Population-Based Stimulant Toxicity Death Rate in Newfoundland and Labrador: A Retrospective Cohort Study

Objective: Substance use is a growing concern in Canada that is characterized by a multitude of contributing factors. Subsequently, there has been a rise in both the harms associated with substance use as well as substance-related acute toxicity deaths. This study will quantify stimulant toxicity deaths in Newfoundland and Labrador. Methods: This study used a retrospective cohort design to characterize the sample of patients who died via stimulant toxicity in NL from January 1st, 2020 to December 31st, 2023. Results: Stimulant-related deaths in Newfoundland and Labrador increased between 2020 (n=10) and 2023 (n=31); this increase is generally in line with national trends. Males consistently surpassed females for all stimulant-related drug toxicity deaths throughout our period of observation by large ratios. Both sexes have seen upward trends in total stimulant-related drug toxicity deaths for each year of observation. Stimulants were frequently used in conjunction with opioids. We were interested in the role of polysubstances within our sample and found that almost half (48.5%) of the substances involved in stimulant-related deaths contained opioids. Conclusion: Significant increases in stimulant-related mortality warrant further study of stimulant use in the country and reinforce the need to identify effective policy solutions. Almost all (96%) stimulant-related deaths reported in NL from 2020-2023 were accidental, further justifying the need for the identification of relevant risk factors and effective initiatives aimed at reducing stimulant misuse.