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The Opioid Crisis Is Mostly Killing Men, New Stats Show

Public health experts aren’t sure why the gender split on Canadian opioid-related deaths grew even wider in 2017.
A man who uses fentanyl shows the potent drug in powder form in a folded-up piece of paper. Photo by the author

Worst-case projections for Canada’s opioid crisis death toll were confirmed this week: Nearly 4,000 opioid-related deaths occurred in 2017, up from about 3,000 the year before. The majority of these deaths—76 percent—were men.

That disproportionate gender split increased from the year before, when men made up 71 percent of opioid-related deaths in Canada.

So why are so many men dying from opioids?

Those on the frontlines say the disproportion in gender lines up with what they’re seeing in their everyday work.

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“Men might be more likely to use on their own—women are typically more likely to use with a partner or in groups,” Nick Boyce of the Toronto Overdose Prevention Society told VICE. “The biggest risk factor for dying from an overdose is that you’re on your own and there’s no one there.”

Boyce explained that men typically use overdose prevention sites and needle exchanges more than women. Men make up about two-thirds of the people using the overdose prevention site at Moss Park in Toronto, he said. Sites like the one at Moss Park allow people to use their own drugs under supervision; those working at sites intervene when overdose symptoms arise, such as by giving the opioid overdose antidote naloxone.

Sarah Blyth, a frontline activist in Vancouver who helped set up overdose prevention sites in the city’s Downtown Eastside, told VICE previously that men using alone could be a factor in why more are dying from opioids in British Columbia.

"Using alone is the thing that's actually killing people,” she said. In 2016, more than 80 percent of overdose deaths in British Columbia were men.

Dr. Hakique Virani, a public health expert and addictions specialist who works in Alberta, one of the provinces most affected by the opioid crisis, said he generally sees more men than women seeking treatment for opioid addiction.

“When we started to offer evening and weekend hours, we saw that those spots were being taken very quickly by men,” Virani explained, “particularly men who were working in semi-skilled trades who wanted to continue to work, but wanted to address this problem that had invaded their lives.”

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Virani said, in terms of public health, when you see such a disparity like this manifesting in the population, though, you must ask questions.

“Are men more likely to use than women? If they use, are they more likely to mix drugs, or use alone?” Virani asks. “Are men more likely to have complicating health conditions or other individual factors that can put them at risk?”

Data from the 2015 Canadian Tobacco, Alcohol and Drugs Survey showed that past-year illicit drug use was about five percent higher amongst men than women.

Another factor that need to be considered, according to Virani, is whether men who work jobs that require drug testing are less likely to seek medical treatment for opioid addiction. He suggests that we need to look at whether men and women experience stigma around drug use differently as well.

Boyce said that “encouraging people to not use alone” is an important harm reduction measure, as well as providing spaces for people to use if necessary.

“We need to encourage all levels of government to support harm reduction measures,” Boyce said.

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