3rd death review report into B.C.’s toxic drug crisis warns over complacency

The latest report from a panel of experts into deaths caused by toxic, unregulated drugs in British Columbia says an enhanced model for safer supply is needed now — outside of the health-care system — with the rate of fatalities having doubled since a public health emergency was declared in April 2016.

Entitled An Urgent Response to a Continuing Crisis, the 48-page report was compiled by a panel of 21 subject experts from health authorities and related organizations.

It’s the third report of its kind to lay bare the scope and complexity of the crisis, and the need for solutions to stem the pace of people dying from toxic drugs — which is currently about six every day across the province.

Since the public health emergency was declared, 13,112 people in the province have died of toxic drugs. The report estimates as many of 225,000 others remain at risk of injury or death.

The panel affirmed the need for a comprehensive and timely approach to the crisis.

It said the quickest way to limit deaths from toxic drugs is to reduce dependence on the unregulated toxic drug supply, by creating access to a quality-controlled, regulated supply of drugs for people at risk.

“We can and must do better to reduce the number of deaths caused by the unregulated drug supply in our province,” wrote Michael Egilson, chair of the death review panel.

“Existing responses, initiatives and services, and their associated allocated resources, have not been commensurate with the urgency, magnitude and scope of the crisis.”

Some safer supply initiatives exist in B.C., primarily through the health-care system. But the province says about 20 per cent of British Columbians do not have a primary-care provider, which limits access to safer supply for many.

The panel said fewer than 5,000 people receive safer supply prescriptions each month.

The panel questioned the current model’s ability to address the crisis and built on recommendations in the panel’s second report from March last year, which also included a non-medicalized approach — that is, existing outside of the health-care system — to complement the existing medical model for safer supply.

“The new approach would be more nimble, scalable and responsive to the unique needs of people in communities that are rural and remote, and/or that lack the infrastructure required by the medical model,” said a news release about the panel’s report.

The report said a non-prescriber-based model would be overseen by the province with participation from all levels of government and Indigenous leadership.

Essentially the recommendation would have the province apply for a class exemption from the federal government and delegate responsibility to distribute the regulated drugs without a prescription to agencies who apply and show they can safely do so with accountability.

“Safer supply is not a radical initiative,” said Chief Coroner Lisa Lapointe about her belief in the panel’s main recommendation to the province.

Other recommendations, also made in the 2022 death panel report, include better engagement with people with lived experience and more funding to support and engage with Indigenous leadership to identify Indigenous solutions to the crisis, which disproportionately affect Indigenous communities.

Minister rejects non-prescribed supply

Minister of Mental Health and Addictions Jennifer Whiteside rejected the idea of a non-medicalized safer supply in a letter she sent to Lapointe thanking her for the report.

“Non-prescription models for the delivery of pharmaceutical alternatives are not under consideration,” it read. “Accordingly, I cannot accept the primary recommendation of this report to pursue a non-prescriber model of safer supply.”

Whiteside said Provincial Health Officer Dr. Bonnie Henry is working on a program that would expand the prescriber model.

In a separate release, Whiteside said the toxic-drug crisis “continues to devastate families and communities throughout B.C.”

She chronicled several initiatives to expand prevention, treatment and recovery services in the province. 

“As we continue to improve access to mental-health and addictions care in communities throughout B.C., we are also expanding access to early intervention and prevention programs, harm-reduction tools and resources, treatment and recovery services and complex-care housing,” said Whiteside about the $1 billion earmarked in the province’s 2023 budget to address the crisis.

The release said little about safer supply in the province.

Report addresses perceptions of safe supply

Health Canada granted B.C. an exemption under the Controlled Drugs Act last January to allow people in B.C. to possess small amounts of hard drugs in an effort to reduce stigma and prevent deaths.

The panel’s report addressed perceptions and concern over providing safe supply by describing robust measures required to ensure pubic safety.

Earlier this month the B.C. government has tabled new legislation that would ban illegal drug use in many public places, less than a year into a decriminalization pilot project meant to de-stigmatize drug users.

Last week Vancouver police executed search warrants at the office of the Drug User Liberation Front (DULF), an activist group that has admitted to distributing illegal drugs to substance users deemed at risk of overdosing. 

Lapointe was asked about the bust, and without commenting directly she said she understood the frustration people on the front lines of the crisis are feeling.

“If you see someone in a burning house you feel somewhat justified to smash a window,” she said.

175 deaths in September

The report was released the same day that the coroner also made public unregulated drug death statistics from September.

The latest figures show 175 lives were lost to toxic drugs in September 2023, an average of approximately 5.8 deaths per day.

In 2023, nearly 70 per cent of those dying were age 30-59, while nearly 80 per cent of victims were male.

The September numbers represent a 10 per cent decrease over the number of deaths compared to September 2022, when there were 194, and a two per cent decrease over the number of deaths in August, when there were 178.

Lapointe said the reduction in lives lost was not yet a meaningful trend.