British Columbia sees spike in fatal illicit drug overdoses

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Sixty-two British Columbians died of illicit drug overdoses last month – the largest number of such deaths in a single month in a decade of record-keeping.

In all of 2015, 465 people in British Columbia died of illicit drug overdoses, a 27-per-cent increase from 2014, according to new numbers from the BC Coroners Service. That is 9.9 per 100,000 population – a rate that has not been seen since 1998. Fentanyl, the powerful opioid implicated in rashes of overdose deaths in recent years, was detected in about one-third of these deaths, up from 25 per cent in 2014, 15 per cent in 2013 and 5 per cent in 2012.

Health officials note that while the majority of illicit drug-overdose deaths do not involve fentanyl, there is no doubt that the synthetic opioid is becoming a growing factor in deaths. The street variation of the drug, illegally imported from overseas in powder form, is commonly cut into a range of street drugs and ingested unknowingly. It can be 50 to 100 times more potent than morphine.

Dr. Perry Kendall, British Columbia's provincial health officer, said the growing prevalence of fentanyl has resulted in a shift in who is dying from illicit drug overdoses.

"A number of the deaths seem to be not in long-term drug users, but people who might be more recreational or occasional users," Dr. Kendall said. "The younger, more naive users are scared if something starts going wrong. They're worried that they'll get into trouble, so they won't call 911 in time, or at all."

Sergeant Randy Fincham, a spokesman for the Vancouver Police Department, said the shift is also reflected in where illicit overdose deaths are occurring.

"We're actually seeing more deaths outside of the Downtown Eastside," he said. "In the Downtown Eastside, there are support services like Insite, where people can ingest and do it with health professionals close by. In other areas, we're seeing people use in their own homes, and they don't have the same support systems."

The coroners service noted that the number of deaths in the Fraser region increased by 49.5 per cent in one year, climbing to 166 in 2015 from 111 in 2014.

"Although all the regions have gone up, the huge jump is in Fraser," said Barb McLintock, spokeswoman for the service. Surrey had 67 overdose deaths in 2015, up from 42 the previous year; Abbotsford had 24, up from seven; and Maple Ridge had 23, up from 14.

Marcus Lem, medical health officer for the Fraser Health Authority, was unavailable for an interview on Monday.

In a statement, he also attributed the increase to the growing prevalence of fentanyl and drug users ingesting it unknowingly.

"We provide a wide range of harm-reduction services across our region and have been working very closely with our municipal and community partners to educate illicit drug users about the dangers of fentanyl and provide support for recovery," Dr. Lem said.

The harm-reduction services include funding to provide community organizations with clean needles and the development of a pilot project between the Fraser Health Authority, the BC Centre for Disease Control (BCCDC) and the Surrey RCMP that would see officers carry naloxone, a drug that can reverse the effects of an opioid overdose within minutes.

Health Canada is expected to make naloxone available without a prescription by mid-March. A take-home naloxone program run by the BCCDC has been credited with reversing at least 373 opioid overdoses provincewide since it began in August, 2012.

Abbotsford had prohibited harm-reduction measures until city council voted unanimously to repeal the bylaw in 2014.

Meanwhile, health and police officials are urging drug users to take extra precautions.

"Preferably, don't use, but we understand that's not realistic for everybody," Ms. McLintock said. "Don't use alone; if you're injecting, inject very slowly to make sure you're not getting a bad reaction; make sure that somebody you are with is with it enough to phone 911 if somebody is getting into trouble."