Epidemic-like overdose rate ‘becoming the norm’
Island paramedics adopt new programs and tactics to tackle unprecedented rise
The overdose crisis has led to unexpected shifts in health care on Vancouver Island, with more paramedics on bikes, expanded referral programs in emergency rooms and a course that helps paramedics cope with stress.
A B.C. Ambulance bicycle squad has been patrolling downtown Victoria since the start of summer. The cycling paramedics can respond quickly to overdoses and get to areas difficult to reach by motor vehicle.
They also maintain a close relationship with organizations providing harmreduction services in the area, said Lance Stephenson, Island director for B.C. Emergency Health Services, which co-ordinates the ambulance service.
“Previous to the introduction of fentanyl, we were not seeing the kinds of numbers [for overdose calls] we are now,” Stephenson said.
“This is definitely an epidemic arising and I fear that this is becoming the norm.”
Data from 911 calls show Island paramedics are attending significantly more calls for overdoses than three years ago — 2,739 so far this year, compared with 1,801 in 2014, before the proliferation of the deadly opioid fentanyl in street drugs.
“This has caused us to put in extra resources during peak times, such as weekends and pay days,” said Stephenson, who expects the trend to continue.
There were 978 overdose deaths in the province last year, including 160 on Vancouver Island, according to the B.C. Coroners Service. In 2014, there were 369. In the first seven months of this year, 876 overdose deaths were reported in B.C., with 138 on the Island.
Emergency-room visits and hospitalizations due to overdoses are also up.
According to a report released on Thursday by the Canadian Institute for Health Information, hospitalizations for opioid-related harms have jumped 53 per cent in the past decade, with most of the increase coming since 2014.
Sixteen people are admitted to hospital every day in Canada due to opioid poisonings — accidental or intentional overdoses of drugs such as morphine, heroin, oxycodone and fentanyl. There were 74 hospital stays of several days involving opioid poisonings in Victoria in 2016-2017, according to the report.
Emergency-room visits were much higher. Island Health said there were 1,538 visits to Island hospital emergency rooms for opioid-related issues from April 2016 to April 2017.
On the Island, there are several new emergency-room programs that aim to connect people with addictions to the resources that might help them.
A program at Victoria General and Royal Jubilee hospitals starts people at risk of opioid withdrawal on a buprenorphine-replacement program and refers them to a community support team.
Starting this month, clinicians in Nanaimo and Victoria are following up with people who have visited an emergency room for an overdose, after they’ve been discharged.
Another program at Royal Jubilee, Victoria General and Saanich Peninsula hospitals connects people who have been admitted for a primary condition other than an overdose, but who might have addiction issues, with an addiction specialist and community supports.
Since June, the program has had 119 referrals. Ninety-three of those patients have since been discharged.
The rapid-access addiction clinic is one of the places hospital patients are referred for short-term treatment such as opioidreplacement therapy and connection to community health services. Since the Cook Street clinic opened in February, there have been 700 visits involving 182 individual clients.
Stephenson said the overdose crisis is affecting first responders, too, prompting B.C. Emergency Health Services to develop a resiliency course for staff.
“Because this spike is so unprecedented, we’ve had to also think about our staff’s well-being,” said Stephenson, noting about 200 employees have already taken the course, which promotes self-care and awareness of early signs of post-traumatic stress disorder.
“There are about 1,000 paramedics on the Island and everyone is affected.”