Three people died of overdoses in Castlegar in 2020

The worst year of the overdose crisis resulted in three fatalities in Castlegar and the most fatalities recorded in one year in Nelson.

Six people died in Nelson last year of what the BC Coroners Service describes as suspected illicit drug toxicity, while three people also died in Castlegar and Trail, respectively.

Typically the coroners service has not provided overdose death data in what it refers to as smaller communities due to privacy concerns.

But the service agreed to a request by the Nelson Star to make the statistics available after it announced 1,716 British Columbians had died from drug overdoses in 2020.

The opioid crisis was first declared in 2016 following the emergence of fentanyl in street-level drugs. Since then, 6,702 people in British Columbia have died.

Prior to the crisis, six overdose deaths in the Nelson area occurred between 2010 and 2015, according to the corners service. But there have been 13 since 2016, with 2020 the worst year so far.

Amanda Erickson, the regional community action team co-ordinator with the Nelson Fentanyl Task Force, said increased isolation due to COVID-19 health restrictions has contributed to the rise in opioid deaths that were already soaring due to illicit fentanyl in the drug supply.

“We have to continue the effort across the board within community and health care and our emergency responder realm to respond diligently and with openness and compassion to assist people in our community who might be struggling with mental health and substance-use issues,” said Erickson.

There were also 19 total deaths in the Kootenay Boundary area, which includes Nelson, Castlegar, Trail, Rossland, Grand Forks, Greenwood, Kaslo and Nakusp.

BC Emergency Health Services meanwhile says paramedics in Nelson responded to 53 overdose calls in 2020, a drop of six from the previous year.

Paramedics also went out to 51 calls in Trail, an increase of 10 over 2019, and 17 in Castlegar, a drop of 15 from 2019.

Decriminalization

The calls for decriminalization have become louder as the crisis continues.

Last week the federal government introduced Bill C-22, which would remove mandatory minimum penalties for drug offences in the Controlled Drugs and Substances Act and discourages law enforcement from possession charges.

Despite an endorsement for decriminalization from the Canadian Association of Chiefs of Police, as well as Vancouver’s city council requesting a federal exemption to drug laws during the crisis, Prime Minister Justin Trudeau has said he does not support decriminalization.

Nelson Police Department Chief Paul Burkart believes decriminalizing small possession would save lives and allow law enforcement to focus on trafficking and importation.

But Burkart also thinks decriminalization doesn’t necessarily lead people to the help they need. His officers, he said, struggle with how to encourage people using drugs on the streets to visit the overdose prevention site run by ANKORS instead.

“People don’t want to see that or experience that or watch somebody stick a needle in their arm and overdose right there,” he said.

“That’s not what people want in their community so if we can get people into a more accessible, safer situations such as an overdose prevention site or a safe injection site, then we’re better off.”

Nelson Mayor John Dooley said he wants to see decriminalization packaged with other initiatives, including increased investment by the province into addiction and mental health resources, which he thinks are stretched too thin.

“We have very limited resources for people who have those kinds of challenges,” said Dooley. “Whether it’s resources on the street, resources at the hospital, and rehabilitation programs are limited at best, it has to be a package. It can’t be a one-off.”

Safe supply

A safe supply program created by the provincial government in 2020 gave doctors and nurses the green light to prescribe alternatives that satisfy opioid addiction and are guaranteed to be free of fentanyl.

But the effectiveness of the program has its limits.

Zak Matieschyn, a Nelson-based addiction clinician, is one of just two health-care workers in the city who are using a risk mitigation guidance document released by the BC Centre On Substance Use in March 2020.

That plan suggests specific amounts of opioid medications such as hydromorphone or morphine to prevent withdrawal symptoms and reduce cravings in people who don’t want to take traditional opioid agonist therapies like buprenorphine or methadone.

Buprenorphine and methadone don’t replace the high of street drugs, which Matieschyn says is what some of his patients are still looking for.

The drugs don’t replace the high of street drugs, which Matieschyn says is what many of his patients are still looking for.

“It’s not a great stand in, and people are saying that,” he said.

Safe supply, according to Matieschyn, can be used as a bridge to methadone and harm-reduction services until better guidance is provided by the province.

He cautions however there’s still little research to support safe supply, and that the topic is a matter of ethical debate among health practitioners who are wary of treating addiction with drugs.

But the crisis is getting worse. Matieschyn said until more research is available to show whether or not safe supply benefits or harms a community, it at least offers a creative, if unproven, alternative.

“We know that legality is not a satisfactory discourager for people to use these agents, nor is moralizing, and if we do nothing then we see this body count that has been increasing over the last four years, and 2020 being the worst.”

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@tyler_harper | tyler.harper@nelsonstar.com