Simcoe Muskoka Opioid Overdose Cohort (SMOOC)

Detailed information for 2018

Status:

Active

Frequency:

One Time

Record number:

5361

The Simcoe Muskoka Opioid Overdose Cohort (SMOOC) is an expansion of a pilot project that had previously been conducted with the province of British Columbia to better understand the characteristics of people who experienced an opioid overdose. The objective of the SMOOC was to create a cohort of individuals who experienced a fatal or non-fatal overdose in the Simcoe Muskoka area between January 2018 and December 2019.

Data release - July 15, 2021

Description

Increases to opioid-related mortality and morbidity in Canada have persisted for more than a decade and continue to represent a national public health crisis, with the Simcoe Muskoka region of Ontario being particularly impacted by this crisis. Therefore, the objective of the Simcoe Muskoka Opioid Overdose Cohort (SMOOC) was to create a cohort of individuals who experienced a fatal or non-fatal overdose in the Simcoe Muskoka area between January 2018 and December 2019.

The data were collected by the Centre for Social Data Insights and Innovation in collaboration with other partnering agencies. The SMOOC is made up of administrative databases provided by partnering agencies in Ontario and those held at Statistics Canada. Specifically, the SMOOC combines records of overdoses through its partnerships with the Simcoe County Paramedic Services, selected police services from the region, the Canadian Institute for Health Information (hospitalizations from the Discharge Abstract Database and emergency department visits from the National Ambulatory Care Reporting System), and the Canadian Coroner and Medical Examiner Database (Ontario, unnatural deaths having closed investigations). The cohort can then be linked to other Statistics Canada data holdings, in order to identify which public and private systems people made contact with prior to the overdose. The system touchpoints include, but are not limited to: emergency department visits, hospitalizations, receipt of social assistance, employment, contact with police as an accused of a crime, and contact with the criminal courts. Cohort creation and data linkage was conducted within Statistics Canada's secure Social Data Linkage Environment.

The SMOOC will serve to address an important gap in existing knowledge, not only providing the number of overdoses that occurred as a result of opioids, but provide a greater understanding of the various socio-economic and health-related factors of those individuals who experienced an opioid overdose.

This data will be useful for researchers, policy makers and front-line workers in all levels of government, as they develop evidence-based recommendations and interventions aimed at improving the response to the opioid crisis and potentially saving lives.

Reference period: 2018 to 2019

Collection period: September 2020 to February 2021

Data sources and methodology

Target population

Individuals who experienced an opioid overdose (fatal or non-fatal) in the Simcoe Muskoka region within January 1, 2018 through December 31, 2019 and were captured by formal interactions with police, paramedics, coroners, and/or some types of health care services.

Instrument design

Not applicable.

Sampling

This survey is a census with a cross-sectional design.

Data sources

Data collection for this reference period: 2020-09-01 to 2021-02-28

Data are extracted from administrative files.

The Centre for Social Data Insights and Innovation (CSDII) first completed all required steps of the data acquisition process. Once approval for data acquisition was granted, the CSDII sent out official requests for microdata via e-mail to each of the participating partners between September 2020 and February 2021.

Information relating to opioid overdoses in the region were requested. Data were submitted electronically via Statistics Canada's secure electronic file transfer (EFT) site. Additional support files and documentation such as reporting manuals and code books were also provided to the CSDII.

Follow-up was conducted via e-mail and/or telephone.

The administrative data were obtained from various databases housed in one of the following organizations: County of Simcoe (Paramedic Services), the Ontario Provincial Police, South Simcoe Police Service, Barrie Police Service and Rama Police Service. In addition, three separate data holdings at Statistics Canada were also included in the creation of the Simcoe Muskoka Opioid Overdose Cohort: the Discharge Abstract Database, the National Ambulatory Care Reporting System, and the Canadian Coroner and Medical Examiner Database.

External data were obtained by following all processes under the 'Directive on Obtaining Administrative Data under the Statistics Act'. It is intended that the data will be used by researchers, as well as first responders and policy makers at the municipal and provincial levels in supporting the development of evidence-informed interventions, precision programming and policies aimed at preventing future overdoses and potentially saving lives.

Upon receipt of the data, the technical lead for the project read in the files received, and then standardized all variables by defining standard formats and/or parsing detailed information into new individual variables. Standardized files then underwent internal and external linkage. Once the linkages were complete, a Senior Social Researcher then used these files to construct the overdose cohort by integrating the administrative data files.

One of the objectives of creating a study cohort of individuals who experienced an opioid overdose was to then link it to other data holdings at Statistics Canada via the Social Data Linkage Environment to better understand system touch points prior to the overdose. To date, the cohort has been integrated with the following databases: Census of Population, National Household Survey, T1 Family File, National Ambulatory Care Reporting System, Discharge Abstract Database, Ontario Mental Health Reporting System, Vital Statistics Death Database, Immigration Database, Integrated Criminal Court Survey, Canadian Coroner and Medical Examiner Database, Longitudinal Worker File, T5007 Statement of Benefits, and the Uniform Crime Reporting Survey.

Error detection

Not applicable.

Imputation

Not applicable.

Estimation

Not applicable.

Quality evaluation

The Simcoe Muskoka Opioid Overdose Cohort was intended to be a census database. Formal data quality indicators were not part of the methodology.

Disclosure control

Statistics Canada is prohibited by law from releasing any information it collects that could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. Various confidentiality rules are applied to all data that are released or published to prevent the publication or disclosure of any information deemed confidential. If necessary, data are suppressed to prevent direct or residual disclosure of identifiable data.

In addition, to abide by the disclosure rules of the Canadian Coroner and Medical Examiner Database - which was the data source used for capturing fatal overdoses in the cohort - numbers and rates based on numbers greater than zero and less than five will not be published. Where denominators are small, consideration will also be given to the difference between the denominator and the numerator, as differences of zero and less than five represent similar potential breaches of confidentiality to the situation where the number of cases is between zero and five.

Revisions and seasonal adjustment

Not applicable.

Non response

The Simcoe Muskoka Opioid Overdose Cohort was intended to be a census database. Formal data quality indicators were not part of the methodology.

The degree to which people who experience opioid overdoses not captured by formal sources differ from those captured in our study is unknown.

Data accuracy

The Simcoe Muskoka Opioid Overdose Cohort was intended to be a census database. Formal data quality indicators were not part of the methodology.

Known limitations of this cohort include:
- it only included overdoses that were captured by formal interactions with some types of health care services, police, paramedics, or coroners; therefore, overdoses that were not recorded by one of these systems would not have been included.
- The data available was unable to capture all types of contacts with formal systems. For instance, police interactions that did not result in an offence (e.g., where the person was the complainant or victim), and healthcare interactions other than acute care hospital or emergency department visits (e.g., visits to a family doctor) were not documented in this study. As well, the study did not examine deaths due to causes other than opioid overdoses that may have also occurred during the study period.
- It is also acknowledged that the first overdose during the study observation period may not have been the first overdose for the cohort member.

The impact of these limitations likely represent an underestimate of all opioid overdoses that occurred in the Simcoe Muskoka region during the study period, as well as an undercount of the number of contacts with the systems studied.

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