What can paramedic data tell us about the opioid crisis in Canada?

The nature of Canada's opioid crisis necessitates additional data sources that can provide a more comprehensive picture of the epidemic, in order to provide public health officials and decision-makers with a robust evidence base. Paramedic data provide a conduit into the community where overdoses occur. Prehospital events and circumstances surrounding opioid-related overdoses provide unique opportunities to collect evidence that can contribute to prevention, harm reduction and health promotion efforts. Using data extracted from the Ottawa Paramedic Service (OPS), this proof-of-concept study demonstrated that paramedic response data were useful in providing near real-time epidemiological information (person, time and place) on the opioid epidemic and in assessing trends and opportunities to develop alert triggers. Between January and June 2017, the OPS responded to an average of four opioid-related calls each week. On average, 0.5 mg of naloxone was administered each time. For the study period, linear trends show a small but insignificant increase in calls (p = 0.18). A higher volume of calls occurred between April 16 and 29, 2017. According to local media reports, this spike in paramedic responses was due to the arrival of high-grade fentanyl in Ottawa. With further validation, paramedic data can potentially provide a novel data source to monitor opioid-related overdoses.