Thousands more Canadians received substance-related hospital care during the COVID-19 pandemic than in the previous year, disproportionately effecting men and people from lower-income neighbourhoods, a study revealed.
In the first 7 months (from March to September 2020) of the outbreak of the CCP (Chinese Communist Party) virus, which causes the COVID-19 disease, up to 81,000 Canadians were hospitalized due to harm caused by substance use, representing an increase of about 4,000 cases compared to the same period the year before.
The numbers released Thursday in a report (pdf) by the Canadian Institute for Health Information (CIHI) is based on data provided by experts from across the country.
Emergency department (ED) visits for harms caused by all substances declined by 5 percent (from 186,529 visits in 2019 to 176,902 in 2020), while hospitalizations rose by 5 percent (from 76,948 in 2019 to 80,954 in 2020).
ED visits and hospitalizations for “any reason” have decreased more than “substance-related” ED visits and hospitalizations in 2020 compared with the same period in 2019, according to the report. This likely means that Canadians “began accessing health care differently as a result of the pandemic.”
“During the first 7 months of the pandemic, some services that help people cope with substance use, such as harm reduction programs and substance-related therapies, were operating at reduced capacity or were temporarily closed. The reduction in available services could be one factor that influenced the rise in hospital treatment for opioid poisonings,” said Tracy Johnson, director of CIHI health system analytics.
Substances examined in the study include alcohol, opioids, cocaine, amphetamines, and others.
The CIHI report states that alcohol was the most reported substance, representing 59 percent of all ED visits and 55 percent of hospitalizations.
While alcohol-related hospitalization rose by five percent in 2020 compared with 2019 across the country, ED visits dropped by 11 percent during the same period, which can be attributed to behavioral changes related to the COVID-19 lockdowns.
“Usually, when people come to the ED for alcohol, they do so because of acute alcohol intoxication, which tends to happen at high-risk events such as bars and parties. What we’ve been seeing since the onset of the pandemic is that with bars closed and parties shut down, there has been a decrease in ED visits,” Catherine Paradis, senior researcher and policy analyst at the Canadian Centre on Substance Use and Addiction, said.
The report also observed “substantial increases” in ED visits and hospitalizations related to opioids, stimulants, and cannabis harms, increasing by a range between 5 percent and 8 percent in 2020.
Notably, the report stated that lockdown measures such as business and border closures, and physical distancing have all affected the supply of and access to substances—possibly leading users to replace or modify their substance use, which likely poses additional health risks to Canadians.
According to the CIHI report, lower-income neighbourhoods in Canada had the most dramatic increase in hospital visits.
In 2019, more than one-third of hospitalizations for substance-related harm were seen in the lowest-income neighbourhoods. During the CIHI COVID-19 study period, alcohol-related visits rose by 14 percent in low-income areas across the country, while there was almost no change in the highest-income communities.
The study also shows more men are being hospitalized than women. In 2019, men accounted for two-thirds of hospitalization for alcohol and over half of hospitalization for opioid-related harms. In 2020 during the pandemic, men hospitalized for substance harm rose by 8 percent, compared to 1 percent for women. The largest difference was among opioid users, where hospitalizations among men rose by 17 percent in 2020 and deceased by 5 percent among women.
“These findings may reflect the disparate burden of the pandemic on certain populations, particularly among those who use substances. Evidence has shown that people with lower incomes were more impacted by the pandemic. The higher prevalence of multiple chronic conditions among less-affluent Canadians may be one of many contributing factors,” the report concluded.