Durham Region Opioid Information System

As per the Ontario Public Health Standards, Durham Region Health Department serves as a naloxone distribution lead, and provides training and other supports to eligible organizations.

Through the Ontario Naloxone Program (ONP), the Health Department currently distributes naloxone to over 30 local community agencies that have met the eligibility requirement of the Ministry of Health. These community agencies then distribute naloxone kits/refills and provide training to individuals who use opioids as well as family/friends of individuals who use opioids.

Source: Ontario Naloxone Program Quarterly Reports (MOH) 2022-2024

2023 Map of RDPS calls

2022 Map of RDPS calls

2017-2018 Map of RDPS calls

Suspected opioid overdose paramedic services response calls

Source: Region of Durham Paramedic Services Ambulance Call Report Database.

Paramedic services calls for suspected opioid overdoses consisted of calls responded to by the Region of Durham Paramedic Services (RDPS) where naloxone was administered (by paramedics or prior to their arrival), or where the patient was thought to be overdosing on one or more opioid drugs or a combination of opioid and non-opioid drugs. Intentional overdoses were included. Because no drug testing was performed, it is possible that the patient did not overdose or overdosed on a non-opioid drug. The diagnosis recorded by the hospital or cause of death determined by the coroner may differ from paramedic services. Not all paramedic services calls result in the patient being transported to hospital. RDPS calls in Durham Region may include non-Durham Region residents. As well, RDPS may respond to calls outside of Durham Region and some overdose calls in Durham Region may be responded to by other paramedic services. Calls by other paramedic services would not be captured in this data. Calls responded to by RDPS outside of Durham Region are excluded from this data. We mapped calls based on the pick-up location of the RDPS call which may or may not reflect where the patient lives. Individuals may have more than one suspected opioid overdose call on separate occasions. The number of calls should not be interpreted as the number of individuals. This data only includes instances where 911 was called and underestimates the true number of overdoses in the community.

Emergency department visits for opioid poisonings

Sources:

National Ambulatory Care Reporting System (NACRS), Canadian Institute for Health (CIHI). IntelliHealth Ontario. Ontario Ministry of Health.

National Ambulatory Care Reporting System (NACRS), Canadian Institute for Health (CIHI). Weekly emergency department visits for opioid overdose report. Ontario Ministry of Health. 

Annual Rates: Ontario Agency for Health Protection and Promotion (Public Health Ontario). Interactive Opioid Tool. Toronto, ON: Queen’s Printer for Ontario. Available from: www.publichealthontario.ca/en/data-and-analysis/substance-use/interactive-opioid-tool.

A confirmed opioid overdose emergency department (ED) visit is an unscheduled ED visit made to any emergency department in Ontario and includes ICD-10-CA codes T40.0 (poisoning by opium), T40.1 (poisoning by heroin), T40.2 (poisoning by other opioids), T40.3 (poisoning by methadone), T40.4 (poisoning by other synthetic narcotics), or T40.6 (poisoning by other and unspecified narcotics). For data from April 1, 2018 onwards, the following codes were also included: T40.20 (poisoning by codeine and derivatives), T40.21 (poisoning by morphine), T40.22 (poisoning by hydromorphone), T40.23 (poisoning by oxycodone), T40.28 (poisoning by other opioids, not elsewhere classified), T40.40 (poisoning by fentanyl and derivatives), T40.41 (poisoning by tramadol), T40.48 (poisoning by other synthetic narcotics, not elsewhere classified), T40.6 (poisoning by other and unspecified narcotics). We excluded cases with a query/suspected diagnosis (diagnosis prefix = Q). Each visit was captured only once, even if multiple opioids were involved. The number of visits does not represent the number of unique individuals, as individuals may have more than one visit at different times.

Durham Region rates and counts represent patients who were residents of Durham Region and visited any ED in Ontario. To have the most current information possible, preliminary data were used from a weekly Ministry of Health report using the same diagnosis codes referenced above. This preliminarily data is subject to change and likely an underestimate of final data. Finally, ED visits underestimate the number of opioid overdoses since not all individuals who have an overdose visit an emergency department.

Opioid toxicity deaths

Sources:

Office of the Chief Coroner, Ontario. OCC Monthly Update: Suspect drug opioid related deaths report. 

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Interactive Opioid Tool. Toronto, ON: Queen’s Printer for Ontario. Available from: www.publichealthontario.ca/en/data-and-analysis/substance-use/interactive-opioid-tool.

Opioid toxicity deaths refer to all deaths in which a coroner or forensic pathologist determined the cause of death to be drug toxicity with opioid involvement, whether accidental or intentional. The Interactive Opioid Tool excluded deaths due to chronic substance use, medical assistance in dying, homicide, and trauma where an intoxicant contributed to the circumstances of the injury. Deaths were assigned to public health unit based on decedent’s postal code of residence. If residence postal code was unavailable, the postal code of the incident location was used, with location of death postal code being used if no other data available.

Preliminary data were obtained directly from the Office of the Chief Coroner and includes both probable and confirmed opioid toxicity deaths. Preliminary data is subject to change and is assigned to public health unit primarily based on location of incident. If location of incident data is pending, region reflects location of death.