Levels of morphine and methadone in Metro Vancouver’s wastewater are the highest in Canada

Levels of codeine in sewage have plummeted, possibly due to canceled surgeries and people not catching colds or the flu due to pandemic masking and physical distancing restrictions.

Levels of morphine and methadone in Metro Vancouver’s wastewater were the highest in Canada in 2019 and 2020, reflecting high crime rates and heroin use, according to a recent Statistics Canada report .

However, BC sewage codeine levels dropped in 2020, possibly due to the cancellation of surgeries during the pandemic and changes to BC drug regulations. .

The study indicates that morphine is produced as a metabolite when the human body consumes heroin and ends up in sewage.

And, for 2020, show police-reported crime for select drug offense statistics, British Columbia had the highest rate of heroin offenses at 1,240. The second highest province was Ontario with 883.

Fentanyl loads were also highest in Metro Vancouver.

The report says it’s possible the two are linked because methadone is used as a treatment for opioid addiction, including fentanyl addiction.

Department of Health spokesman Thomas Hunt, however, said the data he has cannot be used to validate Statistics Canada data.

“The Ministry of Health has data on community pharmacies dispensing prescription drugs, including those containing codeine, methadone and morphine. However, the data does not account for different dosages or amounts of drugs dispensed,” Hunt said.

The agency’s Canadian Wastewater Survey has been regularly testing water in Metro Vancouver, Halifax, Montreal, Toronto and Edmonton since March 2019.

Codeine level

With pandemic public health restrictions, including physical distancing and the wearing of masks, less use of cold medicines containing codeine may also have contributed to the decline, as people did not catch colds or flu from each other, the report said.

In British Columbia, the Board of Trustees of the College of Pharmacists of British Columbia redesignated certain prescriptions containing codeine in January 2020 to require a duplicate prescription form, designed to prevent counterfeits.

The study found that codeine levels in wastewater were generally lower from March to August 2020 compared to the previous year.

Additionally, cancellations of surgeries during the pandemic could have been less, as these cancellations may have reduced prescriptions for postoperative medications, including opioid painkillers.

The Canadian Institute for Health Information estimated that from March to June 2021, there were 560,000 fewer surgeries nationwide compared to the pre-pandemic period of January to December 2019.

The Public Health Agency of Canada’s September 2021 FluWatch report noted that lab-confirmed influenza was plummeting from 55,378 cases in the 2019-20 flu season to 69 in 2020-21.

“It could also have led to a decline in the use of cold and flu medicines containing codeine, also influencing the levels of codeine detected in wastewater,” the report said.

Researchers can track this drug data because the metabolites produced by the body when a drug is broken down enter the waste system. And this is generally expected to reflect the overall amount of drugs consumed by the population of a geographic area.

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