Using health service data to understand unregulated toxic drug deaths in Alberta (2018-2023): an ecological study

Ten years into the most acute phase of the toxic drug crisis in Canada, trends in drug-related deaths remain poorly understood. This is hindered by delayed reporting of drug deaths in some provinces, including Alberta. We used publicly available emergency medical services (EMS) and supervised consumption site (SCS) utilization data to examine their associations with drug poisoning deaths to assess if these measures could serve as reliable proxies for fatalities to support evidence-based public health responses.

Data on Alberta-wide EMS dispatches for opioid poisoning, Alberta-wide drug deaths, and SCS drug poisoning events at the SCS in Calgary from January 2018 to March 2023 were analyzed. We used linear regression modelling to investigate the association between EMS dispatches and drug deaths (by month) and between SCS drug poisoning events and drug deaths (by month).

Significant associations were found between drug-related deaths in Alberta and both the number of EMS dispatches (β = .06, 95% CI: 0.05-0.06) and SCS drug poisoning events (β = .73, 95% CI: 0.57-0.88), suggesting these measures mirror drug-related deaths in the province. Inverse associations were also found between drug-related deaths and SCS visits as well as visits in which drugs were consumed.

Drug poisoning events recorded in EMS or SCS data may serve as a proxy for understanding trends in drug deaths. These alternative data are often publicly available and may help inform public health response to periods of increased death risk when official death data are delayed or unavailable.