Understanding Opioid Use and Harms among First Nations People in Ontario: Integrating Administrative Data with Guidance from Communities

Harms related to opioid use have had devastating and long-lasting impacts on First Nations communities in Ontario, Canada. Yet, information on factors that contribute to these harms is limited and poses a critical barrier for communities who are working to identify evidence-based public health responses. Recent research led by the Chiefs of Ontario (COO) in collaboration with ICES and the Ontario Drug Policy Research Network (ODPRN) found that rates of opioid-related hospitalizations and deaths were up to four times higher among First Nations relative to non-First Nations in Ontario. From this work, the Opioid Surveillance Steering Committee, led by COO and comprised of First Nations community members and Elders, identified several essential research questions to better understand this health crisis. This research program will use databases at ICES to characterize the real-world patterns of opioid use and related harm, pathways of healthcare use, and treatment outcomes among First Nations people broadly, and in the context of the COVID-19 pandemic. Further, it will bring together community and research expertise through joint leadership by COO and the ODPRN. This will also support meaningful community engagement, direct liaisons between the research team and communities, and broad dissemination of research products tailored to various stakeholders at the community and policy-level. Rates of opioid-related harm in Ontario are among the highest in the country and First Nations people are disproportionately experiencing these effects. This program of research will provide First Nations communities with an understanding of the current state of the opioid crisis in their communities, how this is being impacted by the COVID-19 pandemic, and will identify opportunities for an evidence-based approach to public health and policy development with broad implications across Canada.