Manitoba begins 2024 with record 56 drug-related deaths in a single month

Manitoba's drug crisis continues to wreak havoc despite efforts to curb deadly overdoses, with preliminary numbers revealing January saw 56 deaths — a record number for a single month.

That follows a previous high of 54 drug-related deaths in December 2023. That year started with 39 in January and so far 445 deaths have been recorded, the second-most in any year. The year-end numbers are still being finalized 

And now there is a new worry with the emergence of the designer drug desalkylgidazepam, or DAG, which was involved in 18 of those January deaths, according to data from the Office of the Chief Medical Examiner.

DAG is resistant to the anti-opioid drug naloxone because it is a benzodiazepine (central nervous system depressant), which means it will be more difficult to rescue users overdosing on the streets, the examiner's office said in an email.

"Those numbers aren't just numbers. That's two deaths a day, almost. That's people," Davey Cole, director of Sunshine House's mobile overdose prevention site, told CBC Information Radio guest host Emily Brass on Wednesday.

"You look in the city and you see you can just look out into the crowd and you can see people who have been affected by this drug toxicity crisis. It's called that for a reason."

Fentanyl continues to be the leading cause of deaths, with 36 in January, the chief medical officer's data shows.

"While it is hard on the heart to work in this … you can see that things are working and we can see that the community there really wants to take care of each other and that really sustains the work, you know," Cole said, referring to the success of the mobile site, known as MOPS, which is entering its second year.

Looking at its first full year, a report released last month listed 7,086 times when drugs were consumed at the converted RV, which offers users a safe place where they can also be supervised by staff trained in overdose response.

Those visits included 20 overdoses but no deaths.

The site also distributes harm-reduction supplies, including clean needles and pipes, and tests the chemical composition of drugs.

'It's not safe'

So far, there has been no appearance of DAG at the mobile site, but staff are on the lookout, Cole said.

"I've been hearing about it from other cities [but] we haven't specifically seen anything we've tested on site. When we hear things, we start to put out little whispers and be like, 'Hey, if you hear anything let us know.' And folks will come and test their supply."

Cole believes part of the reason for the increase in drug-related deaths is the impact of police busts on supply. As dealers are jailed and supply is impacted, users look beyond their trusted sources. That means newer and riskier mixes filling the void.

Opioids sold on Winnipeg's streets, such as hydromorphone, oxycodone and heroin, are increasingly replaced with fentanyl-laced with benzodiazepines and other tranquilizers, according to Jeff Elder, a volunteer with the Manitoba Harm Reduction Network.

Recreational drug users are likely to get a new mix of drugs each time they purchase opioids on the street, so should be cautious, he said.

"When you pick up a new bag, just try a small amount. Don't use your standard dose. It's not safe," said Elder.

"I've lost a good few friends to it.… We just lost another one last weekend," he said.

"It hurts."

Sunshine House's Cole said what's really needed is a permanent supervised consumption site with a safe supply.

"We really need to start looking at the drug toxicity crisis as an actual crisis and start thinking of what are other ways to address that," he said.

"People are going to do drugs, they know the drugs they want to do and they should be able to have the autonomy to choose that and not just some random drug that is the new designer drug."

The absence of drug-related deaths at the mobile prevention site proves the model works, Cole said.

The provincial government's most recent budget included $2.5 million for a supervised consumption site that would also help connect users to support services. However, consultations need to happen first and an exact location in Winnipeg has not been chosen.

"We need to get moving. Manitoba has historically been pretty behind in harm-reduction stuff," Cole said.

"We're on our way and that's exciting but … people's lives are at stake."