Opioid use can have a devastating effect on users. As the crisis continues to spread across Canada, CIHI data shows that it is affecting even the youngest Canadians.  

Neonatal abstinence syndrome in Canada

Neonatal abstinence syndrome (NAS) refers to the condition of an infant being born with symptoms of drug addiction and withdrawal after being exposed to drugs in utero. While opioids aren’t always the cause of this condition, they are the class of drug associated with the majority of NAS cases.

CIHI data shows that NAS numbers are on the rise. Across Canada (excluding Quebec), the number of babies born with NAS increased 27% over a 4-year period, jumping from 1,450 to 1,850 cases between 2012–2013 and 2016–2017. 

More than half of these cases (988) were reported in Ontario, followed by British Columbia (252) and Alberta (207), reflecting the larger populations of these provinces. Detailed hospitalization data is available for further comprehensive analysis, including comparative rates.

Response to rising number of NAS cases

Far from abating, the crisis is getting worse.

The number of Canadians hospitalized because of opioid poisoning increased 19% between 2014–2015 and 2016–2017, as detailed in CIHI’s Opioid-Related Harms in Canada release. Including the increase in number of babies born with NAS, the opioid crisis has impacted the health systems, requiring more hospital beds, nurses and physicians.

In response to growing NAS numbers, the Canadian Paediatric Society (CPS) released updated guidelines outlining its recommendations on how to treat babies born with NAS. To improve health outcomes, the guidelines recommend keeping mothers and newborns together, and encourage breastfeeding and the use of skin-to-skin contact to manage withdrawal symptoms.  

“Keeping mothers and their infants together has been shown to lower NICU admissions, promote breastfeeding, shorten hospital stays and decrease the need for prescription drugs,” said Dr. Thierry Lacaze, chair of the CPS Fetus and Newborn Committee.

Although not all cases of NAS can be attributed to illicit drug use, the steady rise of illicit opioid use across the country, along with the use of prescription opioids, directly links the opioid crisis to the increase in babies born with NAS.

CIHI’s work on opioids

  • In November 2016, CIHI’s president and CEO David O’Toole signed a joint statement of action committing CIHI to help address the national opioid crisis.
  • CIHI works with the provinces and territories, provincial coroners and medical examiners, partner organizations and other jurisdictions across the country to fill gaps in opioid data, including death statistics that are released each quarter by the Public Health Agency of Canada.
  • In support of the Ontario Ministry of Health and Long-Term Care’s response to the opioid crisis, CIHI is collecting opioid-related emergency department data on a weekly basis. In September 2017, we released our second report on opioid harms in Canada, which includes 2016–2017 data on emergency department visits and hospitalizations due to opioid poisoning.
  • In November 2017, CIHI released a report on pan-Canadian trends in opioid prescribing, which included 5 years of data from community pharmacies.

For more information on CIHI’s ongoing work on the opioid crisis, consult Opioids in Canada on cihi.ca.