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People walk past a bus shelter advertisement warning of the dangers of fentanyl on Granville Street in Vancouver, B.C., on Wednesday August 12, 2015. DARRYL DYCK FOR THE GLOBE AND MAIL (DARRYL DYCK For The Globe and Mail)
People walk past a bus shelter advertisement warning of the dangers of fentanyl on Granville Street in Vancouver, B.C., on Wednesday August 12, 2015. DARRYL DYCK FOR THE GLOBE AND MAIL (DARRYL DYCK For The Globe and Mail)

Globe editorial

Globe editorial: Act now, before the fentanyl epidemic spreads Add to ...

The epidemic – and there is no other word for it – of fatal drug overdoses in British Columbia beggars belief: 755 so far this year, 128 in November alone, 13 in a single day in December.

There were more deaths from fentanyl last month in B.C. than there were murders in the province last year.

If a virus were the cause of these deaths, a massive public-health response would be under way. But the health crisis in this case is one of addiction, a contentious and misunderstood disease that is viewed with suspicion instead of empathy.

And so officials in Vancouver, where the majority of the overdoses are occurring, and the B.C. government are scrambling to deal with this mind-boggling onslaught largely on their own.

The province has been flooded with toxic synthetic opioids that are deadly in low doses. Imported from China, illicit fentanyl and carfentanil have been killing addicts and recreational drug users who are unprepared for the potency of these new drugs.

Vancouver’s city council has responded by raising property taxes to fund a new community policing centre, more front-line staff and a new medic unit in the Downtown Eastside, where many of the overdoses occur.

The province has declared a public-health emergency and promised more hospital beds to treat people with addictions. It has also opened new safe-injection sites where addicts can get their fix with other people around, in case they overdose.

But health officials have had to acknowledge that, at this point, they are losing the battle.

The federal government needs to bring its considerable resources to play. Ottawa has taken steps, but they have been legislative ones aimed at stopping the import of the drugs, and the equipment used to prepare them for sale, as well as removing legal roadblocks to supervised injection sites.

What is needed now is an acknowledgment by the federal government that this is not British Columbia’s problem alone. This is an epidemic that will likely spread, and it needs to be contained and rolled back in the same fashion as an outbreak of a deadly disease would be.

Ottawa should go at it the same way it would deal with an epidemic spread of a deadly flu. The first step involves Health Canada reinforcing the message that drug addiction is a disease, not a crime, which would help overcome the inertia that has stalled the response to this crisis.

Prime Minister Justin Trudeau could drive that point home, and bring a lot of attention to the human side of the story, by visiting one of the new supervised injection sites. The federal and provincial governments should also be pitching in more financially: Health emergencies crossing boundaries are not a challenge that should be left to municipal taxpayers, or municipal governments. It’s bigger than them.

And then once the situation in B.C. is brought under control, Ottawa has to launch something that has long been needed in Canada: an aggressive program to help people wean themselves off the opioids that are at the root of the crisis.

This is a catastrophe that was in part created innocently, and by accident, in doctor’s offices. Many physicians have been over-prescribing opioids for years, inadvertently dooming patients to addiction.

Ontario, like other provinces, has begun to crack down on MDs who liberally prescribe the drugs, a response that came after more than 700 people died from opioid overdoses in the province in 2015.

It’s the right move, but there’s a catch.

Patients who cannot wean themselves off the drug once their prescription ends – again, it’s an addiction – may well turn to the street for a replacement. That could put them in contact with illicit fentanyl in the form of counterfeit pills masquerading as the less-powerful prescription brand they are familiar with – as has happened to some users in B.C. who overdosed.

The best way to protect people from overdosing on illicit opioids is to help them get off their addictions. This will require more treatment centres and more trained personnel. Ottawa could consider leaning on the manufacturers of opioids to help cover the costs, but whatever it does, it should not do it in half-measures.

The B.C. crisis is partly about what happens when societies fail to recognize that addiction is a health issue, and instead leave it mostly up to police and courts to deal with the problem. Fentanyl addiction is literally knocking on the door of every province. A number of northern U.S. states are having their own opioid crises, and the drug is primed to flow north.

Canada can either treat this as a national issue, and stand a chance of success, or it can deal with the problem in a piecemeal fashion – one local epidemic at a time.

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On the ground with Downtown Eastside firefighters battling opioid overdoses (The Globe and Mail)

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