Alberta drug deaths underreported by 25 per cent: researcher

Alberta’s public substance use surveillance system is significantly under-reporting drug-related deaths, and the gap in data was particularly bad in 2023, according to a prominent Canadian researcher.

Since the beginning of the pandemic, Dr. Tara Moriarty, associate professor and infectious diseases researcher at the University of Toronto, has been tracking excess mortality statistics to estimate the number of Canadians who died from COVID. First as part of the Royal Society of Canada’s COVID-19 Task Force and through ongoing research with the Moriarty Lab at U of T, Moriarty looks to data from Statistics Canada, the Canadian Vital Statistics Death Database (CVSD), and the Public Health Agency of Canada (PHAC) to assess fatalities.

In the course of their work, Moriarty said her team is also indirectly monitoring for drug-related deaths, because they want to know how many people in the same age brackets are dying from drug poisoning compared to the number that may be dying from COVID.

Because they do this on a regular basis, the researchers can track how provinces are reporting drug poisoning deaths by comparing public data on provincial websites to what is reported to PHAC. The discrepancy between Alberta’s public death statistics and PHAC data stands out, and reporting seemed to have lagged more than usual in 2023, Moriarty said.

“The reason for concern about Alberta’s death reporting is that we are able to account for a lot more of the excess deaths that have happened in B.C. … by reported toxic drug deaths than we are in Alberta. In 2023 reporting seems to be particularly slow in Alberta, and a lot of those numbers are just not coming in,” she said.

“Even though we know that in Alberta and B.C., per capita number of excess deaths of people under 65 are very similar. So, B.C. and Alberta are almost certainly experiencing very similar COVID and drug crises in terms of excess deaths, but we’re not seeing as much reporting in Alberta.”

The province has acknowledged that there can be some delays in reporting cases as they come in, but Moriarty said that even going back to data from 2016–2019, reporting is incomplete.

“For those years Alberta, only, on average, 74 per cent of drug deaths that showed up in the CVSD were reported on public pages by Alberta and to PHAC,” she said.

Moriarty said that there are many reasons some cases could be missed and never get added to public-facing databases but noted that B.C., during the same period, publicly reported 90 per cent of drug-related deaths.

Alberta’s substance use surveillance system data is produced in collaboration with the office of the chief medical examiner (OCME), Alberta Health, Mental Health and Addiction, and Alberta Health Services. In a statement released in July, Chief Medical Examiner Dr. Akmal Coetzee-Khan acknowledged the province was facing a backlog of cases, but said this “does not impact the validity of data published” on the province’s data portal.

“To ensure accuracy, data is carefully reviewed and approved within the OCME to avoid inconsistent information being released to Albertans.”

A spokesperson for the Ministry of Mental Health and Addiction did not respond to detailed questions about the under-reporting of drug-related deaths identified by Dr. Moriarty, only saying in an email that the previous statement made by Coetzee-Khan still stands.

Moriarty said that reporting on other causes of death, like COVID, are also delayed. And while the province may be grappling with a generalized lag in submitting death data, more resources could be dedicated to those caused by ongoing public health crises.

“The seriousness of the current problems with COVID-19 and toxic drugs mean that reporting of those deaths, if anything, should be prioritized. Because these are ongoing epidemics that we need to try to address and that the general public needs to understand are still major ongoing issues,” she said.

In 2023, 2081 Albertans died from drug poisoning, the worst year on record. Only preliminary data for the first six months of 2024 have been released, showing 712 deaths.

Petra Schulz, co-founder of the advocacy group Moms Stop the Harm, said she has come to expect Alberta’s drug-poisoning death statistics are lacking, and emphasized that these gaps in reporting represent hundreds of Albertans and their families.

“And to see such a such a horrific year becoming even worse than it is already is, to me, is a heartbreak. But also, a sign of an absolute failure on the part of the government to address the crisis before them,” Schulz said.

Schulz said a more accurate and timely record of substance use related data helps inform appropriate responses from health care and service providers, but doubts there is any real motivation within the Alberta government to improve death reporting.

“I think they’re hiding the data because the data doesn’t look good for them,” Schultz said, noting that in 2020 the province stopped sharing neighbourhood-level data for Edmonton and Calgary. The province said it stopped releasing this information to protect privacy and prevent stigmatization.

“A health response to public health crises, may it be COVID or the drug poisoning crisis, is impossible if those who are at the front lines of responding don’t have the data. And it is government’s responsibility to provide that data.”

Hunter Baril, press secretary for Alberta’s Ministry of Mental Health and Addiction, issued the following statement after this story was originally published:

“After reviewing the data referenced by Dr. Moriarty on twitter and in this article, there is no logical way to understand what she is claiming. It seems that she is speculating at best. We can’t comment on speculation of this nature, given it’s not based in fact,” Baril said.

Baril said the ministry compared the data published on the Alberta Substance Use Surveillance System with the number of total apparent opioid toxicity deaths in Alberta on PHAC, and found only very small differences between 1-6 fatalities per year over the last 5 years, with any higher reporting being done on Alberta’s system.

“Alberta publishes regularly and transparently on fatalities related to opioid addiction by regularly reporting valid data from the Office of the Chief Medical Examiner in Alberta. The toxicology data from the OCME is the point of truth for opioid related fatalities in Alberta. All opioid related fatalities are published publicly.”