Confirmed and suspected illicit drug overdoses killed 914 people in B.C. in 2016, according to numbers released last week by the BC Coroners Service. That is nearly double the number of overdose-related deaths—510—recorded in 2015, and an increase of 79.2 per cent over last year. The Coroners Service warns that this data is subject to change as investigations are concluded.
Chief coroner Lisa Lapointe says the exact percentage of overdoses that stem from the use of fentanyl will be confirmed in March, as detection tests continue. Fentanyl is a potent synthetic opioid that is 50 to 100 times more powerful than morphine, which has been detected in 60 per cent of overdose deaths in 2016 as of November.
The Coroners Service notes that the increase of fentanyl in street drugs appears to be largely responsible in the dramatic increase in overdose deaths. Fentanyl began to be detected in the province in 2012, and while overdose deaths have risen, the number of non-fentanyl related overdoses per year has remained relatively stable since 2011, with an average of 293 per year.
There were 142 overdose deaths recorded in the province in December 2016, the most ever in one month in the province and nearly twice the 2015 monthly average. Not a single overdose death of the 142 in December occurred at a supervised consumption site or overdose prevention site. Since these sites opened, first responders and volunteers there have reversed almost 100 overdoses.
Health Minister Terry Lake announced last month that overdose prevention sites would be set up in Vancouver’s Downtown Eastside, Surrey, and Victoria. All three of those cities saw the highest numbers of overdose-related deaths in 2016, with Vancouver at 215, Surrey at 108, and Victoria at 88.
Kamloops recorded 40 overdose deaths in 2016, up from seven each in 2014 and 2015. Interior Health estimates that the cost of dealing with the overdose epidemic in the region cost $1.5 million in 2016. That amount does not include the cost of visits to emergency departments by people who have overdosed.
Two overdose prevention sites were opened in Kamloops in late fall 2016, and Interior Health (IH) will be submitting an application for mobile supervised consumption services in Kamloops and Kelowna. These mobile units would allow supervised consumption, support, and other health-care services to be provided in an outreach model to more than one area of the community.
“Our data shows that in Kamloops ovcerdoses are occurring most often in both the North shore and downtown areas,” says Dr. Trevor Corneil, chief medical health officer with IH. “A mobile service is the best way to make supervised consumption services accessible in the areas where it is needed most.”
The decision to submit an application was based on the outcome of meetings with key stakeholders, public feedback, data on where overdoses were occurring, and operational considerations. Once the application is submitted, it is unknown how long it will take for Health Canada to make a decision. If approved by Health Canada, mobile supervised consumption services in IH would be among the first in Canada.
Province-wide, males accounted for 80.7 per cent of the deaths, with people aged 30 to 39 (252 deaths, or 27.6 per cent of the total) and 40 to 49 (216 deaths, or 23.6 per cent) accounting for more than half the deaths.
Roughly 90 per cent of overdose deaths occurred indoors, and in the majority of cases the victim was alone at the time. Lapointe urges those using drugs to not use alone, and to keep naloxone kits close.
She also applauded the efforts of social agency workers, volunteers, and first responders, saying that the numbers would be much higher if not for them, and calling the year-end overdose statistics “the tip of the iceberg.” Lake says that “The work going on at the front lines has been incredibly important in saving hundreds and hundreds of lives in our province.”
Many social agency workers and first responders now carry, and are trained in the use of, naloxone, which—if administered promptly after an overdose—can reverse the effects of opioids. Take home naloxone kits are also available at hospitals, health sites, and pharmacies for those who are at risk of an overdose, or for the family and friends of at-risk users.
Lake said that the province is pledging $16 million to expand a variety of recovery supports.
Of these new funds, $10 million will be used for 60 new intensive residential treatment beds (40 for adults, 20 for youth) and 50 intensive outpatient treatment spaces. Both will provide 90-day programs and a year of follow-up care through weekly group counselling and ongoing access to counsellors. It is estimated that the new treatment spots will help 240 people with opioid addictions.
The province will also provide 100 per cent coverage for opioid substitution therapies to eligible British Columbians as of February 1, 2017. This coverage falls under PharmaCare’s Plan G psychiatric medications program, which provides no-cost coverage to those with lower incomes. Individuals who qualify for MSP premium assistance, or who have an annual income under $42,000, would be considered eligible for no-cost buprenorphine/naloxone or methadone under this plan.
“We want to be able to provide treatment as quickly as possible,” Lake says. “But we don’t have the resources to provide treatment on demand for all conditions.” He called on the federal government to declare a federal health emergency because of the significant number of illicit drug deaths. The surge in drug overdose deaths caused B.C. provincial health officer Dr. Perry Kendall to declare a public health emergency in April 2016.
Lake adds, “We haven’t seen the response that I think this type of epidemic requires on a national scale.”
With files from Ashley Wadhwani/Black Press
