OPIOIDS TAKE RECORD TOLL IN ALBERTA
The United Conservative government unveiled a new online tool to track substance use data in Alberta this month. The comprehensive resource catalogues details related to substance consumption, overdose deaths, hospitalizations, visits to supervised consumption sites and more. Alanna Smith lists five standout statistics recorded in Alberta's substance use surveillance system. 1. Rate of opioid overdose deaths 1.5 times higher than last year
The deadly overdose crisis has killed more Albertans this year than any other on record, with 904 deaths between January and October.
Monthly death tolls, which have been tracked since January 2016, had never surpassed 100 before May. They continued to climb until hitting a peak in July, when 142 Albertans died. In the following months, numbers remained higher than average compared with previous years.
The day Premier Jason Kenney released the latest substance use data, he said “there are some encouraging trends in these numbers that are cause, we hope, for optimism.”
Kenney said he feels “cautiously optimistic” that a decline in overdose deaths and opioid-related EMS responses by the end of October might signal “the return to pre-pandemic levels in terms of the opioid overdose crisis.”
Opioid overdose deaths dropped from 142 in July to 94 in October, a 34-per-cent decline. However, the number of deaths in October represents an almost 114-per-cent increase compared with the same month in 2019.
Kenney has linked the rise in opioid-related deaths to the COVID-19 crisis and the Canada Emergency Response Benefit (CERB), which he said gave Albertans more money to purchase substances.
Experts argue the overdose spike was “well underway” before the introduction of CERB.
2. Lethbridge facing highest rate of opioid-related deaths in Alberta
Lethbridge has the highest rate of opioid-related deaths in the province at 50.9 per 100,000 people — a rate that has more than doubled since last year.
This is the highest yearly rate in any Alberta city since the province began collecting data in 2016. Only Red Deer reached a similar high, at a rate of 50 opioid-related fatalities per 100,000 people in 2018.
All major cities in Alberta except Medicine Hat recorded a rate of opioid poisoning deaths higher than last year.
In June, Lethbridge recorded the most overdose deaths in a single month in the city, which also trended above average in the following two months.
“The Lethbridge data is very, very shocking,” said Dr. Monty Ghosh, an addictions physician in Alberta. “The centre focus should be Lethbridge for everything right now.”
The city used to be home to the busiest supervised consumption site in North America, operated by the AIDS Outreach Community Harm Reduction Education Support Society (ARCHES), with almost 61,530 visits to the site per quarter in 2019.
The UCP government pulled funding for the site earlier this year after allegations of financial mismanagement, forcing its closure at the end of August. Lethbridge police, after an investigation into ARCHES, said last week there will be no criminal charges.
The government has opened a temporary mobile overdose prevention site, operated by Alberta Health Services in the southern Alberta city. While it can serve only a fraction of the clients ARCHES could accommodate, the UCP has repeatedly said capacity is adequate to meet demand.
“Since ARCHES was closed in Lethbridge, we've actually seen the number of opioid-related overdose deaths decline in that city,” Kenney said last week, after announcing no plans for another fixed site in the city.
The decline in opioid-related overdose deaths since the site closed at the end of August is consistent with trends seen in previous years — a spike in deaths over the summer followed by a decline through year's end.
Deaths in September and October were above average compared with the same period in previous years.
3. Visits to supervised drugconsumption sites decline significantly
Visits to supervised consumption and drug overdose prevention sites nosedived during the COVID-19 pandemic, falling between 30 and almost 90 per cent, depending on the location.
When comparing the third quarters of 2019 and 2020, there was an average 40 per cent dip in visits to supervised drug-use sites in Grand Prairie, Edmonton, Calgary and Red Deer.
In Lethbridge, there was an 88-per-cent decline in visits between the third quarters of 2019 and 2020.
Despite a significant drop in visits to sites in Calgary and Edmonton — where the most opioid fatalities were recorded — the number of adverse events, such as overdoses, attended to by staff at the sites rose or remained stable.
In these situations, staff can offer supportive care, administer oxygen or naloxone, call emergency services or a combination of those interventions.
For example, there were 16,880 visits to Calgary's lone supervised consumption site in the third quarter of 2019 compared to 10,639 in the same quarter this year, an almost 37-per-cent decline.
Yet, when comparing the same quarters for adverse events, Calgary site staff attended 193 in 2019 compared to 195 this year.
Experts say this further highlights a toxic drug supply circulating in Alberta.
4. Naloxone kit distribution higher than ever
Distribution of life-saving naloxone kits hit record-high numbers following the deadliest summer Alberta has ever seen for opioid overdose deaths.
Naloxone blocks or reverses the effects of opioids, such as fentanyl, including loss of consciousness, drowsiness and slowed breathing. It can save the life of someone suffering from an opioid overdose.
During the third quarter of 2020, naloxone kit distribution through community organizations and pharmacies hit a peak. More than 27,640 kits were distributed, up from the previous record of almost 26,400 in the third quarter of 2019.
Kenney said this, among other data points, represented an “encouraging trend” and could be “cause for optimism,” in reference to a predicted decline in fatalities in the months to come.
Last year, there were 7,042 self-reported overdose reversals in the province.
Alberta recorded 6,091 self-reported reversals between January and September of this year.
5. Rise of benzodiazepines could hinder overdose reversals
A toxic drug supply amid the COVID-19 pandemic is considered the “main reason” for growing opioid-related deaths in the province, according to experts.
Ghosh said a troubling trend is emerging with the addition of benzodiazepines as a mixing agent with opioids, which can be fatal.
“That's something we're seeing more and more of,” Ghosh said.
“What that means is when you use a naloxone kit to try to reverse an overdose, it doesn't work as well. The clients will still be (experiencing) respiratory distress, and you try to reverse it but you can't, so that's quite scary.”
Benzodiazepines — which include anxiety medications Valium, Ativan and Zanax — used in addition to opioids increases the risk for drug-related emergencies.
The latest substance use data released by the province includes some information about unintentional acute drug poisoning deaths involving benzodiazepines, but it does not include deaths related to fentanyl.
Twenty-seven drug poisoning deaths have been linked to benzodiazepines in 2020, the government says.
There were 42 cases in 2019.