2016 in Review: Vancouver and B.C.'s fentanyl crisis
“We’ve seen nothing like this before. Nothing. This is unique in my experience,” says B.C. Provincial Health Officer.
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If there was any doubt about the existence of a fentanyl crisis in 2015, there was no denying it in 2016. By the end of November there had been 755 overdose deaths in the province.
About four-out-of-every-five drug samples tested at Vancouver Coastal Health’s Insite since July came back positive for fentanyl, according to the health authority.
“We’ve seen nothing like this before. Nothing. This is unique in my experience,” said Perry Kendall, B.C.’s Provincial Health Officer who declared a public health emergency in April 2016.
The declaration over fentanyl was the first and only in Canada but it hasn’t been enough to steady the growing number of deaths from the opioid.
“We haven’t seen a stabilization of the deaths. It has continued to go up,” Vancouver Coastal Health’s chief medical officer, Patricia Daly, told Metro.
“B.C. should be commended for its leadership on this, right up to the Premier, who has spoken about this. But the community will say we haven’t done enough. We certainly agree with that. We need to do more.”
The health authority started flooding the Downtown Eastside (DTES) community with take-home naloxone kits early this year. They continued to launch harm-reduction initiatives late into the year, most recently with the volunteer-run Spikes on Bikes program in partnership with the Portland Hotel Society. Paramedics and many fire departments now carry the opioid antidote as well.
Increasing access to naloxone was the fastest way to try and reduce the dramatic number of fentanyl-related deaths, said Daly.
In October 2016, VCH submitted an application to Health Canada to set up two more supervised injections sites in Vancouver’s Downtown Eastside. Health Canada came back with a recommendation the sites undergo renovations, according to Daly. VCH is currently waiting for renovation permit approval from the City of Vancouver.
She hopes the supervised injection sites will be up and running in early 2017.
In the meantime, VCH opened three supervised-consumption sites in the DTES and a mobile medical health unit that functions as a satellite emergency department for St. Paul’s Hospital in December. The City of Vancouver also approved a 0.5 per cent tax increase to help deal with the crisis.
But while those measures help prevent overdose deaths, Daly says they do not address the root cause of the problem – quality control.
“This is an illicit supply of drugs. It can be contaminated. We need to get people off illicit drugs. We need to get them on substitution therapy – legally prescribed heroin,” she said.
Regulating all psychoactive substances, including heroin, fentanyl, cartfentinal, w18, and others, could be the next step in the fight against overdose deaths, she said.
When asked whether that means decriminalization, “it’s a quality control issue,” is all she would say.
In the meantime, health authorities are teaming up with police to slowdown the flow of illicit drugs into the province. Most of the fentanyl on B.C.’s streets comes from China, noted Kendall.
“We were advocating recently […] with the RCMP for an agreement with China to make the Chinese aware of our concerns and to seek their support in trying to crack down on illicit fentanyl markets in China.”
Year in review:
This overdose epidemic poses tougher challenges than the heroin-fuelled drug crisis of the 90s, said Kendall.
“What is very different now is we’re not dealing with imported heroin. We’re dealing with mail-order pharmaceutically produced synthetic opioids which are hundreds of times more toxic than heroin was.”