and postal code can influence opioid overdoses, study finds

A new report released by Public Health Canada is connecting socioeconomic status to opioid-related overdose rates.

Researchers at the University of Waterloo wrote the peer-reviewed paper, which looked at opioid-related deaths, hospitalizations and emergency department visits between 2000 and 2017.

The report found that area income was found to be highly associated with opioid overdoses and hospitalizations. Psychosocial factors, like stress, unemployment, or housing insecurity, are typically concentrated in low-income areas and may play a significant role in the opioid epidemic.

The most recent numbers from the province's chief coroner show that last year, 2,819 Ontarians died due to opioids, a figure that includes both confirmed and probable opioid-related deaths.

The six public health units with the most deaths per capita in 2021 were all in northern Ontario, with Thunder Bay at the top of the list.

Public Health Sudbury and Districts, which topped the list in 2020, saw a slight drop, with 100 probable and confirmed deaths in 2021, compared with 106 the year before.

Hard to be optimistic, addictions specialist says

The report's findings don't come as much of a surprise to Sudbury addictions specialist Dr. Michael Franklyn.

"We all like to think we're a very egalitarian society in Canada," Franklyn said. "But I think many people would be shocked at the levels of disparity in health care and outcomes based on income levels and where you live, or based on your postal code."

Franklyn said he also hopes that the report, one of the first that connects income levels and addiction-related health outcomes, opens a few eyes to the people most likely to be impacted by the crisis.

"Not to be overly critical, but there's tremendous ignorance," Franklyn said. "People don't see that segment of society. I think the biggest benefit of showing this…discrepancy in terms of negative outcomes is that hopefully it opens people's eyes to the need for greater care for targeted populations, particularly those marginalized by social determinants of health."

But even with the data made public and in plain view, Franklyn said he wasn't terribly optimistic that politicians were willing to make big changes to address the opioid crisis.

"I think people on Ontario Works, on ODSP (Ontario Disability Support Program) have such dramatic income disparities with the middle class and that's made much worse with inflation," Franklyn said.

"So as bad as things were, I think they've only gotten worse. And we know that overdose deaths have increased dramatically because of the escalation from the pandemic."

"So it's hard to be optimistic about positive change."