More Manitobans died of overdose deaths in 2021 than ever before: chief medical examiner's data

For the second year in a row, Manitoba has seen a record number of deaths from illicit substances.

Last year, 407 Manitobans died from overdose due to illicit substances like fentanyl, methamphetamine, cocaine, etizolam or a combination substances, according to data from the chief medical examiner. 

That's a jump from 372 deaths in 2020 — which was a record number then.

"I've spoken with mothers from last year that have lost children. So for me, when I hear this, I automatically go to what will happen from those losses," said Arlene Last-Kolb, co-founder of Overdose Awareness Manitoba.

Her son Jessie died from a fentanyl overdose in 2014.  

Last-Kolb says the provincial Progressive Conservative government's approach to the issue focuses on addictions treatment, which ignores the root cause of many overdose deaths.

"We can't ignore the elephant in the room — that people are dying from the toxic supply that they're getting from the street," she said.

"We can't just continue to applaud our government for giving us more hours at the RAAM [rapid access to addictions medicine] clinic or … talking about treatment beds, when it's the toxic supply that's killing everybody."

The province says it is dealing with the issue of drug-related deaths by expanding services at its RAAM clinics, which first opened in 2018 and provide support for people looking for medically assisted treatment to deal with addiction.

Two RAAM clinics recently increased capacity to allow more walk-in patients, a spokesperson for Mental Health and Community Wellness Minister Sarah Guillemard says.

The province has also invested in 100 new supportive recovery housing units in Winnipeg, Brandon, and Thompson, according to the spokesperson. 

But that's not good enough, says Last-Kolb, because the clinics don't provide support for those who continue to use illicit substances. 

"Our government sounds like it's just a reward system that, you know, 'If you want to quit, well, we'll help you. But if you use substances, then we're not going to help you,'" she said.

"The stigma around those that use substances is killing us."

Pandemic leads to toxic supply chain

In a statement to CBC, Minister Guillemard's office said the COVID-19 pandemic exacerbated substance-related harms across the country, including in Manitoba.

"The disruption of some support systems and services due to the pandemic, coupled with increased social isolation and economic insecurity, has had an impact on substance use and substance-related harms," the spokesperson wrote in a statement to CBC. 

As well, the pandemic affected the drug supply chain, driving up drug prices and causing shortages of certain substances, such as methamphetamine. That led some users to turn to other substances, including high-risk mixed drugs like "down" — a mixture of heroin and fentanyl.

For the first time the drug etizolam — a form of the depressant benzodiazepine, or "benzos" — has appeared in the data on drug-related deaths. Etizolam is typically prescribed as a sedative, but when combined with fentanyl it can be dangerous, and even fatal. 

In 2021, 38 people died from overdose due to combined fentanyl and etizolam, a substance often referred to as "benzodope," the chief medical examiner's data says.

In a statement to CBC, the province says it remains committed to expanding Manitoba's naloxone kit program, with over 16,000 kits distributed last year. 

Naloxone can reverse the effects of opioids, but it is not effective against etizolam overdoses.

Last-Kolb says her top priority is to advocate for a safe supply of drugs for users. The fact etizolam has been added to the data shows just how unsafe street drugs now are, she says.

"What we are seeing is that there [are] no safe substances out on the street — that coke can be filled with other products. Heroin can be filled with other stuff," said Last-Kolb. 

"When a person goes out and decides to buy maybe some cocaine for the weekend, that's what they're consenting to. But they don't want to die, and they shouldn't." 

Calls for supervised consumption sites 

Supervised sites where users can consume drugs are popping up across the country, but not in Manitoba. 

"We need safe consumption sites, we need them all over Manitoba, but we especially need them [in] downtown [Winnipeg]," said Last-Kolb.

"We need to start talking about harm reduction, about saving people's lives."

CBC asked Guillemard's office about the government's position on supervised consumption sites, and did not receive a response.

In December, Premier Heather Stefanson told CBC that she was skeptical of how useful the sites are at reducing drug-related harms. 

"If you look at some of the results of other jurisdictions, I don't think they're necessarily as good as what we're doing here," she told CBC in a 2021 year-end interview, highlighting the expansion of the RAAM clinics and treatment facilities. 

"It's not an ideological thing for me — it's about results."

Last-Kolb says in talking about last year's record-setting rate of overdose deaths, it's essential to remember that "these numbers are people."

For many families, living with the stigma and shame is often the first hurdle to overcome.

"My son was a wonderful man, a wonderful person. [His addiction] was not all of who he was. But if I don't talk about this, if we aren't open about what happened, then we're part of the problem," said Last-Kolb.  

"We have to talk about how our loved ones died. There is no shame."