The Yukon and British Columbia experienced the highest rates of apparent opioid-related deaths in Canada last year.

According to a new national report from the federal government, the territory and province had a rate of over 15 deaths per 100,000 population compared to a national rate of 8.8 in 2016.

“I don’t think it’s a surprise,” Dr. Brendan Hanley, the Yukon’s chief medical officer, told the Star of the findings this morning.

He noted that the territory’s high rates are driven by the five deaths officially linked to fentanyl since April 2016.

“Each death is so significant for our community; because we’re small, it tends to hit harder, it tends to affect us all, but the other thing is a small number of deaths can, because of our small population, put us into these high rates.”

An apparent opioid-related death is a death caused by toxicity or poisoning as a result of drug use where one or more of the drugs is an opioid. In 2016, there were 2,458 of these deaths across Canada.

And western Canada experienced the highest rates with the Yukon, B.C., N.W.T. (10 to 14.9) and Alberta (10 to 14.9) all having rates over 10 per 100,000 population.

The report notes that B.C.’s numbers are likely an overestimate, as the province reports on unintentional deaths related to all illicit drugs.

According to the B.C. Ministry of Health, there were 914 illicit drug deaths in the province in 2016, an almost 80 per cent increase over the number of deaths in the previous year (510).

“We can’t think we’re untouched here by opioids and fentanyl,” Hanley said of the Yukon.

Recognizing the issue, the Yukon government hosted the Preventing and Managing Opioid Addiction/Misuse Through Innovative Models of Care conference on May 31 and June 1.

The two-day event included speakers and panels on addiction, non-pharmacological methods of treating pain, substitution therapy, harm reduction, community-based models of care, and current guidelines for opioid prescribing.

“It was really a very rich discussion over two days,” said Hanley.

He noted major takeaways from the conference include the importance of trauma-informed care, recognizing and treating addiction as a relapsing chronic brain disease, managing pain more holistically, and better co-ordination among existing services.

“We do have a lot of services, but they don’t necessarily talk with each other,” he said.

As well, Hanley said, many of the visiting and local speakers helped inform discussions on addressing the issue in the Yukon.

This included Mae Katt, an Ojibway nurse practitioner who pioneered a high school Suboxone program in Thunder Bay.

She spoke about the success of the program that includes wrap-around cultural supports, including land-based programs, elders and grief counseling.

“What that informed us was that Suboxone has tremendous success if it’s done right with the appropriate support,” said Hanley.

“The people you’re treating, they need support, they need social support, they need counselling, they need aftercare.”

He added, “There are probably enormous possibilities for supporting people with addictions better, whether it’s here in Whitehorse or in the rural communities.”

Hanley noted that discussions from the conference will be taken back to the opioid and pain management working group and will help prioritize its actions over the following months.

In related data, the Canadian Institute for Health Information (CIHI) recently released a report which notes the Yukon has nearly three times the national rate of hospitalizations entirely caused by alcohol.

The territory’s rate is 676 per 100,000 population compared to 239 across Canada.

Hanley said addictions often involve multiple substances and that alcohol and opioid misuse are related.

“The determinants of alcoholism and alcohol are very close to opioids,” he said.

He added that the public consequences of alcohol misuse are larger than opioids. This includes chronic liver affects, chronic disease and acute trauma and injuries.

According to the CIHI, government health care spending per person in the Yukon is $8,413, and the cost of a standard stay in an acute care hospital in the territory is $8,094.

Hanley noted that better opioid addiction management and treatment will have a positive effect on alcohol use.