Fatal overdoses in British Columbia have surpassed 1,000 a year for the first time on record, a grim milestone in a province that has already gone further than others in its response to a worsening opioid crisis.
From January through August, at least 1,013 people died of illicit drug overdoses – more than 2016's year-end total of 982 – with four months still to count. The projected year-end total of 1,500 for 2017 is about seven times what the average was in the 2000s.
While Ontario has resisted calls to declare a state of emergency due to overdose deaths, B.C. did so in April, 2016. Health officials in New Brunswick are still debating whether and how to distribute kits of the overdose antidote naloxone, while B.C. has given away more than 55,000 since 2012. Alberta this spring created an opioid emergency response commission to explore solutions; B.C. has opened more than 20 government-sanctioned sites where people can use drugs, and is set to become the first jurisdiction in North America to expand a program that provides pharmaceutical-grade injectable opioids as a way to get people off street drugs. But as the death toll climbs into four digits, some groups are calling for even more bold moves from the government, including progressive approaches that have worked elsewhere, such as decriminalization, while others demand stiffer criminal sanctions, such as manslaughter charges, for dealers who sell fentanyl-laced drugs that result in a death.
B.C.'s Chief Coroner, Lisa Lapointe, called the escalating number of deaths "heartbreaking."
"This highlights the complexities of drug dependency and illicit drug use, and the importance of a co-ordinated, health-focused approach to this medical issue," she said in a statement.
At the core of this crisis is a problem that B.C. has never before confronted: an illegal drug supply in which most substances contain fentanyl even if they are sold as something else.
Illicit versions of the powerful synthetic opioid were present in 81 per cent of overdose deaths this year, and other chemically similar opioids are being detected as well, underscoring the futility of trying to contain them with prohibition.
In a position paper released this month, the Global Commission on Drug Policy called for the "elimination of illicit drug markets by carefully regulating different drugs according to their potential harms" and making them available in circumstances that can reduce the danger to users.
This has happened on a small scale in Vancouver, where about 100 people receive pharmaceutical-grade heroin to inject under supervision at a specialized clinic. The province this week also released official guidelines that would allow health authorities to offer a similar service with hydromorphone, which is easier to access and has been shown to be equally effective in treatment.
The commission – along with B.C.'s provincial health officer, the head of the BC Centre for Disease Control and others – is also calling for the decriminalization of petty drug use and possession to reflect the fact that substance use disorder is a health issue rather than a criminal one.
Recognizing that this will not likely happen at federal levels any time soon, the commission recommends that city, state or provincial level for jurisdictions that are so inclined stop enforcing the federal laws.
Judy Darcy, Minister for Mental Health and Addictions, said on Thursday the province is neither contemplating this option nor pushing for decriminalization from the federal government.
"It's a conversation that we need to continue to have, and we're going to continue to have that conversation," she said in an interview.
The minister noted that the province is breaking ground with its harm-reduction initiatives.
Meanwhile, B.C. Minister of Public Safety and Solicitor-General Mike Farnworth was asked on Thursday if B.C. would follow the lead of provinces that charge fentanyl dealers with manslaughter.
Mr. Farnworth said the issue was raised at a recent meeting of federal and provincial public safety ministers.
"We strongly believe that if you're dealing fentanyl, you're dealing death and you should be facing much more severe penalties such as manslaughter charges," he said.
The minister said the province is working on a package of initiatives on fentanyl to unveil in the weeks and months ahead.
Addictions experts have cautioned against harsher penalties for low-level drug dealers, many of whom use illegal substances themselves.
With a report from Ian Bailey