B.C.'s shocking rise in opioid deaths 'is not street use,' say experts

"We've treated it as a law enforcement problem for so long. It's hard to see what the alternative would look like," says B.C.'s chief coroner

Ian Mulgrew 5 minute read February 10, 2022

A pair of running shoes with a personal message hangs on the fence on the Burrard Street Bridge as part of awareness-raising art display, "Lost Soles: Gone Too Soon" with each pair of shoes represents a life lost to a drug overdose. RICHARD LAM / PNG

In reporting 2,224 people died in 2021 from toxic drug use, the province’s chief coroner lamented Wednesday that B.C. was worse off six years after declaring illicit consumption a public health emergency.

It was the most lives lost in a single year and is a 26 per cent increase over 2020 when 1,767 people died.

In November and December, seven a day were dying — 210 and 215 respectively, the highest monthly suspected illicit drug toxicity death counts recorded.

More than one in three was 50 or older — 38 per cent — a number steadily increasing year after year for the past six years; seven out of 10 were aged 30 to 59, and 78 per cent were male.

People dying of cancer are on average septuagenarians, those dying of drug use are men between 30 and 59.

To put the numbers in perspective, the national toll between 2016 and 2021 tops more than 25,000 — equivalent to more than half the country’s casualty count in the Second World War.

Canada lost 45,400 in that global conflagration and the alarming spike of suspected drug deaths suggests we’ll surpass that horrific marker too soon.

Consider, too, other wars — in Afghanistan, 158 died and in Korea, the third deadliest conflict after the great wars, 516.

“Sorry to be the bearer of some mind-numbing news,” chief coroner Lisa Lapointe said Wednesday releasing the latest annual toll — the total since a public health emergency was declared in 2016 now topping 9,000 dead.

“It is with tremendous sadness that I report the province is at a worse place than it has ever been in this drug toxicity crisis …I  am so sorry for your loss.”

She maintained it was essential the federal government act on the province’s request to stop enforcing criminal laws against drug users, that a safe supply of a range of drugs be available through prescriptions, that safe-consumption sites for those who smoke substances be established and the government provide more detox and treatment services.

“Obviously, the status quo is not working,” Lapointe added.

“It is an abject and costly failure. … It creates social mayhem in our communities and devastates lives. … We’ve created a system in our country that benefits nobody but those who sell drugs on a major scale. … We’ve created this massive system that is now very hard to dismantle. … We’ve treated it as a law enforcement problem for so long. It’s hard to see what the alternative would look like.”

The trouble, however, is that many users will not meet the medical requirements to obtain a prescription, don’t want to trade an illicit habit for a pharmaceutical facsimile, don’t want to let their doctors know they use and there is a paucity of detox and treatment resources.

“It is beyond devastating that we lost 2,224 people, our brothers, sisters, children, parents, neighbours and friends to toxic drugs,” echoed Sheila Malcolmson, minister of mental health and addictions.

“No words can soften these losses. … We must reduce the fear and shame that leads so many to hide their drug use, avoid services and use deadly drugs alone. That’s why we continue to push Health Canada to approve our exemption so we can implement decriminalization of people who use drugs throughout B.C.”

Since COVID began roughly two years ago, a few more than 2,700 have died in B.C. but health orders have closed the borders, restricted travel and disrupted the illicit drug market by restricting supply, encouraging illicit dealers to use more adulterants and forced social distancing for users, putting more at risk.

“It has become apparent the two health emergencies are intertwined,” said Dr. Bonnie Henry, the provincial health officer.

The availability of more powerful substances, such as fentanyl, in the last decade also has exacerbated risks in an underground market supplying a range of drugs — heroin, cocaine, crack, methamphetamines and benzodiazepines.

Fentanyl patches have even been made available by prescription.

In 2021, the coroner said the highest number of illicit drug toxicity deaths were in Vancouver, Surrey and Victoria — six of 10 in the Fraser and Vancouver Coastal Health authorities, 765 and 615 deaths respectively.

Most — 83 per cent — occurred inside (56 per cent in homes and 28 per cent in social and supportive housing, SROs, shelters and other locations) and 15 per cent occurred outside in vehicles, sidewalks, streets, parks, etc.

Malcolmson acknowledged the lack of services but insisted the province was trying to rectify that and spending nearly $3 billion a year on the crisis.

“We’re in such a terrible time,” she added. “This is not street use taking people down.”

Still, if you can’t get a prescription, find treatment and decide you have no option but to use an illicit substance alone in your home at risk of death, the minister advised using an app — Lifeguard.

Users open the made-in-B.C. app and respond at certain intervals to show they’re OK: After 50 seconds an alarm sounds; if the user fails to hit a button, the alarm grows louder; if 75 seconds pass, the app alerts first-responder dispatchers of a potential overdose using the same GPS information collected on a 911 call.

It’s not exactly an addiction vaccine or a real solution, but it’s better than dying alone.




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