Polysubstance toxicity deaths in Newfoundland and Labrador: a retrospective study

The present study examined the prevalence of polysubstance toxicity deaths in Newfoundland and Labrador between 2018 and 2023, describing sociodemographics of decedents and the most common substances contributing to death.

Death investigation data from the Office of the Chief Medical Examiner pertaining to polysubstance toxicity was obtained. Polysubstance toxicity deaths were defined as drug toxicity deaths in which substances from more than one drug class contributed to death. Trends in sociodemographics and substance combinations were quantitatively summarized.

313 individuals died from drug toxicity in the province between 2018 and 2023. Most deaths (n = 185, 59%) were determined to be caused by polysubstance toxicity. Polysubstance deaths increased 46% from 26 in 2018 to 38 in 2023. Most deaths were accidental in manner and the proportion of yearly accidental deaths increased sharply through the study period from 69% in 2018 to 89% in 2023. Male decedents outnumbered female decedents across the study period except for 1 year (2022), and young people (< 40 years old) had the highest death rate in the most recent study year. Cocaine was the most prevalent substance in toxicology reports and the combination of stimulants-opioids was the most prevalent drug class combination, followed by benzodiazepines-opioids and sedatives-opioids.

Polysubstance toxicity is rising in Newfoundland and Labrador in recent years and our findings provide important information about sociodemographics and substance combinations to policymakers to aid in addressing this public health issue.