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Health

Opioid-related death count up to more than 11,500 nationally: government data

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OTTAWA — Canada’s opioid crisis claimed the lives of more than 11,500 people between January 2016 and December 2018, the Public Health Agency of Canada reported Thursday.

New data shows that 4,460 people died in 2018 alone and many of these deaths were related to the contamination of the illegal drug supply, the agency said.

The federal health agency said an analysis of national trends suggests there was a significant increase in death rates between January 2016 and June 2017, noting the rates then stayed high from July 2017 to December 2018.

It also said Western Canada remains the most affected region of the country.

The epidemic remains the most challenging public-health crisis in decades, said the co-chairs of federal government’s advisory committee on the epidemic of opioid overdoses, chief public-health officer Dr. Theresa Tam and Saskatchewan chief medical-health officer Dr. Saqib Shahab.

Fentanyl and other fentanyl-related substances continue to be a major driver of the crisis, they added.

Fentanyl is an opioid more potent than heroin or morphine, often cut with fillers and then passed off as its less-powerful cousins because it’s easier to transport and hide. People who use illegal drugs often can’t know exactly what they’ve bought and a tiny excess dose can be fatal.

“There is still much work to be done to abate the opioid crisis, and Canadians can be assured that addressing it remains our priority,” Tam and Shahab said in a joint statement.

Numbers on opioid overdoses take a long time to extract from sources like hospital records because they aren’t always tracked in easily comparable ways and people who suffer them often have other serious health problems. It’s only now, almost halfway into 2019, that the public-health agency has been able to compile figures through to the end of last year.

Even so, the 11,577 deaths since January 2016 are qualified as “apparent opioid-related overdoses.” According to the health agency, most of the people who have died also had other potentially harmful substances in their systems, such as alcohol, cocaine or methamphetamines.

As the death toll climbs, the federal government has faced pressure from health advocates to allow for a safe supply of opioids to be made available to people suffering from addiction so they do not have to turn to a toxic street supply.

There has also been a push to decriminalize simple possession, including by Liberal MP Nathaniel Erskine-Smith, who is putting forward a private member’s bill proposing the removal of penalties for simple possession of drugs from the Controlled Drugs and Substances Act.

Earlier this week, the House of Commons health committee issued a report urging the federal government to look at Portugal’s decriminalization of simple possession and examine how the idea could be “positively applied in Canada.”

It made the recommendation, among others, in a report produced after committee members travelled across Canada to witness the impacts of methamphetamine use.

Witnesses who appeared before the committee called for the federal government to work with provinces, territories, municipalities, Indigenous communities and law-enforcement agencies to decriminalize simple possession of small quantities of illicit substances, the report said.

The Conservatives on the health committee issued a dissenting report saying that several other things need to be done before decriminalization, pointing out a number of differences between Canada and Portugal. They say Canada needs better drug-treatment programs and more public education about drugs.

Kristy Kirkup, The Canadian Press


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Health

Food fight: Liberals, Tories trade shots as pre-campaign battles intensify

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liberals, tories, trade shots

OTTAWA — Health Minister Ginette Petitpas Taylor is trying to distinguish the Liberals as a party of scientific, evidence-based policy while she says Conservative Leader Andrew Scheer is spreading misinformation about Canada’s new food guide.

Petitpas Taylor held a news conference in Ottawa today, along with her colleague Marco Mendicino, to say the Conservatives are willing to throw away research and evidence underpinning the creation of the new dietary guide.

In January, Health Canada released an overhauled document that did away with traditional food groups and portion sizes and focused instead on broader guidelines, including eating more plant-based protein and drinking more water.

Last Wednesday, Scheer told an annual gathering of the Dairy Farmers of Canada in Saskatoon that the process to craft the new version of the document was “flawed” and that the guide needs to reflect what “science tells us.”

He also pledged that a Conservative government would “absolutely” review the guide, adding there was a “complete lack of consultation” on the new version.

Petitpas Taylor’s news conference followed an appearance by the Conservatives’ Pierre Poilievre, attacking the Liberals for bringing back Gerald Butts as a campaign adviser following his resignation in the SNC-Lavalin affair last winter.

The Canadian Press

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Environment

Lyme-spreading ticks so common thanks to mild winters, some places stop testing

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Lyme infected ticks becoming common in Canada

OTTAWA — Lyme disease has settled so deeply into parts of Canada many public health units now just assume if you get bitten by a tick, you should be treated for Lyme disease.

In Ottawa, where more than two-thirds of the ticks tested in some neighbourhoods carry the bacteria that causes Lyme disease, the public-health unit no longer bothers to test ticks at all.

Dr. Vera Etches, the unit’s top doctor, said that in 2016 and 2017 more than one-fifth of black-legged ticks tested in Ottawa came back positive for Lyme.

“That’s a threshold,” she said. “Once you know that more than 20 per cent of the ticks in your area carry Lyme disease bacteria then we don’t need to check in on that. That is what we now call an ‘at-risk area.’ “

That means if a tick is found on a person, and is believed to have been there for more than 24 hours, then the patient should get antibiotics to prevent Lyme infection, even without any testing of the tick. It takes 24 hours before bacteria in the tick’s gut move to its salivary glands and are transferred to a person.

After three days, the preventive treatment won’t work so patients then wait for symptoms or enough time for antibodies to evolve to show up on a test. It can take more than a month before symptoms appear. They’re mostly similar to the effects of influenza, including fever and aches, as well as — usually but not always — a rash. It typically takes just about as long for the immune system’s antibodies to show up on a lab test.

If left untreated, Lyme disease can cause serious illnesses such as meningitis, but Etches is quick to point out that because it is caused by a bacteria, it’s treatable with drugs.

“It’s a good-news story, actually, that there is antibiotics that work to treat Lyme disease,” she said.

Most public-health offices in Canada used to test ticks submitted by the public, as well as conducting their own surveillance by actively seeking out tick populations and testing them. Some, including Ottawa’s, have decided now that Lyme is endemic, they should shift to public education and prevention as well as treatment.

Lyme disease was named after the town of Lyme, Conn., where the first case was diagnosed in 1975. It is caused by bacteria that are traded back and forth among black-legged ticks and migratory birds and small mammals like mice and chipmunks. Ticks bite birds and small mammals infected with the bacteria and get infected and then spread the disease when they bite their next victims.

Before 10 years ago, most of the cases diagnosed in Canada were in people bitten by ticks while travelling in the United States. But climate change has led to southern Canada seeing milder winters, which means the ticks that migrate to Canada on the backs of migratory birds are now surviving the winter in larger numbers, spreading the Lyme-causing bacteria more rapidly.

Canada started keeping track of Lyme disease cases in 2009, when 144 cases were confirmed or considered probable. Only 79 of those cases were believed to have been contracted in Canada.

In 2017, more than 1,400 cases were confirmed or probable across the country, more than two-thirds of them in Ontario and most of them believed to have been contracted locally.

National statistics for 2018 are not yet available but in Ontario, the number actually fell significantly, from 967 in 2017 to 612 in 2018. Etches said that was because 2018 was hotter and drier than 2017, and ticks thrive in wet, cool weather.

A 2014 study by the National Collaborating Centre for Infectious Diseases at the University of Manitoba suggested the Lyme-carrying ticks are expanding their territory by about 46 km a year, an expectation being borne out in health units’ mapping

In 2017 and 2018, Point Pelee National Park near Windsor, Ont., was considered to be an at-risk region but the rest of Windsor-Essex County in Ontario’s southernmost tip was not. In 2019, almost all of the county has been added as an at-risk area.

In 2017 all of Nova Scotia was declared to be at risk for Lyme Disease.

In New Brunswick, six of 15 counties were declared at-risk as of 2018.

There are also at-risk areas for Lyme in southern Manitoba, northwestern Ontario, British Columbia and Quebec. While some cases of Lyme have been found in the other four provinces, the numbers are very low and mostly contracted elsewhere.

Mia Rabson, The Canadian Press

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