Cocaine overtakes opioids as drug-related killer for first half of 2018

For the past several years, people working on the frontline of addictions in Newfoundland and Labrador had their sights set on fighting opioids.

And rightfully so — powerful painkillers like oxycodone, morphine, fentanyl and methadone helped contribute to a total of 25 deaths in 2017.

But in the first six months of 2018, a party drug often known for its quick high and ability to leave someone's system has surpassed opioids as being the most deadly. 

• Last year, 25 people in Newfoundland and Labrador died after taking drugs

"When you think of cocaine, you think of a good time.… But then we forget that cocaine also kills," said Dr. Bruce Hollett, divisional chief of family medicine, chronic pain and addiction at the Waterford Hospital.

"Cocaine is very easy to have fentanyl added to it, to have other products added to it that may have nothing to do with opioids or substances that can be abused but are just fillers that can cause the wrong reaction in a person and kill them."

Preliminary numbers from the Office of the Chief Medical Examiner show cocaine-related deaths rose significantly, while opioid deaths dropped, between January and June.

• Cocaine-related deaths: 9
• Opiate (oxycodone): 1
• Cocaine plus morphine: 1
• Codeine plus alcohol: 1
• Multiple drugs (prescribed methadone present): 1
• Solvent inhalation (pressurized duster): 1

The majority of the overdoses happened in St. John's. Eight males and six females between the ages of 30 and 61 died provincewide. 

The death rates identified by the medical examiner matches what Hollett sees in his practice.

"We're seeing a lot more cocaine on the streets, a lot more people who are doing well and then all of a sudden, they're getting into cocaine and we're having a lot more trouble trying to get them back on track."

When a patient had a slip two years ago, it would take doctors a week or so to get them back on track, Hollett said. That's no longer the case.

"I'm not sure if it's the cocaine, whether it's the climate of doom and gloom because oil prices are down and there's not as much work … but we are finding people are using more cocaine to obliterate social problems."

In Hollett's office, he's noticed patients skipping multiple appointments, then once their urine is tested, cocaine is detected. 

"So instead of being opiates that they've returned to, they're on Suboxone, that's taken care of, no issue. Now they've gone to cocaine."

The speed with which cocaine leaves a person's system is another reason why it's a drug of choice, especially for offshore oil workers who are subject to random drug tests. 

Report points to rise in opioid hospitalizations

However, the drop in opioid-related deaths doesn't necessarily point to a decrease in those with addictions to painkillers.

A recent report by the Canadian Institute of Health Information indicates Newfoundland and Labrador has some of the highest opioid poisoning hospitalizations in Atlantic Canada.

St. John's is No. 8 on the list of metropolitan Canadian cities with the highest rates of opioid poisoning hospitalizations. According to the CIHI report, 48 people were hospitalized with opioid poisoning in St. John's in 2017.

Hollett said he doesn't know why the province is higher than other jurisdictions.

One of the pieces of data that stands out to Hollett is the average age of people who are ending up in hospital with accidental drug overdoses.

While the rest of the country is seeing the 25-to-45 age bracket grow, this province has a larger number of users in the 50-to-69 range.

"They're going to be at risk of dying, at risk of things happening."

Fewer opioids being prescribed

Meanwhile, the provincial government says a new program has cut down on the number of legal opioid prescriptions.

The Prescription Monitoring Act came into effect Jan. 1, 2018, with the goal of tackling the growing opioid problem.

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All prescribers and dispensers in Newfoundland and Labrador are now required to check their patients' medications profile using the provincial electronic health record, before prescribing and dispensing a monitored drug.

So far, the province has noted a 15 per cent reduction in opioid prescriptions.

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