B.C. urged to expand safer drug supply to prevent overdose deaths

The death review panel report looked into the staggering 6,007 deaths from toxic illicit drugs between Aug. 2017 to July 2021.

Cheryl Chan 4 minute read March 10, 2022

A panel of 26 experts told the provincial government Wednesday it must “think outside the box” to create a comprehensive system of care to manage the overdose crisis.

The coroner’s death review panel on illicit drug toxicity deaths included experts in health, law, and social services to examine what’s needed after more than 8,700 overdose deaths since a health emergency was declared six years ago.

“Deaths from illicit toxic drugs account for more deaths than homicides, suicides, motor vehicle incidents, drownings and fire-related deaths combined. Deaths due to illicit drug toxicity are second only to cancers in terms of potential years of life lost in B.C.,” the report said.

And it found the majority of people dying would not be considered addicted.

The panel noted the province has not acted with the same sense of urgency it has in responding to COVID-19.

“If we want to ensure we don’t lose another 2,000 community members in 2022, then we need to ensure we take some really courageous actions,” chief coroner Lisa Lapointe said. “Thousands more lives are at risk.”

The panel’s recommendations include specific actions, such as developing a standard for health care providers to assess and diagnose patients for substance use disorders and refer them to evidence-based services, and developing standards and oversight mechanisms for treatment centres.

The panel said all of that needs to happen under a framework of care that doesn’t exist.

It wants government to create a management framework by May 9 that sets goals and targets for reducing illicit drug overdoses and deaths and identifies roles for health agencies to implement the plan.

Sheila Malcolmson, B.C.’s minister of mental health and addictions, said it may not be possible to meet the deadlines of 30, 60 and 90 days set by the panel, but the medical framework is being created.

“It’s in my mandate letter and is part of my ministry’s work plan and the urgency of that informs our work every day,” she said.

Cheyenne Johnson, executive director of the B.C. Centre for Substance Use, said that work “is a crucial priority. … It’s difficult to mount an emergency response to the overdose crisis on the backs of a non-existent system.”

Johnson said a substance use framework would operate in the same way as the framework for treating other chronic medical conditions like diabetes or heart disease.

“If you have a heart attack there is a whole system in place: The ambulance comes and the hospital is called ahead to prepare to meet you at the door, they take you in for treatment and your primary care doctor is notified and you are discharged from hospital with a plan for diet, exercise and medication and you are followed for life,” she explained.

“If you have an overdose and end up in the emergency department, if you’re lucky you will get a referral card and it’s up to you to navigate the system to get treatment, and it’s certainly not a continuum of care.”

Johnson highlighted the panel’s recommendations to expand the safer drug supply to include a non-medical model of community-based harm reduction.

Currently, B.C.’s safer supply system allows physicians and other health care providers to prescribe alternatives to illicit drugs but many health care providers are unwilling to join the program.

“There are examples like compassion clubs for cannabis or buyers clubs that were created during the AIDS epidemic, for people to get medicines that had not been approved,” Johnson explained.

The Vancouver Area Network of Drug Users established its own community-based harm reduction program last April with a pilot project run by the Drug User Liberation Front.

It bought heroin, methamphetamines and cocaine, had the supplies tested, then distributed the drugs free to users in the Downtown Eastside.

“We did not have a single overdose death,” said Vince Tao, a community organizer with VANDU. “We see this as an important, necessary and urgent non-medical model of safe supply.”

Tao said he’s encouraged by the strong language around the need for safer supply and to create a continuum of care, but he remains cynical about what government will do.

“The real question is, ‘When and how is this going to happen?’ The coroners office only has the power to recommend and not demand and every time, we see the politicians play the hot potato about who is supposed to do what,” said Tao.

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