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It’s been a long, painful road in the seven years since British Columbia declared a public-health emergency because of the rising death toll from illicit-drug overdoses.

Deaths from overdoses back in 2016 were rising sharply, and fentanyl was the cause in about a third of cases – far higher than a few years earlier. But no one predicted how bad it would get. Overdose deaths in 2016 reached 994 in B.C., almost double from the year before. And that turned out to be just the start.

What began as a health emergency in one province has since seemed intractable. In B.C. and Alberta, overdoses have killed more people since 2016 than COVID-19 has during the coronavirus pandemic.

The worst year for overdoses came in the middle of the pandemic. In 2021, 2,306 people died in B.C. and 1,852 people in Alberta, the two hardest-hit provinces. The death rate in Ontario was roughly half that of Western Canada, but opioid overdoses still killed 2,866 people in that province in 2021.

As the accompanying chart shows, there was finally some good news last year: The number of overdose deaths fell slightly in 2022, down 1.5 per cent in B.C., 12 per cent in Alberta and an estimated 12.4 per cent in Ontario (complete data have not yet been published online). The three provinces account for most of the overdose deaths in Canada. Fentanyl, once the cause in a minority of cases, now accounts for four out of five deaths.

For years, political leaders moved too slowly to grapple with overdose deaths. In the past year, however, after the terrible spike of deaths in the pandemic propelled by an increasingly toxic supply of street drugs, there’s been a renewed policy and funding push, led by B.C. and Alberta.

The end goal has to be the successful treatment of individuals who are trapped in the grip of substance-use disorders. It’s a difficult goal, and a long journey for a person to get off dangerous drugs and the merciless grip of strong opioids. But successful treatment – requiring a major investment of public money and health care resources – means one less person exposed to a potential deadly overdose.

Improving a person’s life, by helping them get off drugs, is critical. Keeping people who are currently struggling with drugs alive is just as essential. As we have repeatedly said, a person who dies of a drug overdose cannot seek treatment.

Political leaders are finally taking more action, but there has been sniping between political parties in B.C. and Alberta. Addiction is often entwined with challenges of housing and mental health. The scale and breadth of the issues demand that all policy options be deployed. This means everything from harm reduction – whether that’s supervised consumption sites, a regulated supply of pharmaceutical drugs or B.C.’s new experiment in decriminalization of small amounts of illicit drugs – to innovative approaches to treatment. Both B.C. and Alberta, despite differing political rhetoric, are investing in similar treatment strategies.

One glaring issue in treatment is there isn’t a cohesive system to deliver it. Many facilities are privately run; some are publicly funded. And there’s not much government oversight. There’s also a lack of data – such as available spaces, the length of the waiting list, and the success or failure rate.

Alberta has built two specialized treatment centres, with six more to come. B.C. is working on several approaches. One is called the Red Fish Healing Centre, for especially difficult cases, and another is a strategy billed as the “Road To Recovery” that includes 45 beds set to open this fall at a downtown Vancouver hospital. B.C. Premier David Eby in February told The Globe’s editorial board that his government is trying to knit together an integrated treatment system, and gather and publish data “so people can see where we’re going and where we’re struggling.”

Drug overdose deaths have finally ticked down. There is cause to hope that the worst may be over. But there’s still a long way to go to declare any sort of victory.

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