2021 now deadliest year for illicit-drug overdoses in B.C., after record 201 deaths in October, coroner says

As the number of people dying from illicit drug overdoses in British Columbia continues to climb to grim heights, the province's coroner is calling for an urgent and immediate response from all levels of government to expand safe supply.

"Simply put we are failing," said B.C. chief coroner Lisa Lapointe. "With six people now dying every single day in our province, the status quo cannot be accepted." 

Numbers released from the B.C. Coroners Service show a death toll through the first ten months of 2021 of 1,782, surpassing the 1,765 deaths recorded in all of 2020. 

B.C. also saw a single month record high of 201 illicit drug overdose fatalities in October. Deaths were recorded in all age groups and in every local health area in the province.

Lapointe said fentanyl continues as the main factor in overdose deaths, but increasing levels of stimulants and benzodiazepine are being detected in the illicit drug supply. Benzodiazepine is a depressant that cannot be reversed by naloxone, which is used to treat fentanyl overdoses.

While the province has embarked on a safe supply program, Lapointe said it is too limited in scope and facing too many barriers, including the lack of prescribing clinicians and slow action from regulators on drug decriminalization.

"I know that work is being done but we are too far along in this crisis with these number of deaths to have 12 or 18 or 24 months to plan a roll out. We need a massive roll out on an urgent basis," she said.

"Today we will lose six more people. Tomorrow we will lose six more people. And by Christmas we will lose another 40 or 50 members of our community." 

B.C.'s minister of mental health and addictions said the government is pushing out safe supply programs in every health authority, but there are challenges. 

"This is a first in Canada. We don't have models of what prescribed safe supply looks like in our provincial-federal system," said Sheila Malcolmson.

Malcolmson said addressing the COVID-19 public health emergency has been easier because it is being fought on the foundation of a strong health-care system, something that doesn't exist in the realm of mental health and addictions.

"We've been working to fight two public health emergencies while also building up [the mental health and addictions] system of care. And at the same time the health authorities are unrolling the largest vaccination program in our province's history," she said. 

"We are pushing the system in every way we can." 

Safe supply advocate Garth Mullins said governments are abdicating responsibility by not acting quickly in the face of a worsening crisis.

"We call it a kind of 'necro-politics,'" said Mullins, a member of the Vancouver Area Network of Drug Users. "People sit in capitals like Victoria or Ottawa and they just decide who's going to live and who's going to die by policy."

The B.C. Coroner Service report said more than 70 per cent of illicit drug overdose deaths in 2021 were among those aged 30 to 59. Men account for 79 per cent of the deaths.

Vancouver, Surrey and Victoria saw the most overdose deaths so far this year, according to the report, with 602 deaths in the Fraser Health Authority and 494 in Vancouver Coastal Health.

The highest rates of fatal overdoses per local health area from January to August were in Upper Skeena, Lillooet and Merritt.

Over 8,500 British Columbians have died of toxic drugs since the province declared a public health emergency in 2016.

Back then the rate of overdose deaths per 100,000 people was 20.4. It has now doubled to more than 41.2 deaths per 100,000. 

Toxic drugs are now by far the most common cause of unnatural death in the province, and the leading cause of death among British Columbians aged 19 to 39. 

The report noted that no deaths have yet been recorded at overdose prevention sites, or due to prescribed safe supply.