These 5 myths about B.C.'s toxic drug crisis are hurting efforts to stop the deaths, say experts

In the five years and 10 months since B.C. declared a public health emergency because of drug-related deaths, the problem has only gotten worse.

Statistics released by the B.C. Coroners Service this week confirmed that 2,224 lives were lost in 2021, making it the deadliest year on record.

Advocates argue part of the problem is that many people with the power to make a difference are relying on outdated or incorrect ideas.

"People don't want to actually confront some serious realities here, and so these comforting lies are embraced in many ways. It's horrible because it prevents all of us from actually addressing this in a real way," said Karen Ward, a drug policy consultant with the City of Vancouver.

To get a better handle on some of the misconceptions, CBC spoke to experts who are experiencing the crisis from three different viewpoints: Leslie McBain, co-founder of Moms Stop the Harm, chief coroner Lisa LaPointe, and Ward.

Here are five of the most common myths they've encountered.

It's an 'opioid' or 'overdose' crisis

These shorthands for the emergency have only become less accurate as the years wear on. 

"People are actually trying to find opioids," Ward said. "The problem is that they're getting basically unknown substances."

If people don't know what they're taking, the word "overdose" — which implies someone has simply taken too much — hardly captures what's happening.

LaPointe adds that unlike in other parts of North America, B.C.'s crisis has never been about over-prescription of painkillers like oxycodone, and attempts to address the problem by limiting doctors' ability to prescribe opioids have been misguided at best.

The latest statistics from the coroner show a mishmash of drugs linked to deaths in B.C., with fentanyl and analogues like carfentanil detected in 91 per cent of fatal doses in December, and stimulants like methamphetamine and cocaine in 73 per cent

Perhaps most alarmingly, benzodiazepines were found in half of the samples, up from just 15 per cent in July 2020.

There could be some serious consequences as a result. For one thing, benzodiazepines are highly addictive, LaPointe notes.

"Withdrawing from opioids is difficult but it's nothing compared to withdrawing from benzodiazepines," she said.

There's also the fact that naloxone, one of the key planks in B.C.'s harm reduction strategy, will not reverse overdose from non-opioid drugs like benzodiazepines.

"Naloxone doesn't touch benzodiazepines," McBain explained.

B.C. has a safe supply of drugs

As it's been nearly two years since B.C. announced plans to provide a safe supply of drugs during the COVID-19 pandemic through access to prescription alternatives, shouldn't safe supply be widely available by now?

"I dearly wish that was true," LaPointe said.

She says she checks in regularly with health authorities to see how many people are able to access safe supply.

"The answer is always hardly anybody."

There are just a handful federally funded safe supply programs in B.C., all located in Vancouver and Victoria.

"How do you actually access them? Nobody really knows," Ward said. "If you have the social power to have your own doctor … you might be able to do something."

McBain also takes issue with the drugs offered through the programs she's seen.

"If you're a person who, let's just say, is addicted to fentanyl, the government isn't willing to give you fentanyl. They say, 'Well, we're just going to give you some hydromorphone,'" she said.

"That doesn't work for people."

Only 'addicts' are dying

According to LaPointe, the B.C. Coroners Service convened a death review panel in December to discuss the drug poisoning crisis, and the data they reviewed show that people with severe drug dependencies do not represent the majority of deaths.

"You can be a first-time user, you can be a weekend user, you can be every few days, you can be a daily user," she said. "The supply is the unknown."

Ward says the increasingly toxic drug supply is making her feel more and more worried about the dangers of what she describes as "the normals" — people who might dabble in drugs for fun at a party, for example.

"If you're a regular user of an opiate, you've actually got the tolerance," she said. "But … the vast majority of people who use drugs just do it a once in a while."

People die from injected drugs

The image of someone dying with a needle stuck in their arm just doesn't match up with B.C.'s reality. According to the latest report from the coroner, only 19 per cent of toxic drug deaths in 2020 could be traced to consumption through injection.

By far the most common path to a drug-related death in 2020 was through smoking, at 56 per cent.

"There is another myth that smoking is safer, but it is not," LaPointe said.

This is significant in part because of the role that supervised consumption sites and overdose prevention sites play in saving lives. According to the coroner, no one died of illicit drug poisoning at these sites in 2021, but they are still largely geared toward injection drug users.

"If we want to keep people safe, then consumption sites only for intravenous use or needle users are not going to be effective," LaPointe said.

She acknowledged concerns about protecting staff from drug fumes, but said overdose prevention sites are now beginning to accommodate more smokers.

It's a Downtown Eastside problem

LaPointe describes this as one of the most frustrating myths she encounters.

"The drugs are toxic, so it doesn't matter where you live in the province or your socioeconomic status or your job. If you take a drug that is toxic, you will die," she said.

Even so, services for drug users in B.C. are largely concentrated in the downtown Vancouver core and other urban areas.

It's true that the largest number of toxic drug deaths happen in Vancouver, but every corner of the province is seeing people die from drug poisoning: the Thompson Cariboo, Northwest, Northern Interior and Fraser East regions saw some of the highest death rates in 2021.

"It is in every community in B.C.," McBain said.

"It is in rural communities, it's in small towns, it's in bigger towns, it's urban, and it just so happens that the people in the Downtown Eastside are more visible."