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Paramedics in British Columbia responded to 130 suspected overdose calls last Friday, matching a single-day record reached only once before and serving as a reminder that the province’s overdose crisis remains largely uncontrolled more than five years after the arrival of illicit fentanyl.

Premier John Horgan said the fact that not one of the 130 calls resulted in a fatality speaks to the professionalism of B.C.’s first responders.

“I’ve had the experience of going on the [ride-alongs] with the paramedics in Vancouver; I’ve also been at the safe-injection site – the Insite facility – and actually watched calm, capable people bring someone back to life,” Mr. Horgan said in Victoria.

“To think that that happened 130 times last week, on one day, is staggering for the public and speaks to the amount of work we have to do to get this scourge out of our cities and out of our province.”

There were no fatalities among the 130 calls, according to BC Emergency Health Services. The figure does not include overdoses tended to by front-line workers and ordinary civilians armed with naloxone kits. Some people in such circumstances are revived before 911 is called and choose not to go to hospital.

The only other time B.C. recorded as many overdose calls in one day was in April, 2017.

The uptick comes on a “cheque week” – the days following the monthly distribution of welfare cheques, a time historically linked to an increase in overdoses.

Overdose calls have climbed significantly in recent years, with Vancouver recording the most in the province. In 2015, paramedics responded to 3,055 suspected overdose calls in the city; that climbed to 5,944 in 2016 and 7,939 in 2017, according to BC Emergency Health Services. In 2017, about 5,000 of those calls were in the Downtown Eastside.

Vancouver averaged about 22 overdose calls a day to B.C. paramedics in 2017 and has averaged about 20 calls a day in 2018. There were 40 calls in the city on cheque day last Wednesday, 47 the day after and 45 on Friday.

Insite, which once averaged a couple of overdoses a day but now sees closer to seven a day since the fentanyl crisis took hold, recorded 16 overdoses on cheque day and 11 the following day.

Sarah Blyth, executive director of the Overdose Prevention Society, a longtime Downtown Eastside advocate and an independent Vancouver city council candidate in this October’s election, said her East Vancouver overdose-prevention site usually sees at least a couple of overdoses a day. Last week, it was between five and 10; on Friday, it was “more than 10.”

“It’s just been constant. We’re definitely seeing more right now, in general. And that doesn’t include out on the street or down at the [nearby Downtown Eastside] market.”

Ms. Blyth said the overdose crisis has led to some helpful initiatives – such as infrared spectrometer tests to determine whether drugs contain harmful substances and a notification system that alerts the public when particularly problematic drugs are in circulation – but that overdose deaths will continue to climb until there is a regulated drug supply to address the issue of fentanyl-contaminated street drugs.

“We would love to give out – and are prepared to give out – safe medications so that people aren’t taking more than they know, so they know what their dose is,” she said. “But we haven’t been given that option. So we’re stuck having people go get whatever’s out on the streets and then we have to deal with the overdose.”

Front-line staff in Vancouver have also reported an increase in atypical overdoses last week. Tim Gauthier, an Insite nurse who co-authored a paper on the matter, has said that high doses of fentanyl injected quickly can cause muscle rigidity and flailing, whereas typical opioid overdoses are characterized by drowsiness, slowed breathing and heartbeat, and fingertips and lips turning blue.

A record 1,449 people died of illicit drug overdoses in B.C. in 2017, and another 620 died in the first five months of 2018. In comparison, an average of about 200 people died of overdoses every year in the 2000s, before fentanyl supplanted illicit supplies of drugs such as heroin and oxycodone.

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