Coronavirus worsens another health crisis
Measures intended to keep people safe during the COVID-19 pandemic might have contributed to more deaths from drug overdoses, B.C.’s longer-running, less-publicized and far deadlier health emergency, Vancouver council heard this week.
Yet the city also reported progress is delayed on setting up a new facility intended to save lives from overdoses.
While B.C. has done a laudable job of containing the spread of COVID-19, some of those measures may have had “harmful unintended consequences” during the province’s deadliest month for overdoses, Dr. Patricia Daly, Vancouver Coastal Health’s chief medical officer, told council on Tuesday.
B.C. had a record-breaking 170 overdose deaths last month, more than the total number of deaths from COVID-19 in March, April and May combined. The pandemic — and public health officials’ responses to it — reduced the capacity of life-saving services such as overdose-prevention sites and restricted visitors in social-housing buildings, which could have contributed to more people using drugs alone, Daly told council in a sobering, brutal presentation.
In Vancouver’s Downtown Eastside, the centre of Canada’s overdose crisis, and in much of the rest of B.C., the risk of death by overdose is significantly greater than the risk of a severe COVID-19 infection, Daly said.
The pandemic also has closed borders and restricted trade, disrupting the flow of illicit-drug imports from Asia and the U.S., making Vancouver’s drug supply an even more deadly “toxic soup,” council heard Tuesday.
But despite this — and despite B.C. Coroners Service figures showing a growing number of overdose deaths are from people smoking their drugs — progress has been delayed on a 2018 recommendation for the city to open an inhalation overdose-prevention site.
That lack of progress has been maddening for drug users and their allies in Vancouver and B.C., who have watched their friends die during the years they’ve been calling for safer spaces for people to inhale drugs in an atmosphere similar to the handful of supervised injection sites running in the province.
Vancouver has either completed or is on track for 38 out of the 41 recommendations issued by Mayor’s Overdose Emergency Task Force in 2018, council heard Tuesday, but one of the three actions classified as “delayed” is the new inhalation site.
In 2017, smoking overtook injection as the most common form of consumption for fatal overdoses in B.C., and it has remained in the top spot since.
“The B.C. Coroners report confirms that about 40 per cent of deaths are caused by inhaling fentanyl; however, there is only one inhalation tent operating in Vancouver,” the 2018 task force report said, recommending the city help find an appropriate site for “a new outdoor inhalation Overdose Prevention Service in the Downtown Eastside.”
That one inhalation tent is run by the Overdose Prevention Society and funded by Vancouver Coastal Health, but its future is uncertain. The inhalation tent is “due to be relocated in the coming months to make space for an Indigenous-led social housing and health services development” in that space at 62 East Hastings St., said Dianna Hurford, a senior planner with the city, in an emailed statement.
“City staff are working with OPS, VCH and B.C. Housing to identify other locations for the inhalation tent to ensure that access to the service is not interrupted.”
The rollout of the safe-supply program has, however, been bumpier than hoped. Only a small segment of B.C.’s drug users have been able to get prescriptions, Daly said. “The fact we did have this prescription alternative, it certainly did help hundreds of people. But by reducing access to other types of substitute treatment, reducing access to harm-reduction services … that did lead to an increase in deaths.”
Today, for the vast majority of drug users, the supply is more dangerous than ever, Karen Ward, an advocate for drug users who does advisory work for the city, told council.
“All the supply is a toxic soup right now, and it’s a direct result of COVID,” Ward said.
While the imported fentanyl that circulated on Vancouver’s streets before the pandemic was typically manufactured in more of a factory setting, Ward said, the drug supply now is “more of a backyard mixture” produced domestically by “inexperienced chemists.”
The situation gets more dangerous when someone is using a lighter and foil to smoke opioids by themselves in an alleyway, instead of injecting with a clean needle in a supervised setting indoors, Ward said, adding that smoking appears to be increasingly popular with the younger generation of drug users.
When people look at stylized charts and graphs showing the number of overdose deaths, Ward urges them to see them not as lines and numbers, but as “piles of corpses.”
Our neighbours, friends and family members keep dying, and Ward isn’t optimistic for the future.
“This is going to get worse, I’m afraid,” Ward predicted. “I really don’t like being right. … But it’s going to get much worse.”