An overview of illegal opioid use and health services utilization in Canada.
OBJECTIVE
Systematic research on health and treatment services availability for and utilization by illegal opioid users in Canada are very limited. Comparative data across provinces and territories is almost entirely absent. This study was designed to provide an overview of illegal opioid use and health services utilization among illegal opioid users across Canada.


METHODS
A combination of statistical data and key informant data was used. Surveys were sent to key informants in all provinces and territories of Canada. Survey questions covered the number of illegal opioid users in each province, the number of opioid users receiving methadone maintenance treatment (MMT), the number of physicians authorized to prescribe methadone, and the number of opioid users receiving other outpatient and inpatient treatment. In addition, relevant data were collected from several statistical sources, both provincial and federal. The number of substance-use-related overdose deaths was obtained from the provincial coroners' offices.


RESULTS
It is estimated that there were more than 80,000 regular illegal opioid users in Canada in 2003. The most prevalent treatment utilized was MMT; about one-quarter (26%) of the estimated opioid users received this type of treatment in 2003. Other forms of outpatient and inpatient treatment were of only minor importance compared with MMT. The number of illegal drug-related overdose deaths in Canada was 958 in 2002. Rates of drug use, health services utilization and overdose deaths showed considerable variation by province.


CONCLUSIONS
Although the opioid use treatment system in Canada has expanded in recent years, especially with respect to the availability of MMT, the treatment utilization rates are still lower than in most countries in Western Europe. Rates of current treatment utilization as well as the relatively high number of overdose deaths suggest that there is still room for improvement in the Canadian health and social care system with respect to opioid use.
Faculty of Social Work, University of Toronto, Toronto, Ont., Canada. lana_popova@camh.net
S
S
Popova
J
J
Rehm
B
B
Fischer
D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D062787:Drug Overdose / Q000401:mortality; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning*; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*
D013287:Illicit Drugs; D008691:Methadone