Opioids responsible for one in every four deaths among young adults: study

The staggering cost of illicit drug toxicity in Canada, especially among young people, is laid bare in new research published Monday that highlights rapid increases in opioid-related deaths with the arrival of the COVID-19 pandemic.
The research finds that not only did premature deaths due to opioid overdoses double across the country between 2019 and 2021, but also that opioids were responsible for one in every four deaths among young adults between the ages of 20 and 39 during this time.
“These findings show the stark and devastating impacts of a highly unpredictable illicit drug supply,” said Tara Gomes, a scientist at Unity Health Toronto and senior author of the study, published in the Canadian Medical Association Journal.
The drug-toxicity crisis has killed more than 40,000 people in the past eight years nationwide, with the Public Health Agency of Canada estimating that an average of 22 people died of opioid overdoses each day in 2023.
Gomes and her colleagues found that during the study period, deaths attributed to opioids more than doubled, from 3,007 in 2019 to 6,222 in 2021, and that one in four of all deaths in people ages 20-39 were related to opioids. That increases to one in three deaths for people in their 30s.
“That, to me, is staggering. Think about the degree to which these accidental deaths, these preventable deaths, are shortening people’s lives,” Gomes said.
She added the findings serve as a call for all levels of government to co-ordinate efforts to invest in a variety of evidence-based treatment and harm-reduction services that are adaptable to the communities they serve.
The researchers also found that the burden of premature death from opioid overdoses was felt most acutely in Manitoba and Saskatchewan, where deaths between 2019 and 2021 rose 387 per cent and 195 per cent, respectively. The authors speculate this could be due to a drug supply that became more volatile during the pandemic without responsive increases in access to community-based treatment and harm-reduction services.
The age group with the largest increase in the percentage of deaths caused by opioids over the study period were those between 30 and 39 years old — a 50 per cent rise — followed by people between 20 and 29, who saw a 48 per cent jump. 
Co-author Shaleesa Ledlie, a PhD candidate at the University of Toronto’s Leslie Dan Faculty of Pharmacy, said there are likely several factors in why deaths in younger people were so high. One is that there aren’t a lot of other competing causes of death in these age groups, as younger people tend not to see high rates of cancer or heart disease diagnoses, for example. Another is that young people are often in social situations that could lead to intermittent drug use, where naloxone may not be present and no one is fully equipped to respond to an overdose. This is one advantage of safe consumption sites — users can consume drugs surrounded by professionals equipped with both naloxone and knowledge with how to deal with overdoses.
They may also be unaware of the risks associated with drugs from the unregulated supply, which can often have drastically different amounts of fentanyl even if they come from the same batch — sometimes referred to as the “chocolate chip cookie effect.” (“If you think of a batch of chocolate chip cookie dough, some of the cookies you make will have two chocolate chips, and others might have 10,” explained Ledlie.)
In her role as an overdose prevention support worker at Parkdale Queen West Community Health Centre’s Safe Consumption Services at Queen West, Meghan White says she has seen an increase of younger visitors in recent years, including some in their early 20s, as well as those in their 30s, 40s and 50s. 
“I had a very specific idea of who the people who were using drugs were before getting into this field,” she said. “Working at a safe-consumption site definitely switched my mindset.”
She noted that opioid potency tends to fluctuate but it’s the additives, such as tranquilizers, that she and her colleagues are seeing more often that can add a new dimension to overdoses and makes users more vulnerable, especially if they are experiencing homelessness. White says it is crucial that safe-supply programs receive increased funding, and remain funded, to save lives and help drug users live dignified lives.
“It’s about meeting the person where they’re at and understanding that if that person is using drugs, they still deserve basic human rights,” she said. “Safe supply programs really do fall under that health care umbrella.”