Canada’s other epidemic, the opioids overdose crisis, is more deadly than ever this year.
Deaths in British Columbia hit new highs over the spring, including a monthly record of 181 illicit drug toxicity deaths in June, and Alberta on Wednesday revealed that opioid poisoning killed 301 people in the spring – also a record. In both provinces this year, overdoses have taken far more lives than COVID-19.
Since 2016, more than 3,100 Albertans have died from opioid overdoses; in B.C., the number is more than 6,000 people. This public-health challenge, like the fight against the virus, is far from over. Work to date has saved thousands of lives, but more must be done.
Last week, B.C. took a major step toward ensuring a safer supply of clean drugs, regulated and overseen by medical professionals. The goal is to protect addicted people whose lives are at risk because of the toxicity of illicit drugs sold on the street.
B.C. is a pioneer in harm reduction, a set of pragmatic policies that work toward the goal of addiction treatment and recovery. A person cannot get treatment if they die of an overdose. Supervised drug consumption sites have been key in keeping people alive, so they’ve got a shot at overcoming addiction.
The sites were controversial at first but are proved to save lives. Another important measure championed by B.C. since 2012 has been the distribution of more than 200,000 free naloxone kits, a medicine that can be used in an emergency to reverse an opioid overdose. The success of these approaches helped expand their use elsewhere in Canada.
B.C. has also led on ideas like decriminalization. Provincial Health Officer Dr. Bonnie Henry called for it last year, arguing that addictions are a health care problem, not a criminal justice issue. This page agreed. In July, so did the Canadian Association of Chiefs of Police and, in August, the Public Prosecution Service of Canada issued new guidelines to ease up on minor drug charges because of the “health impact of substance use.”
B.C.’s Centre for Disease Control estimates about 6,000 deaths have been averted in the more than four years since the province declared its opioids public-health emergency. Despite this, a core issue remains unaddressed: the toxicity of the drugs bought and sold on the streets. That’s what is killing people. Fentanyl, the highly potent opioid, is involved in most overdose deaths.
This is where the idea of safe supply comes in. Before the pandemic, a small number of people in B.C. were prescribed clean opioids by a doctor, to be used in a medical setting. This spring, the province and Health Canada broadened access for a take-home supply. Change was slower than hoped but pharmacies are dispensing greater amounts of hydromorphone, one of the safer supply drugs.
Last week, Dr. Henry issued a public-health order to further improve safe supply access in B.C. for people at risk of an overdose. Nurses and psychiatric nurses will be able to prescribe pharmaceutical options, as well as offering a path to treatment and other services. Previously, only doctors and nurse practitioners could prescribe these drugs.
Few jurisdictions deliver safe supply. Switzerland is a rare example. It has provided medical-grade heroin since the 1990s and the program, part of a sweep of policies, has been a success. Studies there and in trials elsewhere show the benefits. The hurdle is politics, and public opinion. Many people are scared by the idea of giving drugs to addicts.
Ottawa has adjusted rules to allow for a safer supply. It’s up to the provinces, which run health care, to make it happen. Health Minister Patty Hajdu in August urged provinces to work on access. Some are wary. Alberta has cut back on supervised consumption, is slow to report data and focuses on treatment. Saskatchewan opposes what it calls “free drugs.”
But attitudes are changing. Canada’s Chiefs of Police include safe supply among the harm-reduction measures they support.
That addiction is still common speaks to how difficult it is to overcome, and the need for pragmatic policies. It’s understandable people may have a reflexive aversion to medical professionals prescribing otherwise-illicit opioids. But addicted people are dying, daily. Their deaths are preventable.
We know the root of the problem, and we have solutions. We should use them.
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