170 dead from overdoses in B.C.’s worst month ever
May was the deadliest month in B.C. history for illicit drug overdoses, a toll exacerbated by the very provisions that were helping get the COVID-19 pandemic under control.
Last month, while most people heard sirens and thought COVID, paramedics were responding to close to 2,300 overdose calls.
Every day, an average of 5½ people died, double the number of the previous month — and April’s number had jumped by 39 per cent. With 170 dead in May and the year-to-date total already at 554, this other epidemic may now be in its own deadly second wave.
The sudden spike reported on Thursday by the coroner’s service isn’t just happening here. Epidemiologist Jane Buxton at the B.C. Centre for Disease Control said colleagues across the country are also seeing overdose deaths resume their deadly climb.
Ontario’s coroner recently reported a 25 per cent increase over the past three months.
It’s a devastating and disturbing setback, especially in British Columbia — the epicentre of the opioid overdose crisis that’s now in the fifth year of a public health emergency.
In late March, with the backing of the federal government, British Columbia became the first province in Canada with a “safer supply” of drugs — prescription medications including hydromorphone and amphetamines provided to users as alternatives to street drugs.
It was meant to both curb overdose deaths and promote physical distancing because users would no longer need to go to pharmacies for opioid alternative medications like methadone and Suboxone, or hit the streets to search for a dealer.
On Thursday, following the coroner’s release of the May death toll, no one appeared more shaken than Dr. Bonnie Henry.
The provincial health officer has been widely credited with keeping B.C.’s COVID infection rates in check with her low-key insistence that people self-isolate and maintain physical distance.
Henry has also been one of the most vocal proponents of decriminalizing personal possession of drugs so that addictions can be dealt with as a medical issue, not a criminal one. It’s a call Henry repeated Thursday.
But even if the federal government isn’t willing to amend the Criminal Code, Henry believes there are ways that British Columbia could have de facto decriminalization with an alternate administrative process that would include a path to people getting the help they need to address the root cause of their addictions.
“I’m talking about dealers or manufacturers (of drugs),” she said. “We’re talking about alternatives for people who use drugs.”
Prior to COVID, overdose rates had been declining, and there was some optimism that the worst was over; that the measures put in place were working. COVID overturned that. The three-month shutdown of the country has changed everything.
Borders have closed, travel restricted. Businesses closed. Unemployment has soared. Anxiety has increased along with fears and uncertainty about the future.
Alcohol consumption has risen as Canadians self-medicate, and so too has illicit drug use.
But there’s been one major difference. Alcohol is now more readily available than ever, while the illicit drug supply chain was severed with border closures, flight cancellations and travel restrictions.
Supplies of fentanyl — the epidemic’s major killer — have decreased, but its toxicity of what little there is has increased exponentially.
The B.C. coroner described the concentrations found in the May post-mortem toxicology tests as “extreme.”
The May results are provisional, with more testing still to be done, including testing to determine what other drugs the 170 people who died had in their system — including those provided as part of the safer supply.
Because among the many questions that need to be answered is what effects safe supply is having.
“Obviously, when you’re needing to isolate and not go out, that’s when prescribing really increases the safety of what they are using,” Buxton said. “I’m not aware of any additional concerns from this prescribing. But it is something we are looking at very closely.”
But as Henry, Buxton and others acknowledge, preventing overdose deaths and dealing with addictions are wicked problems.
Unlike COVID, there is no hope for a vaccine. Unlike COVID, the root causes of addiction are myriad and have been exacerbated by the very thing that has kept us safe from COVID — physical distancing.
Supervised consumption sites, overdose prevention sites, treatment services, detox and recovery facilities have all been affected. One-on-one counselling in person was suspended. Meetings of even small support groups were banned for a time.
It’s resulted in more people all across the province and country using and dying alone in their homes. They’re overwhelmingly men aged 19-49, who are ashamed, afraid, or otherwise unwilling to ask for help or ask a buddy to stay close when they self-medicate.
Some 170 people died last month amid a lull in a pandemic.
That’s what it has taken to focus attention back on what may be the biggest health crisis of all.