Opioid overdoses spike amid COVID-19 pandemic, with more than 3 Albertans dying per day

The number of people who died of opioid overdoses in Alberta has surged during the COVID-19 pandemic, according to data just released by the provincial government.

A total of 301 deaths were recorded from April to June. That's more than three deaths per day — twice the rate recorded from January to March.

A similar surge in deaths from opioids has also been observed during the pandemic in other jurisdictions.

In British Columbia, provincial health officer Dr. Bonnie Henry has said the pandemic has led to more people using and dying alone.

B.C. has seen more than 170 deaths from opioids per month in May, June and July.

Advocates for those suffering from addiction have been awaiting the latest data from Alberta, which takes longer to report the information.

The province released the data midday on Wednesday, as part of its latest quarterly report, which highlighted the effects of the pandemic on the opioid situation in Alberta.

"Vulnerable populations, including those with substance use issues, have faced even more adversity in accessing the supports and services they depend on, increasing stress and anxiety," the report reads.

"Beginning in March 2020, the number of harms associated with opioid use began to increase significantly, reaching record levels not previously seen. This sharp rise was in conjunction with a decrease in the utilization of treatment and harm reduction services."

Adherence to opioid dependence treatment programs declined sharply during the early stages of the pandemic, falling from 86 per cent in March to 52.6 per cent in April and 55.8 per cent in May.

Adherence started to rebound in, June, however, when it returned to 84.2 per cent.

"The trend in treatment followed is likely due to the significant change in the population of [patients] accessing in-person services in April and May," the report reads.

Elaine Hyshka, an assistant professor at the School of Public Health at the University of Alberta, said the pandemic has also affected the supply of opioids in the province.

"Border closures and travel restrictions are increasing the toxicity of the illegal drug market," she said.

Minister declines interview

Alberta's associate minister of mental health and addictions, Jason Luan, declined an interview request Wednesday.

Heather Sweet, the NDP critic for mental health and addictions, said the minister declining to comment — and the fact that the government released the long-awaited opioid data during the federal throne speech — shows they know it's bad news.

"I think that speaks to the fact that the government knows they're not doing enough," Sweet said.

"The hard truth is that the number of overdose deaths began to rise before the pandemic and this government has chosen not to respond."

More Albertans died from opioid overdoses from April to June than have died from COVID-19 throughout the entire pandemic, Sweet noted.

Hyshka said 301 deaths in three months is "staggering" and the provincial government hasn't shown that it's taking the crisis as seriously as she believes it should be.

"We get daily or near-daily updates on the COVID-19 situation, and yet this is the first data we've seen on overdoses in months," she said. "And we don't have a news conference about this data. It's just being released."

When it comes to supports for people with addiction, the report says: "We know people are struggling during these trying times and while we cannot predict what the next quarterly report will show, we remain committed to ensuring that services are available for any Albertan who needs treatment or recovery supports."

At the same time, the Alberta government has limited access to safe consumption sites.

Less access to safe consumption sites

Shortly after being elected in 2019, the UCP government announced it would freeze funding the facilities, pending a review.

The results of that review were released in March and Luan said at the time he was "deeply troubled" by what was found.

"From increases in social disorder, to discarded needles …  what we see is a system of chaos," he said.

Critics, however, said from the outset that the review was flawed and its mandate was too limited. 

The review panel did not consider the effect safe-consumption facilities have on harm reduction, they noted, nor did it consider provincial funding levels or the establishment of new sites.

Over the summer, the Alberta government also halted funding for ARCHES, a safe-consumption site in Lethbridge that had been the busiest site in Canada. That came after a government-ordered audit found evidence of mismanagement and misuse of public funding. The facility closed Aug. 31.

Some public-health experts have warned that the loss of the facility could lead to a further increase in fatal overdoses.

"There's a real risk that we'll see more people die," Hyshka told CBC News in August.

Fentanyl takes heavy toll on Lethbridge, carfentanil returns to Edmonton

The vast majority of opioid deaths over the past three months were from fentanyl poisoning, according to the report, which accounted for 284 of the 301 deaths.

Among cities, Lethbridge has seen the highest rate of fentanyl deaths per capita in Alberta so far this year. It is on pace for 42.4 deaths per 100,000 residents in 2020, compared to a rate of 16.3 last year.

Red Deer had the next highest rate of fentanyl deaths so far this year, at a pace of 30.8 per 100,000 residents, followed by Grande Prairie at 26.5, Edmonton at 26 and Calgary at 21.4.

Included in those numbers are overdoses from carfentanil, an especially deadly fentanyl analogue that first appeared in Alberta's data in 2016 and saw a surge of fatalities in 2017 and 2018, especially in the Calgary area.

Carfentanil deaths then declined in late 2019 and, in the first three months of 2020, there were just two recorded provincewide.

But that surged to 21 in the second quarter of 2020, mostly in the Edmonton health zone, where 17 of those deaths occurred.

'Recovery-oriented services'

In a government news release, Luan said Alberta's "focus on recovery-oriented services seemed to be having a positive impact" prior to the pandemic.

He noted an 8.6 per cent decrease in the number of opioid deaths in the first quarter of 2020 compared with the same time period in 2019.

"As we move forward, it is more important than ever to continue to ensure every Albertan who needs it can find help and be supported on their path to long-term recovery," he said in the release.

Hyshka said the government's approach isn't in line with the available evidence.

"It has been concerning to watch a shift away from a public-health response to the overdose epidemic," she said.

"We are seeing new investments in the addiction and mental health system, but those investments are into programs and services that are not effective for addressing opioid-use disorder ... so I do worry that, without concerted efforts to invest in what we know works, we will continue to see overdose deaths rise."

Kym Porter, whose son Neil died of a fentanyl overdose in 2016, wants the province to focus more on harm-reduction strategies, including safe consumption sites.

"They're basing their approach on ideology," she said. "And these numbers right now are evidence that what has been in place isn't working."

For Albertans struggling with addiction, the provincial government said in a news release that help is available by calling the Addiction Helpline at 1-866-332-2322, which is a 24-hour, confidential, toll-free service.