An investigation of demographic and drug-use patterns in fentanyl and carfentanil deaths in Ontario

The opioid epidemic in Ontario has seen opioid-related deaths double in recent years, from 676 deaths in 2014 to 1,474 in 2018, with an overwhelming prevalence of fentanyl and fentanyl-analogues, such as carfentanil. The presence of drug paraphernalia and a history of drug-use is often a strong indicator of a drug-related death, indicating a need for toxicological analysis. Demographic and drug-related patterns associated with opioid deaths in Ontario from June 2017 to December 2018 (n = 2403) were investigated using data collected from the Coroner’s Opioid Investigative Aid (OIA). This work aims to provide insight on how the opioid epidemic affects certain demographics to aid investigators conduct targeted analyses and help public health officials identify vulnerable communities. Chi-square and logistic regressions were conducted to evaluate if age and sex were predictors for the presence of drug paraphernalia, and if drug paraphernalia, sex, age, or history of drug use were associated with causes of deaths (COD). Chi-square analysis revealed that sex (p < 0.001), the presence of drug-use history (p < 0.001), and the presence of drug paraphernalia at the scene of death (p < 0.001) were significantly associated with CODs. Sex was also significantly associated with the presence of drug paraphernalia (p < 0.001). Logistic regression analysis indicated that age (p < 0.001) influenced the probability of opioid-related deaths. Probability models relating age to various opioid-related CODs were also generated. These results demonstrated that fentanyl-related deaths are more associated with males, younger individuals, individuals with a history or drug-use, and the presence of drug paraphernalia.