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Alberta’s emergency medical services teams have responded to a spike in calls related to opioid use since the coronavirus pandemic hit the province in March, according to government statistics.

The jump coincides with a drop in the number of people being brought to emergency departments for overdoses, particularly in Calgary. There is a risk that this combination could prove deadly for people who use illicit opioids.

Alberta has been struggling to control illicit substance use, particularly of crystal methamphetamine and opioids like fentanyl, for years. It is too early to determine whether the coronavirus pandemic, which has ushered in waves of unemployment and anxiety, has exacerbated the province’s drug problems. However, the increasing volume of EMS responses related to opioids, coupled with drug users making fewer visits to emergency departments and urgent care facilities, makes some experts nervous.

“That makes me think people are showing up less to hospital and overdosing more in the community, which is worrisome in that we may see an increase in overall deaths," said Rob Tanguay, an addictions psychiatrist and clinical lecturer at the University of Calgary. Fatality statistics are not yet available.

EMS responded to 317 incidents involving opioids in April and 257 in March, according to Alberta Health Services. In both February and January, EMS responded to 182 opioid-related cases. (Dr. Tanguay has found EMS opioid statistics do not follow patterns, so it does not matter that these figures compare different months of the same year, rather than the same months of different years.) AHS could not provide a geographical breakdown for these statistics.

Coronavirus safety protocols clash with harm-reduction strategies for substance users, putting people with addictions at greater risk. Supervised consumption sites for illicit drug use, for example, reduced capacity to meet physical-distancing guidelines. Further, people are supposed to avoid gathering with others, and that may mean drug users are consuming substances alone, rather than with a buddy who could seek help in an emergency. People, regardless of medical condition, are avoiding hospitals for fear of being infected with the coronavirus.

Overdose victims are typically delivered to hospital by EMS or other individuals. Visits to emergency departments may be falling because victims with complex overdoses, fearing COVID-19, may refuse to go to the hospital for further treatment after EMS workers revive them in the field, experts said as an example of why hospital visits are down.

Eddy Lang, the emergency department head for Calgary zone, is edgy about the rise in EMS cases, but said it is too early to say whether that means fatalities will climb.

“It worries me that more people are using opioids unsafely,” he said.

In Vancouver, police tallied nearly 30 suspected overdose deaths in March, the highest number in the city since the previous March. April was on track for a similar jump.

In Alberta, the number of visits to emergency departments and urgent care centres for overdoses dropped to an average of 17 a day in April, below the province’s normal range. By way of comparison, AHS data showed an average of 22 visits a day in June, 2019, which is near the high end of the normal range. Visits across Alberta climbed into the standard range in May. In Edmonton, visits dropped below normal in March and April, but shot up in May. In Calgary, visits fell to four a day in April and remained below the normal range in May, according to AHS data. An average of seven people a day visited emergency departments or urgent care facilities in Calgary in December, 2019, which is at the top end of the city’s expected range.

Calgary’s supervised consumption site counted 87 overdoses in April and 83 in March, the most since July, 2019.

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