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Mental Health and Addictions

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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.

  1. 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.
  2. 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

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%).


Demographics

  • Under Construction


By RHA

  • Under Construction



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



Government of Manitoba