British Columbia's health minister is calling on the federal government to declare a national public-health emergency to combat an overdose crisis that killed more than 900 people in B.C. last year – nearly double the number in 2015, and the province's worst death toll in three decades of record keeping.
However, Terry Lake's federal counterpart, Jane Philpott, said while the escalating number of overdose deaths may be the "greatest public-health crisis we face in Canada," her government is already using every tool at its disposal and the Emergencies Act would not grant it any powers it does not already have.
B.C. Chief Coroner Lisa Lapointe said at a news conference in Victoria on Wednesday that 914 people died of illicit drug overdoses in 2016. In comparison, 510 people died in 2015, and 400 in 1998.
The increase is being driven in large part by illicit fentanyl, a synthetic opioid being cut into a growing percentage of drugs due to its low cost and high potency.
B.C. officials have undertaken a broad range of responses, from adding new treatment beds and widely distributing the opioid antidote naloxone to calling for a significant change in federal policy that would make "hard" drugs legal so they can be regulated.
But as the body count climbs, critics are accusing governments of acting too slowly and dawdling on life-saving interventions.
"We lost an unconscionable, unfathomable amount of people, and if this was any other group, this would be dealt with already," said Jordan Westfall, policy analyst for the Canadian Drug Policy Coalition and president of the Canadian Association of People Who Use Drugs.
December's total of 142 deaths is also a new high for B.C., surpassing the previous record of 128 deaths in November. Updated statistics on fentanyl-related deaths, typically released with general overdose death statistics, were not yet available due to the sheer volume of tests being conducted, Ms. Lapointe said.
Carfentanil, a large animal tranquilizer many times more potent than fentanyl, was confirmed to be in B.C. last fall and is suspected to among the causes of the recent surge. The province has no postmortem test for carfentanil, but one is expected to be developed in coming months.
At Wednesday's news conference, Mr. Lake said his government will add 60 new addiction treatment beds to the 500 promised during the last provincial election. Only about 300 have been opened. The province will also provide no-cost coverage for opioid substitution therapies such as Suboxone and methadone to those who make less than about $42,000 a year, Mr. Lake said.
Mr. Lake noted the overdose crisis is spreading to other provinces and called on the federal government to declare a public health emergency, as British Columbia did last April.
"While [Ottawa has] been helpful in looking at supervised consumption sites and looking at changes to Canada Border Services Agency around the precursors of some of these drugs, we haven't seen the response that I think this type of epidemic requires on a national scale," he said. "We know that what we're seeing here will be seen elsewhere."
Dr. Philpott called B.C.'s year-end total "shocking" and said she empathized with those who would like to see the tide turn immediately. Asked about Mr. Lake's call to declare a federal public health emergency, Dr. Philpott said that while the overdose crisis is clearly a public health threat, it does not necessarily meet the requirements to enact the federal Emergencies Act, which includes disasters such as a natural catastrophe or a public order emergency.
The act has not been used since it replaced the War Measures Act in 1988, and she said it would not grant the federal government powers in relation to the current crisis that it does not already have.
"We have literally responded to every request that has come our way [from provinces] and made use of all available mechanisms," Dr. Philpott said in an interview. She cited overturning the Conservative government's ban on prescription heroin and repealing a law governing supervised consumption sites, as recent examples.
"I have tremendous sympathy for the people who desire that we declare an emergency. If I felt that there was something that would do, that we're not doing now, I would certainly be happy to do so."
Provincial Health Officer Perry Kendall called December's record number "unexpected and disheartening." While British Columbia embraces harm reduction and is better positioned to respond to the crisis than some jurisdictions, he said, officials will need to discuss broadening opioid-addiction treatments such as prescription heroin, which is available only to a small number of people in Vancouver.
Dr. Philpott said she supports the treatment option and has written to provinces and territories to ask if her government can do anything further to facilitate its expansion.
"We took the important step several months ago to make sure that pharmaceutical diacetylmorphine [heroin] would be available," she said. "There is nothing from the federal government that is stopping provinces from establishing clinics where they could use some of these treatment mechanisms, including new opioid substitution therapies that we can make access to."
Meanwhile, Vancouver is set to vote on how to spend $3.5-million generated from an extra 0.5 per cent increase to city taxes approved in December. A staff report with initiatives and expenses that will go to council next week recommends immediately approving about $2-million for a new, three-person medic unit in the Downtown Eastside fire hall, a community policing station in Strathcona and training for frontline staff such as those at shelters, and outreach workers.