Acknowledgements
We acknowledge our office is located on Treaty 1 Territory and that
Manitoba is located on the Treaty Territories and ancestral lands of the
Anishinaabeg, Anishininewuk, Dakota Oyate, Denesuline and Nehethowuk
Nations.
We acknowledge Manitoba is located on the Homeland of the Red River
Métis.
We acknowledge northern Manitoba includes lands that were and are the
ancestral lands of the Inuit.
We respect the spirit and intent of Treaties and Treaty Making and
remain committed to working in partnership with First Nations, Inuit and
Métis people in the spirit of truth, reconciliation and
collaboration.
Introduction
This interactive report, provides up to date information on substance
use and related harms in Manitoba. Four key data sources and
corresponding metrics are displayed, which are used in the ongoing
surveillance of substance related harms. This dashboard will be updated
mid-month, each quarter (Jan, Apr, Jul, Oct), and will include
information up to the end of the previous quarter, if available.
These four data sources include:
Office of the Chief Medical Examiner (OCME).
- The OCME is the data source for substance related deaths. In effort
to provide timely information these deaths are assessed prior to the
completion of a finalized autopsy, and are therefore subject to change
as more information becomes available.
Hospital Data - Two Sources.
- Discharge Abstracts Database (DAD), is the source for all substance
related in-patient admissions. These are identified as patients who have
had at least one substance related discharge diagnosis. The availability
of this data source can be 3-6 months behind as it undergoes additional
validation before being released.
- Emergency Department Information System (EDIS), is the source for
all substance related emergency department (ED) visits. These are
identified as either having a substance related discharge diagnosis, or
by a keyword search in the ED visit reason field. This data source is up
to date on an ongoing basis. This data set however, does not fully cover
all ED’s within Manitoba. Only ED’s that are connected to EDIS are
included, which means some smaller rural ED’s are left out from this
source.
Emergency Medical Services (EMS) - Winnipeg Fire and
Paramedic Service (WFPS) Data
- Substance related calls, and incidents where Narcan/Naloxone has
been administered is identified in the City of Winnipeg data sets:
- These data sets are up to date on an ongoing basis. Note that this
data only includes EMS incidents responded to by WFPS personnel (within
the city of Winnipeg).
Take-Home Naloxone (THN) Kit distribution data
- Data is obtained in the Public Health Information Monitoring System
(PHIMS), which tracks the distribution of take-home naloxone kits to
their distribution sites throughout the Province. This data source is up
to date on an ongoing basis.
Provincial Overview
*Substance related death data is subject to change as more
information becomes available. This may mean that the most recent data
may be underrepresented.
Quarters are defined by calendar quarters. I.e. Q1: Jan - Mar, Q2:
Apr - Jun, Q3: Jul - Sep, Q4: Oct - Dec.
Deaths
Over Time
- Definition: Substance related deaths are deaths due
entirely, or at least in part, to the toxic effects of one or more
substances, including alcohols. A death is considered “opioid-related”
if at least one of the substances contributing to causing death is an
opioid. It is important to note that deaths due to the effects of
chronic substance abuse, or deaths due to other causes where substance
intoxication may have circumstantially contributed (i.e., drunk driving,
hypothermia, drownings), are excluded from this case definition.
By Substance
- The vast majority of substance related deaths have occurred with
multiple substances being present. Substances are generally taken
together, with stimulant substances (essentially methamphetamines and
cocaine) being associated with three quarters (55, 76.4%) of the 72
substance-related deaths in the months of August and September, 2023.
Opioids (predominantly fentanyl and para-fluorofentanyl, P-FF) came a
close second, accounting for 50 (69.4%) of the deaths. Bromazolam, the
major benzodiazepine implicated, was associated with about half of the
deaths (34, 47.2%).
Hospitalizations / ED Presentations
In-Patient Admissions
- Please see glossary for definition of categories.
Emergency Department Presentations
- Please see glossary for definition of categories.
- Categories are defined by the ED discharge diagnosis provided in
EDIS.
- Note that a discharge diagnosis is not always provided, and thus
this may be an under representation of the actual number within each
category. The total however, includes all identified substance related
presentations, whether a diagnosis code was provided or not.
- ED overdose presentations are identified in EDIS using a keyword
search in the ED chief complaint field.
WFPS Attended Events
Over Time
- Categories are defined by WFPS, as the main cause for the need for
WFPS personnel to attend an event.
- Suspected opioid overdose events are WFPS attended events where
Naloxone/Narcan was administered.
Demographics
- For October 2023 to December 2023 inclusive.
- Displayed as a rate per 100,000 Winnipeg residents.
By Neighbourhood Cluster
- For October 2023 to December 2023 inclusive.
- Displayed as a rate per 100,000 residents.
- Geo-coded as the neighbourhood cluster that the event was responded
to at. Not necessarily the neighbourhood cluster of residence for the
person being responded to.
Take-Home Naloxone Distribution
Note that holding points are not necessarily the final point of
distribution of the take-home naloxone kits. Also, a person from one RHA
may obtain a kit from another RHA, so is not a fully accurate picture of
where each take-home naloxone kit is eventually kept and/or used.
Glossary
Abbreviations
DAD: Discharge Abstracts Database
ED: Emergency Department
EDIS: Emergency Department Information System
EMS: Emergency Medical Services
OCME: Office of the Chief Medical Examiner
PHIMS: Public Health Information Monitoring System
Q1-Q4: Quarters one through four, as defined by calendar quarters.
I.e. Q1: Jan - Mar, Q2: Apr - Jun, Q3: Jul - Sep, Q4: Oct - Dec.
THN: Take-Home Naloxone
WFPS: Winnipeg Fire and Paramedic Service
Diagnosis Codes
Hospital and ED related substance diagnoses are categorized using the
International Classification of Diseases 10th revision (ICD-10)
diagnoses codes. These are:
- Alcohol:
- F10.1 - F10.9: Alcohol related disorders
- T51.0-T51.9: Toxic effect of alcohol
- X45.0-X45.9: Accidental poisoning by and exposure to alcohol
- X65.0-X65.0: Intentional self-poisoning by and exposure to
alcohol
- Y15.0-Y15.9: Poisoning by and exposure to alcohol, undetermined
intent
- Cocaine:
- F14.0-F14.9: Cocaine related disorders
- T40.5: Poisoning by cocaine
- Opioids:
- F11.1-F11.9: Opioid abuse/dependence
- T40.0: Poisoning by opium
- T40.1: Poisoning by heroin
- T40.2: Poisoning by other opioids
- T40.3: Poisoning by methadone
- T40.3: Poisoning by other narcotics
- T40.4: Poisoning by synthetic narcotics
- T40.6: Poisoning by unspecified narcotics
- Other Depressants:
- F13.10-F13.19: Sedative, hypnotic, or anxiolytic related
disorders
- T42.3: Poisoning by barbiturates
- T42.4: Poisoning by benzodiazepines
- T42.6: Poisoning by other antiepileptic and sedative-hypnotic
drugs
- T42.7: Poisoning by antiepileptic and sedative-hypnotic drugs,
unspecified.
- Other Stimulants:
- F15.1-F15.9: Other stimulant related disorders
- T43.6: Poisoning by psychostimulants