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Résumé (anglais)

BACKGROUND. Two major health emergencies have plagued Canada over the past few years: the COVID-19 pandemic and the drug overdose epidemic. Unfortunately, the drug overdose epidemic has worsened during the COVID-19 pandemic, with increased use being reported across all provinces and territories, despite a decrease in quality and accessibility of psychoactive substances and an increase in substance cost (Ali et al., 2021; CIHI, 2021). Rural communities have also been disproportionately impacted by both crises due to geographical isolation and limited health resources. These issues have led to the possible association between the COVID-19 pandemic and the drug overdose epidemic through an uptake in public health restrictions, deviation of health care resources, international border closures, and closures of substance use treatment centers (Henderson et al., 2021; Khatri & Perrone, 2020; Palis et al., 2021)._x000D_
OBJECTIVES. The primary goal of this study was to determine whether psychoactive drug-related deaths had increased during the COVID-19 pandemic, with a special focus placed on Canadian rural and remote communities. A secondary goal was to determine whether population characteristics of psychoactive drug-related deaths had changed among the overall Canadian, urban, and rural populations. By outlining the various population characteristics associated with these deaths, one can identify specific populations and risk factors when attempting to mitigate this problem._x000D_
METHODS. This retrospective cross-sectional study utilized data from the Canadian Vital Statistics Death Database (CVSD). The sample population extracted from this database consisted of all individuals aged 15 and above who died due to a confirmed psychoactive substance overdose in the ten Canadian provinces between 2000 and 2021. A death caused by psychoactive substances was indicated by a corresponding ICD-10 code present in the CVSD database (e.g., T40, T42, and T43 series’) (WHO, 1992). Due to data limitations, British Columbia cases were constricted to 2000-2017, so it was not included in pandemic-related analyses. Analyses such as cause-specific mortality rates, chi-square tests of independence, and unadjusted odds ratios were used to answer the above objectives._x000D_
RESULTS. Those living in remote and very remote locations saw substantial increases in cause-specific mortality rates between March 2020 and 2021, but no significant association was found. These locations also had higher cause-specific mortality rates compared to those living in more accessible (urban) locations. When population characteristics were examined overall, and in more accessible locations, significant associations between pre-COVID-19 and COVID-19 time periods were found for sex, age groups, marital status, death cause, type of drug used, and death locality. Population characteristics of rural individuals only yielded significance for the type of drug used._x000D_
CONCLUSION. Regardless of rurality, this study found significant associations demonstrating that being male, being between 30-59 years old, and being single were risk factors for psychoactive substance-related deaths during the COVID-19 pandemic. Additionally, individuals were much more likely to die by an accidental overdose in their private homes during this period. They were also more likely to die due to a mixture of substances, especially when the mixture included narcotic analgesics.