In 2016, the province of B.C. declared a public health emergency due to an alarming number of toxic drug-related deaths.
Data from the Coroners Service shows about 14,000 British Columbians have died from toxic drugs since 2016. That year, there were 994 known deaths. The number increased to 2,267 recorded deaths in 2021. There were 1,827 deaths in the first 10 months of 2022.
In North Vancouver Island, there were 27 illicit drug toxicity deaths in 2016. The number jumped to 37 in 2017, then dropped the next three years. However, 66 deaths were recorded in 2021.
Last year in the first 10 months, there were 54 deaths from drug poisoning — 28 of them in the Comox Valley.
Supply remains deadly
“The supply remains deadly and unknown, and it is far from being a stable situation,” said Shari Dunnet, project co-ordinator of the Comox Valley Community Action Team (CAT). She notes the number of suspected drug-poisoning deaths more than doubled locally from 2020 to 2021. “There’s so much stigma, and that’s a huge barrier. People use substances for all kinds of reasons, and it’s people from all walks of life.”
Most drug-related deaths occur at home, and largely involve illicit fentanyl. Many people are calling for decriminalization of small amounts of drugs for personal use. The idea is to reduce the stigma, and encourage users to access health services. On Tuesday, Jan. 31, B.C. will pioneer a three-year experiment on decriminalization that allows users 18 and older to carry a combined 2.5 grams of opioids such as heroin and fentanyl, as well as cocaine, ecstasy and methamphetamine.
Courtenay-Comox MLA Ronna-Rae Leonard said the effort to decriminalize will reduce fear and stigma so people can reach out for life-saving care.
But John and Jennifer Hedican, a Courtenay couple who lost their son Ryan to fentanyl poisoning in 2017, question the value of the experiment.
“What is it going to change?” John said. “It doesn’t address all the harms and deaths caused by the prohibition. That’s just trying to remove some of the stigma.”
More supports needed
Dunnet said the experiment, though groundbreaking, is nowhere near what’s needed to address the opioid crisis, and isn’t what was requested in terms of thresholds that people can hold. The province had asked Health Canada for a 4.5-gram carry threshold.
“It is a landmark event, and it does show there’s some progress towards changing the policies that are causing harm,” she said. “However, the amount is not relevant. It’s not in keeping with where things are at now. Because the governments haven’t acted and for so long, the whole drug supply has changed so much. With the fentanyl added, the thresholds for people are at a different level.
“The government was given a lot of input from people who use substances, and their input does not match this decision,” Dunnet added. “I think it’s going to leave many people in a grey area. It’s going to leave people in a place of paranoia and uncertainty, and that’s harmful.”
Federal policies must change
The Hedicans believe that a federal policy prohibiting drugs enables organized crime to be the sole provider of toxic drugs. Decriminalization, treatment and opioid replacements don’t address the problem.
They believe legalization is the answer to stop preventable deaths. John said a government-controlled system would remove organized crime, and clean up the drugs.
“We want to talk about people, the most vulnerable in society, that we send to organized crime to have their way with,” John said. “The billions we spend fighting organized crime could go into treatment, housing, re-training, support — all the things that will make a difference to people trying to fight the ugliest disease there is.”
COVID has dominated headlines since the pandemic hit, but Jennifer said there has been little onus on numbers for toxic drug supplies, for people in treatment facilities, or for available hospital beds for those suffering from mental health issues or addiction. Revealing such information would foster a greater understanding that people are dying alone at home, in every community, because of a toxic drug supply.
‘Overdose’ not a proper term
The Hedicans do not like the term ‘overdose,’ which puts the onus on the user. They say ‘poisoning’ and ‘toxicity’ accurately reflect the situation.
Jennifer recalls Ryan referring to ‘dope sickness’ — the waves that go through the body when it doesn’t have the substance, which makes a person feel horrible.
“They struggle, the people that are addicted,” Jennifer said. “The people we see on the street, they do not want to be there. People don’t choose whether they are addicted or not. Research has shown it’s physical, biological. But we don’t treat it that way. We are years behind in treatment and recognition. It’s an old narrative of why people use.”
The couple said the Portugal model on drugs involved a radical shift that reacted to deaths from poisoning. It showed that providing support to users lowered the number of deaths, and improved lives.
“It can’t be just legalization, it has to be a whole gamut of things that have to occur to make people healthy,” Jennifer said.
Dunnet said the Portugal model is not perfect, but it provides evidence that a safer supply and decriminalization are good things.
“It’s not harm reduction to criminalize people,” she said. “We really need compassion, we need understanding. Ultimately, most people use substances of one kind or another to mitigate their mood, or relax on the weekend. Our society has a funny lens on substance use. Alcohol is very deadly, and kills many, many people. It’s an interesting way that these types of drugs are framed… We need to find a different way.”
Evidence-based response called for
Courtenay-Alberni MP Gord Johns says an evidence-based response is needed to address the root causes of substance use, to improve prevention and education efforts, and to expand a safer supply and harm reduction services. He is also calling for timely access to treatment and recovery services.
Conservative Leader Pierre Poilievre has called safe supply a ‘failed experiment,’ but Johns said evidence from pilot programs shows that it creates better outcomes for people and reduces strain on the healthcare system.
Last summer, the federal government rejected Johns’s private member’s bill, C-216, to create a national health-based strategy for the toxic drug crisis.
“We’re coming up on seven years since B.C. declared a public health emergency, and since that time, we’ve seen this crisis worsen and spread to communities across the country,” Johns said. “Despite the enormous amount of loss, we haven’t seen the federal government launch a response that matches the scale or urgency they’ve shown with other public health emergencies like COVID-19 or SARS.”
“Our government believes that to tackle the toxic drug crisis and save lives, we must take steps to take substance use out of the criminal justice system, and treat it as a public health emergency,” Leonard said.