Focus overdose prevention on corrections system: panel
Two-thirds of people who died of a drug overdose in B.C. during a 19-month period were involved with the corrections system, a panel that reviewed the skyrocketing number of deaths says.
About 18 per cent of those who died had either been on community supervision or were released from a corrections facility within a month of their death, said panel chairman Michael Egilson, who was part of a team of experts reviewing 1,854 deaths.
Inmates who had received drug substitution treatment such as methadone behind bars would have needed to be offered services in the community, Egilson said.
“There’s an opportunity for services to be targeted for a group that certainly is at more significant risk,” he said, adding those who had been incarcerated could have relapsed in the community and turned to illicit drugs laced with the deadly opioid fentanyl.
“It’s making sure that these people are linked when they’re released, and hooked up with services so there’s a continuation of treatment.”
The deaths reviewed by the panel happened between January 2016 and July 2017, and the report included information from First Nations experts and those in health care, policing, corrections and others working in mental health and addiction.
The panel is calling on B.C. Corrections, the Provincial Health Services Authority and regional health authorities to ensure, by September, that people who are released into the community have access to take-home naloxone, a medication used to reverse overdoses.
It also wants former inmates to be made aware of how to tap into services that check for toxins in drugs, often at supervised consumption sites, and for them to have access to drug-substitution programs providing methadone or suboxone.
Correctional facilities have received services through the healthcare system since October, the Provincial Health Services Authority said in a statement.
It said the report will be reviewed in the coming weeks to address the recommendations.
“We are finalizing a policy that will ensure that all clients at risk for opioid overdose (or clients with family members or friends at risk for opioid overdose) will be offered a take-home naloxone kit and education before discharge,” the statement says.
Nurses have been added at all 10 corrections facilities to help inmates connect with services in the community, the statement says.
Most of the overdoses during the period reviewed were in private residences involving people who used illicit substances alone.
The panel called for the expansion of long-term drug-substitution treatment including suboxone and methadone as well as injectable options, such as medicalgrade heroin.
It also highlighted the need for provincial regulations for treatment and recovery programs and facilities to ensure they offer evidence-based care, with monitoring and evaluation of outcomes.
“It’s really a potpourri of service, that industry, so we’re talking about licensing and regulating all of it,” Egilson said.
It’s difficult to know how many treatment or recovery facilities exist because there’s no provincial registry and some services “pop up and go away quite quickly,” he said.
The health ministry said in a statement there is a registry of supportive recovery homes, which are required to be registered under the Community Care and Assisted Living Act if they offer one or two services, such as psychosocial supports and medication management for three or more people.
However, Egilson said the act covers structural issues including windows and fire-safety standards at daycare and seniors’ facilities, not recovery or treatment centres.
He said people in some recovery facilities are offered only quick detox, which is ineffective because their tolerance to street drugs could be reduced to the point that they’re vulnerable to overdose.
“If we’re providing treatment options, those really need to be evidence-based and regulated so we know we’re providing good service to people,” he said.
Coroner Lisa Lapointe said 1,446 people died of fatal overdoses in British Columbia last year, the highest number of illicit-drug fatalities in the province’s history.
February’s statistics show 102 people died of suspected illicit drug overdoses, a decrease of 16 per cent from the same month last year, the coroners service said.