The grim toll from fentanyl abuse in British Columbia is climbing, accounting now for at least half of the overdose drug deaths this year. Illicit drug overdoses killed an average of 64 British Columbians in each of the first four months of 2016 – a dramatic increase over last year's record-breaking tally.
Fentanyl was detected in 49 per cent of the 200 drug deaths by the end of March.
B.C. Health Minister Terry Lake released the statistics from the Coroner's Service on Thursday. They show that despite efforts to improve warnings and to increase access to naloxone, a treatment that can reverse an opioid overdose, the province is losing ground.
Last year, an average of 40 people died each month from illicit drug overdoses in B.C., and in almost one-third of those cases, fentanyl was detected.
In April, provincial health officer Perry Kendall declared B.C.'s first public health emergency in a bid to gain traction against the rapid escalation of opioid overdose deaths. The declaration gives him new powers to track non-fatal overdoses, allowing authorities to get out warnings to drug users more quickly.
Mr. Lake said he is optimistic the latest measures will start to produce some change in the trend.
"The increased awareness I'm hoping will have an effect and we'll start to see the numbers come down this month. We are all keeping our fingers crossed," he said in an interview.
Since 2012, the province has distributed almost 6,400 naloxone kits to people who use opioids, and more than 6,800 people have been trained to administer the antidote, including opioid users, their friends and family, and service providers.
Dr. Kendall is using his powers under the emergency order to collect data on non-fatal overdoses. This will allow the province to respond more quickly when bad batches of drugs surface on the streets. Many overdose victims are unaware they are taking fentanyl, a synthetic painkiller that can be 100 times more powerful than morphine.
A directive has been issued to emergency rooms and ambulance services to collect information on overdose incidents. The information is being tracked with the Global Positioning System (GPS) to help pinpoint locations and times.
Dr. Kendall said he expects some data to start arriving next week for analysis, and he may require additional resources to do toxicology tests. There were between 25,000 and 30,000 emergency responses for overdoses last year, and lab tests are rarely done unless there is a fatality.
He said the latest statistics are disturbing.
"It it tells me fentanyl is out there and very prevalent," he said. "If half the drugs that people are dying from have fentanyl in them, it is increasing." He said he wants to do additional testing to determine how widespread fentanyl use is among illicit drug users. Urine tests from drug users a couple of years ago showed many people had ingested fentanyl without knowing it, he noted.
Fentanyl was almost unknown as a street drug in British Columbia in 2012, when it was first detected in an overdose death. Since then, the coroner's service has tracked its steady rise as a factor in illicit drug overdoses, starting at 5 per cent in 2012.
The deaths are charted across the province from cities to small communities, and the victims range from teenagers to an individual in his 70s. That makes education campaigns and distribution of naloxone more challenging.
Mr. Lake said 20 first-responder organizations have signed up for training that will allow them to administer the antidote. As well, the province no longer requires a prescription for naloxone, so it is easier for people to access the drug.
British Columbia has led the country in harm-reduction initiatives in response to an earlier drug crisis that peaked in 1998. The rate of death by illicit drug overdoses did decline for more than a decade, but 2015 was the worst year on record since officials began compiling statistics in the 1980s.
In Alberta, which has also increased the distribution of nalaxone kits, the number of fentanyl deaths has been stable so far this year, with 69 recorded in the first three months of 2016. In 2015, the province recorded 274 deaths attributed to fentanyl overdoses.
With a report from Justin Giovannetti in Edmonton