Opi­oid death toll hits record in B.C. de­spite push on pre­ven­tion

The Globe and Mail (Alberta Edition) - - FRONT PAGE - ANDREA WOO VANCOUVER

Fatal over­doses in Bri­tish Columbia have sur­passed 1,000 a year for the first time on record, a grim mile­stone in a prov­ince that has al­ready gone fur­ther than oth­ers in its re­sponse to a wors­en­ing opi­oid cri­sis.

From Jan­uary through Au­gust, at least 1,013 peo­ple died of il­licit drug over­doses – more than 2016’s year-end to­tal of 982 – with four months still to count. The pro­jected year-end to­tal of 1,500 for 2017 is about seven times what the av­er­age was in the 2000s.

While On­tario has re­sisted calls to de­clare a state of emer­gency due to over­dose deaths, B.C. did so in April, 2016. Health of­fi­cials in New Brunswick are still de­bat­ing whether and how to dis­trib­ute kits of the over­dose an­ti­dote nalox­one, while B.C. has given away more than 55,000 since 2012. Al­berta this spring cre­ated an opi­oid emer­gency re­sponse com­mis­sion to ex­plore so­lu­tions; B.C. has opened more than 20 gov­ern­ment-sanc­tioned sites where peo­ple can use drugs, and is set to be­come the first ju­ris­dic­tion in North Amer­ica to ex­pand a pro­gram that pro­vides phar­ma­ceu­ti­cal-grade in­jectable opi­oids as a way to get peo­ple off street drugs. But as the death toll climbs into four dig­its, some groups are call­ing for even more bold moves from the gov­ern­ment, in­clud­ing pro­gres­sive ap­proaches that have worked else­where, such as de­crim­i­nal­iza­tion, while oth­ers de­mand stiffer crim­i­nal sanc­tions, such as man­slaugh­ter charges, for deal­ers who sell fen­tanyl-laced drugs that re­sult in a death.

B.C.’s Chief Coroner, Lisa La­pointe, called the es­ca­lat­ing num­ber of deaths “heart­break­ing.”

“This high­lights the com­plex­i­ties of drug de­pen­dency and il­licit drug use, and the im­por­tance of a co-or­di­nated, health-fo­cused ap­proach to this med­i­cal is­sue,” she said in a state­ment.

At the core of this cri­sis is a prob­lem that B.C. has never be­fore con­fronted: an il­le­gal drug sup­ply in which most sub­stances con­tain fen­tanyl even if they are sold as some­thing else.

» Il­licit ver­sions of the pow­er­ful syn­thetic opi­oid were present in 81 per cent of over­dose deaths this year, and other chem­i­cally sim­i­lar opi­oids are be­ing de­tected as well, un­der­scor­ing the fu­til­ity of try­ing to con­tain them with pro­hi­bi­tion.

In a po­si­tion pa­per re­leased this month, the Global Com­mis­sion on Drug Pol­icy called for the “elim­i­na­tion of il­licit drug mar­kets by care­fully reg­u­lat­ing dif­fer­ent drugs ac­cord­ing to their po­ten­tial harms” and mak­ing them avail­able in cir­cum­stances that can re­duce the dan­ger to users.

This has hap­pened on a small scale in Vancouver, where about 100 peo­ple re­ceive phar­ma­ceu­ti­cal-grade heroin to in­ject un­der su­per­vi­sion at a spe­cial­ized clinic. The prov­ince this week also re­leased of­fi­cial guide­lines that would al­low health au­thor­i­ties to of­fer a sim­i­lar ser­vice with hy­dro­mor­phone, which is eas­ier to ac­cess and has been shown to be equally ef­fec­tive in treat­ment.

The com­mis­sion – along with B.C.’s pro­vin­cial health of­fi­cer, the head of the BC Cen­tre for Disease Con­trol and oth­ers – is also call­ing for the de­crim­i­nal­iza­tion of petty drug use and pos­ses­sion to re­flect the fact that sub­stance use dis­or­der is a health is­sue rather than a crim­i­nal one.

Rec­og­niz­ing that this will not likely hap­pen at fed­eral lev­els any time soon, the com­mis­sion rec­om­mends that city, state or pro­vin­cial level for ju­ris­dic­tions that are so in­clined stop en­forc­ing the fed­eral laws.

Judy Darcy, Min­is­ter for Men­tal Health and Ad­dic­tions, said on Thurs­day the prov­ince is nei­ther con­tem­plat­ing this op­tion nor push­ing for de­crim­i­nal­iza­tion from the fed­eral gov­ern­ment.

“It’s a con­ver­sa­tion that we need to con­tinue to have, and we’re go­ing to con­tinue to have that con­ver­sa­tion,” she said in an in­ter­view.

The min­is­ter noted that the prov­ince is break­ing ground with its harm-re­duc­tion ini­tia­tives.

Mean­while, B.C. Min­is­ter of Pub­lic Safety and Solic­i­tor-Gen­eral Mike Farn­worth was asked on Thurs­day if B.C. would fol­low the lead of prov­inces that charge fen­tanyl deal­ers with man­slaugh­ter.

Mr. Farn­worth said the is­sue was raised at a re­cent meet­ing of fed­eral and pro­vin­cial pub­lic safety min­is­ters.

“We strongly be­lieve that if you’re deal­ing fen­tanyl, you’re deal­ing death and you should be fac­ing much more se­vere penal­ties such as man­slaugh­ter charges,” he said.

The min­is­ter said the prov­ince is work­ing on a pack­age of ini­tia­tives on fen­tanyl to un­veil in the weeks and months ahead.

Ad­dic­tions ex­perts have cau­tioned against harsher penal­ties for low-level drug deal­ers, many of whom use il­le­gal sub­stances them­selves.

We strongly be­lieve that if you’re deal­ing fen­tanyl, you’re deal­ing death and you should be fac­ing much more se­vere penal­ties such as man­slaugh­ter charges. Mike Farn­worth B.C. Min­is­ter of Pub­lic Safety and Solic­i­tor-Gen­eral

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