National Surveillance of Opioid-related Harms Published: ()

Canada continues to experience a serious and growing opioid crisis. Across the country, it is having devastating effects on families and communities. The Government of Canada works closely with the provinces and territories to collect and share data to monitor opioid-related harms, including mortality data.

Emergency Medical Services (EMS) Data

To obtain a more complete picture of the crisis, Emergency Medical Services (EMS) information is being presented at the national level to examine suspected opioid-related overdoses occurring in pre-hospital settings.

EMS data include information documented by EMS providers generally in the form of electronic or written reports. In this second quarterly release, EMS data on suspected opioid-related overdoses were available from seven jurisdictions across Canada: Yukon (Whitehorse), Northwest Territories (Yellowknife), British Columbia, Alberta (Edmonton and Calgary), Manitoba, New Brunswick, and Newfoundland and Labrador.

The Government of Canada in collaboration with provinces and territories will continue to coordinate efforts to present a more complete, national picture of suspected opioid-related overdoses involving EMS responses in subsequent reports.

Why are EMS data important?

EMS providers are typically the first health care workers who respond to opioid overdose emergencies occurring in pre-hospital settings. Having access to such timely data will help to identify populations who may be at risk and to inform the development of public health interventions and policies at all levels of government.

What did we learn from data on administration of naloxone by EMS?

Naloxone is a medication that can help reverse the effects of opioids. Based on data available among jurisdictionsFootnote 1 reporting data for naloxone administrations by EMS providers, main findings show that:


Suspected Opioid-Related EMS Events in Canada in May 2017

Use the map below to see the number and rate of Suspected Opioid-related Emergency Medical Services (EMS) Responses in participating jurisdictions. Navigate the map using the Next and Previous buttons or with Tab or Hover. Once a province is selected, Zoom using Click (when hovering) or Spacebar (when tabbing). Please note: As case definitions vary across jurisdictions, data should not be compared across jurisdictions. Cities have been enlarged for better data visualization and user interactivity. Suppressed: data has been suppressed due to small counts.

Jan 2017 June 2018

Suspected Opioid-related Emergency Medical Services (EMS) Responses as per Winnipeg, Manitoba's case definition.

Between January 2017 and June 2018, there were 1,022 suspected opioid-related overdose EMS responses in Winnipeg, Manitoba. This corresponds to an annual rate of 87.4 per 100,000 population and an average of 57 responses per month.

The largest proportion of suspected opioid-related overdoses occurred among males and females between the ages of 20 and 29.

In May 2017, there were 65 EMS overdose responses reported in Winnipeg, Manitoba.


Notes
Additional Resources

Case Definitions

Table 1 (below) provides case definitions of suspected opioid-related overdoses according to participating jurisdiction. As case definitions vary among jurisdictions, data should not be compared across jurisdictions.

Table 1. Case definitions for Suspected Opioid-related Overdose Emergency Medical Services (EMS) Responses for provinces and territories with available data as of September 2018
Jurisdiction Reporting Period Primary Case Definition
Newfoundland and Labrador Jan 2017 – Mar 2018 Emergency response to an opioid-related overdose where naloxone is administered by paramedics.
New Brunswick Jan 2017 – Mar 2018 A patient who responded to naloxone that was administered by an Ambulance New Brunswick first responder for a suspected opioid overdose.
Northern and rural Manitoba Jan 2017 – Jun 2018 The number of suspected overdose cases receiving naloxone from Winnipeg Fire Paramedic Service (WFPS).
Winnipeg, Manitoba Jan 2017 – Jun 2018 The number of suspected overdose cases receiving naloxone from Winnipeg Fire Paramedic Service (WFPS).
Calgary and Edmonton, Alberta Jan – Dec 2017 Documentation of opioid medical control protocol or administration of naloxone.
Whitehorse, Yukon Jan – Dec 2017 A suspected opioid-related overdose is classified according to the following criteria:
  1. Suspected opioid overuse is identified during the 9-1-1 call taking process; and/or
  2. Opioid overuse or overdose are identified in the Patient Care Report’s narrative, history of event, or chief complaint; and/or
  3. Naloxone administered by a designated emergency responder, allied health care provider, or layperson at the scene.
Yellowknife, Northwest Territories Jan 2017 – Jun 2018 Suspected overdose identified as chief complaint and an opioid identified as the overdose product OR suspected overdose identified as the chief complaint and naloxone administered by paramedics.
British Columbia Jan 2017 – May 2018
  1. Paper-based patient care reports (PCR): Treatment by ambulance crews using Naloxone OR paramedic impression codes indicated possible illicit drugs (but not prescription drugs or alcohol) AND the corresponding dispatch code was consistent with possible drug overdose (Medical Priority Dispatch System (MPDS) cards 9,23,31)
  2. Electronic-based PCR (SIREN): Treatment by ambulance crews using Naloxone OR paramedic impression code indicated possible illicit drugs (but not prescription drugs or alcohol)

Acknowledgment

We would like to thank all members of the Opioid Overdose Surveillance Task Group for their input and feedback, and all EMS data providers in the following jurisdictions: Yukon, British Columbia, Alberta, Manitoba, New Brunswick and Newfoundland and Labrador.

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