Canada’s opioid overdose crisis killed 36,442 people between January, 2016, and December, 2022. The toll continues to rise in 2023, and the country may be headed for its worst year ever.
British Columbia and Alberta – two of the three provinces, with Ontario, where 87 per cent of such deaths occur – are on track to set records.
Alberta recorded 770 opioid toxicity deaths in January through May, compared to 701 during the same period in 2022. It is the worst start to a year since the province began keeping records in 2016.
B.C. has seen 1,455 drug deaths in the first seven months of 2023, also the most in that period since 2016. Only Ontario has seen its numbers stay stable in 2023, to date.
This is an emergency that isn’t about to end. The illicit synthetic opioids that have been implicated in at least 90 per cent of fatal overdoses appear to be getting cheaper and stronger, and are being mixed with other drugs that make them more difficult for emergency responders to counteract.
And yet Canada’s efforts to save lives continue to rely on two pillars – supervised consumption and uncontaminated supply – that were implemented in a reactive fashion after the illegal opioid crisis erupted in 2016.
The death tolls this year do not mean those tools aren’t helpful, but they aren’t enough.
Supervised consumption, where people with opioid use disorders can ingest illicit drugs in a sterile and monitored setting, appears to be a success. According to Ottawa, Canada’s 38 authorized sites have had more than 4.1-million visits since 2017 and managed more than 47,000 overdoses without any reported fatalities on-site.
As well, 239,000 out of 340,000 clients were referred to broader services that included medical care, mental health support and/or housing services.
The success of uncontaminated supply programs is less clear. They involve providing addicted users with a regulated supply of drugs in order to prevent them from resorting to the highly toxic supply on the streets.
In many cases, the consumption of the drugs is done in a clinical setting, and early reports suggest that this has many of the same benefits as supervised consumption.
But, owing to the pandemic, some people in B.C. are now given a day’s or week’s supply at a time to consume as they wish, in order to remain isolated.
With the pandemic over, that needs to end. Uncontaminated supply should only be available in clinical settings to prevent misuse – a concern that one B.C. front-line doctor recently flagged in The Globe and Mail.
Ottawa is also experimenting with the decriminalization of the possession of small amounts of illicit drugs, a move called for by police chiefs in 2020. British Columbia asked for and got permission for a three-year pilot program that started on Jan. 31.
It’s a good idea, within limits (B.C. recently had to ask Ottawa to restrict possession near parks and pools). Funneling an addicted opioid user through the justice system makes little sense, when what they need are health and social supports.
And this is precisely where Canada and the provinces have to step up their games. While supervised consumption and uncontaminated supply can save lives in an emergency, they fall short of giving people what they need in the long run: proper care.
Addiction is a disease, no less so than cancer or diabetes. Like those diseases, it can be related to lifestyle and economic opportunity, or it can be down to bad luck. And yet people with opioid use disorders are mostly required to manage their illness outside a hospital system that welcomes smokers, drinkers and consumers of fast food.
Our hospitals need more addiction treatment wards, where patients can hope to find the beds and the long-term care they require, just like any other ailing Canadian.
There is already a well-established body of research showing that opioid agonist treatments, in which patients are given controlled doses of methadone, heroin and other opioids in a clinical setting, can help keep people in treatment, off the streets, out of criminal activity, able to hold down a job, and even to get clean.
That’s the next step. The opioid crisis isn’t going away. To continue to treat its victims with what are reactive emergency services would be shortsighted and unfair.