As drug overdose deaths continue to climb in British Columbia, new figures on the use of naloxone, which can reverse the effects of an opioid overdose within minutes, show there has also been a significant increase in drug users being pulled back from the brink.
In 2015, paramedics in Vancouver Coastal and Fraser Health authorities administered naxolone 2,030 times, according to BC Emergency Health Services (BCEHS) statistics. This was a 44-per-cent increase from the previous year. Each year between 2011 and 2014, the drug was given between 1,200 and 1,400 times.
In the first three months of 2016 alone, paramedics administered naloxone more than 800 times.
"When we look at the numbers, the spotlight is often shone on those who die. We talk a lot about overdose deaths: That number is very high and the situation is very tragic," said Linda Lupini, executive vice-president of the BC Emergency Health Services. "But when you look at how many people almost died had we not been there, had we not administered naloxone, that would be shocking, I think, for the public."
B.C. declared a public-health emergency earlier this month in response to the surge in both fatal and non-fatal overdoses, making it the first province in Canada to take such a step. The declaration allows health officials to collect real-time data on all overdoses, which will ideally result in a better and more timely response.
The recent increase in naloxone administrations coincides with an increase in fentanyl being detected in illicit drug overdose deaths. In 2012, the synthetic opioid was detected in 5 per cent of all illicit drug overdose deaths in British Columbia; that figure climbed to 15 per cent in 2013; 25 per cent in 2014; and 32 per cent last year. There were a total of 153 fentanyl-detected deaths in British Columbia last year; there were 64 in the first three months of 2016 alone.
A recent Globe and Mail investigation revealed that most of Canada's illicit fentanyl supply is manufactured in China and smuggled into the country, then cut into a range of street drugs for its low cost and high potency. Most people who ingest illicit fentanyl do so unknowingly, which is especially dangerous for those who have not developed a tolerance for opioids.
Toward the Heart, a provincial harm-reduction program launched in 2012, has distributed a total of about 2,000 take-home naloxone kits to date. In 2014, 123 clients reported having used them; in 2015, that figure was 400. As of the first week of April, 385 people who took home naloxone kits under this program had used them this year.
Naloxone can be administered by either an intramuscular injection or a nasal spray, though the latter is not yet licensed in Canada.
Firefighters have also seen a troubling spike in overdoses. Between 2011 and 2015, firefighters in Vancouver responded to about 2,000 reported overdoses – both drug and alcohol – each year, give or take a few dozen. But as of mid-April this year, they have already responded to 934 overdose calls.
In response to the growing number of overdoses in British Columbia, the Ministry of Health earlier this year amended the provincial emergency medical assistants regulation to allow firefighters – who are usually first on scene at emergency calls – to carry and administer naloxone. Crews in Vancouver and Surrey began carrying the drug in February and together have administered it 18 times to date.
Surrey Fire Chief Len Garis said firefighters are happy to be able to do more.
"Firefighters were frustrated that they didn't have the tools to interact with the particular problem and now they do have the tools," he said. "From that perspective, they now feel like they're [helping] as opposed to maintaining that patient [until an ambulance arrives]."
Said Jonathan Gormick, spokesman for Vancouver Fire and Rescue Services: "This is literally a life-saving drug for a call that we're seeing again and again and again."
Any fire department can join the program after signing an agreement with BCEHS. Firefighters must train to administer the drug and provide BCEHS with patient care information to track outcomes.
Meanwhile, Health Canada recently loosened restrictions to make naloxone available for purchase without a prescription.
There were 476 apparent illicit drug overdose deaths in British Columbia last year, a 30.4 per cent increase from 2014. There were 76 such deaths in January alone – the most in one month since at least 2007.