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Heroin and cocaine from a safe supply handed out by the Vancouver Area Network of Drug Users, Drug User Liberation Front and Moms Stop the Harm to mark International Overdose Awareness Day, are displayed in the Downtown Eastside of Vancouver on Aug. 31.DARRYL DYCK/The Canadian Press

Lisa Lapointe is chief coroner in British Columbia, on the job for a decade. Since the mid-2010s, when fentanyl began to emerge, she has seen the escalating number of overdose deaths first-hand.

This year, the overdose crisis, rooted in a toxic supply of drugs on the street, is the worst it has ever been, in B.C. and across Canada.

In October, according to data from the BC Coroners Service released Thursday, illicit drug toxicity killed 201 people, more than in any previous month, and the same as an entire year of deaths in the late 2000s.

Ten months into 2021, deaths in B.C. have reached a record: 1,782, more than in all of 2020. Overdoses have killed more people in the province during the pandemic than COVID-19. Across Canada, overdoses have killed more than 25,000 people since 2016.

To Ms. Lapointe and many other experts, the measures needed to slow the deaths are clear: widespread availability of a regulated “safer supply,” and decriminalized possession of small amounts of drugs for personal use, so people who use drugs aren’t discouraged from getting help.

On Thursday, Ms. Lapointe called for the measures to be fully brought in to respond to the emergency.

“A comprehensive plan to ensure access to safe supply for the thousands of B.C. residents dependent on these substances is essential,” she said. “Shifting from a punishment and stigmatizing regime to a decriminalized, health-focused model is also a critical step to reduce suffering and save lives.”

While everyone agrees on the goals of treatment, rehabilitation and housing – more investments are necessary – the immediate disaster is the number of people dying every day. Street drugs are more toxic than ever. Addiction isn’t solved in 30 days, and rehab offers nothing to a person long struggling with a drug misuse disorder who dies of a preventable overdose.

B.C. has moved, but not fast enough. For years, elected officials said no to calls for decriminalization. Now, both the City of Vancouver and the provincial government are pushing Ottawa to allow it.

B.C. has also opened up a broader regulated supply of drugs, after Ottawa made changes last year for all provinces, but the work has been cautious, and has not kept pace with the problem.

Safe supply remains in its infancy. It shocks some people that one answer to overdose deaths is access to regulated drugs. Some prominent doctors, using anecdotal arguments, fear it could lead to another epidemic of addiction.

The emerging data, however, contradict these views. Preliminary findings in ongoing research is promising. A team from three B.C. universities in November reported: “Mortality rates among persons receiving safer supply opioid prescriptions are lower than previous studies of people who inject illicit drugs or receive opioid agonist treatment. We should base policy decisions on rigorous evidence.”

On Thursday, the BC Coroners Service said that “analysis shows no indication that prescribed safe supply is contributing to illicit drug deaths.”

While the deaths keep coming, there is no shortage of research and recommendations from experts about what could be done. Ottawa has only slowly considered Vancouver and B.C.’s request to decriminalize, which runs counter to what the federal government’s own commissioned reports recommended earlier this year. They unanimously backed decriminalization of small amounts of drugs and said greater access to a safer supply of drugs must be “an urgent priority.”

The broader plan called for a full strategy, from harm reduction to treatment and recovery, under a total rethink of Canada’s approach to drugs. The Liberal government, just before the start of the election in August, said the reports would “inform our next steps,” but four months later little has changed, except that more people are dying than ever.

This procession of bold ideas followed by slow-moving action has been the reality throughout the overdose crisis. B.C. declared a public-health emergency 5 ½ years ago. As the situation worsens, the timidity remains. It is the opposite of the response to the coronavirus pandemic.

Yet the plague of overdose deaths, scarring many families across Canada, grinds away, year after year. Every day greater action isn’t taken is tallied in more unnecessary deaths. October in B.C. is a dark memorial to this truth.

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