Drug-Related Deaths Spiked in Ontario with COVID-19 Measures: U of T Study

Researchers at the University of Toronto have found that accidental drug-related deaths in Ontario increased substantially after implementation of COVID-19 public health measures in 2020.

The study is one of the largest worldwide to look at non-natural manners of death such as suicides, homicides and accidents including motor-vehicle fatalities and accidental drug-related deaths including those from opioids.  

“Over 4,000 COVID deaths were reported in 2020, but we also saw over 1,500 more accidental drug-related deaths than predicted — the sheer magnitude of this effect was unanticipated, but clearly must be considered by policy makers moving forward”, says study lead Jennifer Dmetrichuk, an assistant professor of laboratory medicine and pathobiology at U of T’s Temerty Faculty of Medicine and a forensic pathologist with the Ontario Forensic Pathology Service.

The study was published online late last year in The Lancet Regional Health — Americas and will appear in the journal’s March 2022 print issue.

“There was so much speculation about whether the lockdowns had impacted manners of deaths. We wanted to use a scientifically and statistically sound approach to see what actually happened, with the aim of providing evidence to government officials, public health, and policy makers to assist in their decision-making,” says Dmetrichuk.

Co-investigator Jeffrey Rosenthal, a professor of statistical sciences at U of T, brought expertise to the study and helped identify pre-existing trends over the past decade in Ontario. The researchers reviewed almost 200,000 deaths occurring between 2009 and 2020, using 77,000 for the study.

The study showed no major change to the rate of homicides or suicides during 2020 compared to the period 2009 to 2019. Although motor vehicle collision-related fatalities appeared to decrease slightly in 2020, the researchers could not conclude any lockdown-associated effect.

“In the first stage of the lockdown, we anticipated motor vehicle-related fatalities would decrease due to the stay-at-home order, but the effect was very minimal,” says Dmetrichuk. The presumed protective effect of having fewer vehicles on the road may have been offset by increases in motor vehicle-related deaths due to unsafe driving practices, such as driving under the influence of drugs/alcohol or speeding and stunt driving on emptier roads,” Dmetrichuk says.

Homicides were not substantially impacted by the lockdowns, with no change in the slight upward trend over the last decade, though gun violence is on the increase in Ontario. The data showed that increased domestic violence rates in some jurisdictions following stay-at-home orders may not have translated into increased homicide rates in Ontario during 2020. However, the long-term impact of the pandemic in this regard remains to be seen.

Contrary to many public perceptions, suicides decreased in the first stage of the 2020 lockdown, then returned to baseline rates, but saw no increase above expected based on already existent trends.

“Although suicide rates have been steadily increasing in Ontario and need to be addressed, the lockdowns did not impact them in the way we anticipated,” says Dmetrichuk. She speculated that there may have been positive mental health impacts of studying or working from home that may have helped initially. She added that the long-term impact needs to be studied as we enter the third year of the pandemic and effects on mental health evolve.

Dmetrichuk and her team are already looking at manner of death data for 2021. In the meantime, the team hopes that their results will be part of deliberations as government officials and policy makers continue to consider the benefits and costs associated with the public health response to the pandemic.

“This study highlights the need to consider the impacts of public health interventions that are meant protect the population as a whole, but which may have unintended adverse effects in sub-populations,” says Dmetrichuk. “We need to be able to identify those at risk and put in place safeguards to mitigate against such effects in the event of further whole-population public health measures.”