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Five-year overdose emergency highlights the need for understanding and treatment

British Columbia is commemorating a sad milestone this April, marking five years since the overdose public health emergency was declared. The situation has been exacerbated by COVID-19 pandemic with mortality from the toxic drug supply higher than ever.
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The overdose numbers tell a heartbreaking story of two public health emergencies coinciding, and while we need to continue prioritizing the emergency response, focusing on understanding the root causes of addiction, such as mental health disorders and trauma, is crucial. Vulnerable people who use drugs are in pain and need help.

Since the public health emergency was declared, nearly 7,000 British Columbians have died of overdose. The median age of death is just 42, meaning many children have lost their parents and caregivers to the toxic drug supply and many parents and grandparents have lost their children and grandchildren.  

Looking back

In April of 2016, four British Columbians were dying each day. Fentanyl and carfentanil were contaminating the illicit drug supply, making substances more volatile and toxic. People who had used opioids for years were experiencing overdoses from the stronger drugs and the community mobilized quickly:

  • Sanctioned overdose prevention sites opened so people could use drugs in a space where they knew someone would be able to respond in the event of an overdose.
  • Programs like opioid agonist treatments, where safe, pharmaceutical alternatives to the toxic drug supply, were provided to people with a history of substance use.
  • Naloxone use ramped up.
  • Drug-checking services increased. 

Worsening emergency highlights the need for integrated treatment

In 2019, overdose deaths decreased and across B.C. and there was cautious optimism that interventions may be working. However, when the COVID-19 pandemic hit, overdose deaths increased to unprecedented levels. In 2020, BC Emergency Health Services paramedics responded to more than 27,000 overdose calls, representing an increase of 12% over the previous year. In 2020 and 2021, an average of five British Columbians died each day of overdose.

Importantly, paramedics in B.C now have access to referral pathways for opioid overdose patients to receive ongoing clinical care, management of chronic disease, provision of opioid agonist therapy, addictions support and rehabilitation, mental health support or financial support for food or housing. 

In addition to the ongoing emergency response service, having treatment services available that address why people use drugs in the first place is key to decreasing preventable deaths.

"There are well-documented connections between addiction, mental illness and trauma — people often turn to substances to alleviate emotional pain."
“There are well-documented connections between addiction, mental illness and trauma — people often turn to substances to alleviate emotional pain and mental health symptoms like stress, anxiety, depression, and serious mental illnesses,” says Dr. Vijay Seethapathy, chief medical director with BC Mental Health and Substance Use Services, and an expert in treating co-occurring mental health and addiction issues. 

“For many people, mental illness exacerbates addiction as people use substances to block out how they are feeling, and addiction exacerbates mental illness, impacting the body and brain’s ability to properly process emotions and identify triggers. If we treat only the addiction symptoms, we’re not solving the root of the problem, which makes it challenging for a person to get well and stay well.”

Staying safe and getting help

Today, drugs are not only mixed with fentanyl but also other contaminants such as benzodiazepenes which do not respond to the life-saving medication naloxone, making responding to overdose more complicated.  Benzodiazepines pose a specific risk when people enter detox or go into withdrawal as many people do not know that the substances they purchase contain benzodiazepines.  Withdrawal from benzodiazepines is different than opioids and can result in seizures or even death without medical attention.

If you are using drugs or know someone who is, please review these resources:
  • Don’t use alone
  • Buddy up when using drugs. Using with a friend is safer than using alone even during the pandemic
  • Find an Overdose Prevention Site
  • Download the Lifeguard app
  • Carry naloxone, find a site distributing Take Home Naloxone kits

Learn about overdose and benzodiazepines:

Learn about provincial harm reduction, overdose resources, and treatment services:
addiction; BC Ambulance Service; BC Centre for Disease Control; BC Mental Health & Substance Use Services; BCEHS; overdose; overdose awareness
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