How has the pandemic affected people who use the potentially deadly street drug fentanyl and those who treat them?

A research project by University of Windsor social work professor Adrian Guta will delve into this question, shedding light on the wider impact the pandemic has had on Canadian society.

“In the context of the pandemic, there’s been a lot of change in how we’re responding to opioid addiction and the drug crisis,” Dr. Guta said. “We know the pandemic has complicated access to care and treatment.”

Guta, together with University of Toronto researcher Carol Strike, has been awarded a grant of nearly $322,000 from the Canadian Institutes of Health Research to study how the COVD-19 pandemic and the nationwide epidemic of overdoses are changing addictions medicine. UWindsor postdoctoral fellow Katherine Rudzinski and five other researchers will also work on the project.

Guta said the team will interview clinicians and clients in Hamilton, a city with long history of addiction treatment options. One of the hardest-hit communities when it comes to the opioid epidemic, Hamilton is also where Guta and Strike have existing relationships with physicians and nurse practitioners who work daily with people who use drugs.

The findings can be applied to other cities across Canada grappling with overdoses.

The Public Health Agency of Canada reports there was a 95 per cent increase in the number of opioid deaths during the first year of the pandemic, with deaths remaining high since. According to the latest statistics available, there were 5,368 deaths related to opioid drug overdoses between January and September 2021, about 20 per day.

“A number of factors may have contributed to the worsening of the overdose crisis over the course of the pandemic, including the increasingly toxic drug supply, increased feelings of isolation, stress and anxiety, and changes in the availability or accessibility of services for people who use drugs,” the agency says.

The pandemic triggered a perfect storm that led to the epidemic of overdoses, Guta explained.

The introduction of fentanyl and its more powerful cousin, carfentanyl, into the street supply of drugs has increased the risk of overdose due to the variability of potency. And often, fentanyl is the only opioid available on the streets. The COVID-19 pandemic appears to have exacerbated use and dependency, causing stress on existing treatment programs.

Guta and his research team will weigh the effectiveness of various treatment programs. These include opioid replacement treatment using methadone and suboxone, and a more novel treatment that involves prescribing safer forms of opioids like hydromophone and slow-release morphine.

Previous research by Guta and Strike that included reviewing literature and consulting professionals who work in the realm of drug treatment suggests there is a “considerable evidence gap in respect to how best to provide care to people who use fentanyl,” Guta said.

The researchers aim to interview people who use fentanyl and those who offer drug treatment. They hope to discover what changes clinicians had to make to their treatment programs during the pandemic and what impact those adaptations had.

“The reality is we are losing people to overdose,” Guta said. “We need to find ways to keep people alive.”

—Sarah Sacheli