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Toxic Drug Deaths Continue Grim Rise

A month after government rejected coroners’ call for urgent action, another 174 deaths reported.

Moira Wyton 12 Apr 2022TheTyee.ca

Moira Wyton is The Tyee’s health reporter. Follow her @moirawyton or reach her here. This reporting beat is made possible by the Local Journalism Initiative.

Another 174 British Columbians died of toxic drug poisoning in February, adding to evidence that 2022 will once again be the deadliest year on record without bold and transformative intervention.

Toxic drug poisonings continue to be the leading cause of preventable deaths in the province, with a death rate of about 43.5 per 100,000 people in the first two months of the year, according to new data from the BC Coroners Service.

More than six people are dying each day on average. This February saw one more death than in the same month last year.

Thursday marks the sixth anniversary of the declaration of a drug death public health emergency in B.C.

"As we approach the sixth anniversary of the declaration of the public-health emergency into substance-related harms, we are continuing to lose members of our communities at an unprecedented and terrifying rate," chief coroner Lisa Lapointe said today in a news release.

"The deaths of another 174 B.C. residents, so many of them young and middle-aged men with years of life ahead of them, is yet another reminder that urgent action is needed on a provincewide scale.”

Advocates have criticized government actions to stem deaths over the last six years as insufficient and misguided, particularly in the last two years as the drug supply changed more than ever.

Promises of safe supply have seen little movement and nearly a year has passed since B.C. announced its federal application to decriminalize personal possession, which has not yet been approved.

When former provincial health officer Dr. Perry Kendall declared the emergency on April 14, 2016, nearly 2,000 people had died since 2012.

The per capita death rate was less than half what it is now, around 20.4 per 100,000 people. About 82 people were dying on average each month. There were an average of 191 deaths in the first two months of 2022.

The crisis has claimed almost 10,000 lives since 2012.

851px version of BCDrugToxicityDeathsGraph.jpg
Illicit drug deaths in the province from 1996 to the first months of 2022. When the public health emergency for toxic drug deaths in BC was declared in 2016, the per capita death rate was half what it is now. Image via BC Coroners Service.

Last month, a panel of experts convened by the chief coroner called on the province to set timelines in the next 30, 60 and 90 days for co-ordinated action plans towards safe supply and separating people from the poisoned criminalized supply.

“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,” Lapointe said at the time. “Thousands more lives are at risk.”

The province accepted the report in principle but did not commit to the timelines, calling them unrealistic. The first deadline for action passed on Monday.

“I wish it could be done in 30 days,” said Minister of Mental Health and Addictions Sheila Malcolmson today. “If it could have been… we could have had these systems in place and all these services to prevent loss of life.”

She also said solutions like treatment, recovery and harm reduction have not been able to keep pace with the rising toxicity of the criminalized drug supply.

But most of the province’s response in the last five years has not been focused on separating people from the supply by providing a regulated alternative, as the panel recently recommended.

What the province is calling prescribed safe supply is not a replacement for the criminalized supply and is available for only short periods of time and to a relatively small number of people by prescription only.

When asked whether the government would move more quickly on safe supply, Malcolmson said the province’s response is limited to a medical model of safe supply due to federal regulation.

Her advocacy to Ottawa is focused on the province’s application to decriminalize personal possession currently under review, Malcolmson said.

An increasingly toxic and unpredictable drug supply has been a major contributor to the rising deaths.

Benzodiazepines, a class of depressants which complicate overdose reversal when mixed with opioids, contributed to 43 per cent of deaths in February. That figure was 15 per cent in July 2020. Etizolam, a benzodiazepine analogue, was found in 41 per cent of expedited samples tested since July 2020.

Because benzo-dope depresses the nervous system and does not respond to naloxone, people are more likely to stop breathing. This “creates life-saving challenges for first responders,” the report says.

Fentanyl, a synthetic opioid about 100 times more potent than heroin, contributes to about 76 per cent of deaths. About 21 per cent of deaths had extreme fentanyl concentrations in the last four months, more than double the rate from January 2019 to March 2020.

And carfentanil, an even more potent synthetic opioid, has contributed to 26 deaths thus far in 2022. In 2021, that figure was 188, more than triple the number for all of 2020.

While people in every community and area are dying, some health authorities are harder hit by increasing toxicity than others.

Northern Health, where drugs must travel longer distances to the end user, saw 30 per cent of deaths with extreme fentanyl concentrations in the last four months. Its death rate is also about 50 per cent higher than the provincial average, at around 63 deaths per 100,000 people.

In Vancouver Coastal, Fraser Health and Island Health, where the highest numbers of deaths are reported, extreme fentanyl concentrations were found in 20 to 25 per cent of deaths.

And the profile of people dying has also begun to change. Six youth under 19 died in February, more than any other month in the last year.

Women, who make up about 21 per cent of deaths, are also slowly increasing in proportion to men, up from about 19 per cent last month.

The BC Coroners Service found no evidence that prescribed safe supply has contributed to any deaths. It had previously noted that the majority of people don’t qualify for current limited safe supply programs.

“A safer drug supply on its own will not resolve the public health emergency, but it is needed to stop the unprecedented numbers of deaths,” said coroners’ panel chair Michael Egilson last month.

“The first priority in addressing the toxic drug crisis is keeping people alive.”  [Tyee]

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