Alberta Opioid Response Surveillance Report : Q4 Interim 2018

Alberta Health

Alberta Opioid Response Surveillance Report Q4 Interim 2018

Analytics and Performance Reporting Branch

February 1, 2019

Alberta Health, Analytics and Performance Reporting Alberta Opioid Response Surveillance Report, Q4 2018 Interim February 1, 2019

Disclaimer This surveillance report presents mortality data associated with fentanyl use in Alberta, collected by the Office of the Chief Medical Examiner. Mortality data is subject to change as certification of deaths can take six months or longer. Deaths in this report include individuals who died from an apparent accidental drug poisoning related to fentanyl, or a fentanyl analogue (fentanyl, 3-methylfentanyl, acetylfentanyl, furanylfentanyl, norfentanyl, butyrylfentanyl, despropionylfentanyl, acrylfentanyl, methoxyacetylfentanyl, cyclopropylfentanyl, fluoroisobutyrlfentanyl (FIBF), or carfentanil), detected through toxicology. The number of apparent accidental drug poisoning deaths related to fentanyl may change (including increases/decreases in previous numbers) as certification of cause of death may lead to a change in classification in some instances.

Apparent accidental drug poisoning deaths related to fentanyl  From January 1 to November 11, 2018, 582 individuals died from an apparent accidental drug poisoning related to fentanyl. During the same time period in 2017, 463 individuals died from an apparent accidental drug poisoning related to fentanyl.  In six week period from October 1 to November 11, 2018, 63 individuals died from an apparent accidental drug poisoning related to fentanyl. In the previous six weeks (August 20 to September 30, 2018) 79 individuals died from an apparent accidental drug poisoning related to fentanyl.  In 2018, there are now on average, approximately 13 apparent accidental drug poisoning deaths related to fentanyl per week (1.9 per day), compared to 11 deaths per week in 2017 (1.6 per day).

Figure 1: Number of individuals who died from an apparent accidental drug poisoning related to fentanyl in Alberta, by week. January 1, 2018 to November 11, 2018.

Cumulative total since Jan. 1, 2018 700 20 582 600

500 15

400 21 10 300 18 1817 18 18 18 18 17 16 15 1516 15 15 15 14 13 13 1313 14 13 13 Fentanyl poisoning deaths poisoning Fentanyl 12 1212 12 200 5 11 1011 11 1110 11 111111 11 9 9 8

6 100 deaths poisoning fentanyl Cumulative 4 3 0 0

Week (1st day of week starting on Sunday)

Table 1: Number and rate of fentanyl related drug poisoning deaths per 100,000 population, by Zone and Year. 2017 2018 YTD* Count Rate Count Rate South 28 9.2 43 16.2 Calgary 267 16.3 271 18.9 Central 45 9.3 63 14.9 Edmonton 171 12.5 166 13.8 North 55 11.2 39 9.1 Alberta 566 13.2 582 15.5

*YTD = January 1 to November 11, 2018 © 2018 Government of Alberta Page 2 Alberta Health, Analytics and Performance Reporting Alberta Opioid Response Surveillance Report, Q4 2018 Interim February 1, 2019

Figure 2: Number of individuals who died from an apparent accidental drug poisoning related to carfentanil in Alberta, by quarter. January 1, 2017 to November 11, 2018. Subcategory of fentanyl deaths from Figure 1

South Calgary 60 Central 350 Edmonton 314 50 300 250 40 200 30 150 20

100 Carfentanil deaths Carfentanil

10 50 Cumulative carfentanil deaths carfentanil Cumulative 0 0 Q1 2017 Q2 2017 Q3 2017 Q4 2017 Q1 2018 Q2 2018 Q3 2018 Oct 1 to Nov 11, 2018

 From January 1 to November 11, 2018, 149 individuals died from an apparent accidental drug poisoning related to carfentanil. During the same time period in 2017, 116 individuals died from an apparent accidental drug poisoning related to carfentanil.  In six week period from October 1 to November 11, 2018, 10 individuals died from an apparent accidental drug poisoning related to carfentanil. In the previous six weeks (August 20 to September 30, 2018) 7 individuals died from an apparent accidental drug poisoning related to carfentanil.  The most recent data indicates the South and Calgary Zone have the highest rate of carfentanil related deaths per 100,000.

Table 2: Number and rate of carfentanil related drug poisoning deaths per 100,000 population, by Zone and Year.

2017 2018 YTD* Count Rate Count Rate South 8 2.6 17 6.4 Calgary 92 5.6 90 6.3 Central 14 2.9 14 3.3 Edmonton 38 2.8 24 2.0 North 13 2.6 4 0.9 Alberta 165 3.9 149 4.0

YTD = January 1 to November 11, 2018