Drug users, advocates weigh in on why Sask. overdose deaths are at record high

Samantha Sasakamoose doesn't know the right words for how she feels about so many of her friends dying from overdoses.

In a way, she says, she's "used to it."

"I remember, I think it was five or six Septembers ago, I lost somebody for eight days in a row. It was eight deaths in eight days," Sasakamoose said in Saskatoon last week.  

"We lose numerous people in a month. That's normal." 

But this year the risk feels higher, she said. 

As of the first week of September, the number of overdoses confirmed (40) and suspected (190) by the Saskatchewan Coroners Service is the highest on record for the province.  

Regina deaths triple since 2019

Fentanyl or its derivatives were identified in 33 of the 40 confirmed overdose deaths in 2020 to date. 

In Regina, suspected overdose deaths have tripled to 63 in 2020 so far, up from 21 for the whole of 2019. 

Those numbers come from the Regina Police Service. No equivalent data has been released for Saskatoon because the police service says its system is not set up to track overdoses accurately. Paramedics from Medavie in Saskatoon have responded to more than 1,600 overdose calls in 2020, but the service does not track the number of cases that result in death. In early August, they responded to 100 overdoses in a single week for the first time.

Sasakamoose said the rising prevalence of fentanyl — a potent opioid responsible for a health crisis in British Columbia — is why she is more fearful for her friends now than ever before.  

"I was addicted to fentanyl a number of years back. For over a year it was all that I did and it's a very strong drug."  

She said she now uses a regulated amount of a different prescription drug. 

Pandemic changes flow of drug supply into Canada and Sask.

The COVID-19 pandemic makes identifying the cause of the record-high number of drug overdose deaths more complicated. 

In B.C., where overdose deaths have also spiked this year, chief coroner Lisa Lapointe has said the toxicity of the drug supply in that province is "extreme."

Officials also said in late August that border closures during the pandemic have disrupted the usual flow of fentanyl into B.C., leading to the supply being replaced by unstable and unpredictable substances produced locally by those who might be inexperienced. 

"The quality control has never obviously been there with fentanyl, but it's that much worse now, when drug traffickers and dealers are throwing the kitchen sink and whatever they have to make the product," said Dr. Dan Kalla, head of emergency medicine at St. Paul's Hospital in downtown Vancouver. 

Saskatchewan's drug supply has traditionally come from B.C.

Until this year, methamphetamine has been the drug making headlines most frequently in Saskatchewan, with police services attributing high crime rates to the widespread use of that drug.

In 2017, then director of mental health and addictions services at the Saskatoon Health Region Tracy Muggli said that Saskatchewan was not experiencing an opioid crisis.

"We're having the crystal meth crisis. And who could have predicted that, you know, it wouldn't have been fentanyl here, just like it is in Vancouver?"

Shortage of meth leads to rising fentanyl use: police chief

Drug users and recovering addicts who spoke to CBC said fentanyl has been available in Saskatchewan for years, but that its prevalence is growing.

Regina Police Chief Evan Bray said last week a shortage of meth due to COVID-19 travel restrictions has led to more people using fentanyl.  

Asked how much of the Regina increase in fentanyl use is attributable to COVID-19, and how much is linked to an unrelated geographic spread of fentanyl availability, Bray said "sadly, I think it is a little bit of both."

Shut down of support groups leads to relapse

Another potential factor in the 2020 overdose death rate is cutbacks or closures of some addiction support and rehabilitation facilities due to COVID-19.

Kristina Carty had been in recovery from her drug addiction for seven months when the pandemic started.

The Regina woman was going to daily meetings as part of a 12-step program, but those meetings had to move online when COVID-19 arrived. 

"I was really scared, I knew that those meetings were part of my recovery … I knew that without them I'd have to work really hard to stay clean and unfortunately I couldn't do it," Carty said. 

"I used with a lot of the people that I went to those meetings with. It was a huge shock to everyone I think and there were a lot of us that went back out [and relapsed]." 

Since then Carty has spent a brief period in jail — which she said was related to her relapse — returned to the community and gone back into recovery. She doesn't think her relapse would have happened if it weren't for the services shutting down.

She's optimistic now that some in-person meetings, which have been adapted to include COVID-19 precautions, are scheduled to resume in September. 

"Even a hug, you know, from a fellow addict who understands the pain that you are going through at that moment," said Carty. 

"Going on a computer and talking to addicts … it did help a little bit, but it's not just the same." 

Naloxone in high demand: Harm reduction workers

At Prairie Harm Reduction on 20th Street in Saskatoon last week, people rested on couches while the The Parent Trap played on TV. 

The not-for-profit drop-in centre, which will soon become Saskatchewan's first safe drug consumption site, has hired people to deliver Naloxone kits in the surrounding area. 

Ron Cooper and Mitchelle Lagimodiere, both former addicts, give out about 40 of the anti-overdose kits on a good day, 25 on a bad day. 

They said they know people are using the kits because they come back for more. 

"We just know that people are not using meth as often, everybody is turning to 'down' more, using opiates," said Lagimodiere. 

"We see it, it's right in our face. They do it out in the open so we know what they're using so we can help them if they need help." 

In an alley behind Prairie Harm Reduction last Friday, a woman held her foot up to a needle with a green liquid inside. 

She said more people are turning to street drugs after becoming addicted to prescription painkillers.

"They turn to other drugs and it's got fentanyl in it, and nobody really knows," the woman said. 

"A lot of my friends were addicted to painkillers. My parents were addicted to painkillers."

Now, she said, she is worried about her children following the same path. 

Another woman in the alley explained that she once became ill from a "bad shot" of what she thought was hydromorphone, but turned out to contain at least one other drug, which she had a reaction to. 

She said most street drugs are "cut" with fentanyl now because producers can use a smaller amount and still produce a strong effect. 

'I've saved three lives already'

The woman said there is no way to know what is inside the drugs that she uses and that every time is a risk. 

She carries Naloxone and has used it on friends multiple times. 

"I've saved three lives already," she said, adding that she thinks the safe injection site, which will have a paramedic onsite, will help improve safety for drug users.

In early July, Health Minister Jim Reiter said the province needed to "do better with addictions services right across the board. Detox, addictions treatment beds, counselling, all the services around it." He was responding to news that six people had died of overdoses in Regina in 36 hours.

Last week he announced the provincial government will expand access to Naloxone. 

He told The Canadian Press that 12 pharmacies are providing Naloxone and talks are underway to expand the service and possibly waive the cost. Pharmacies don't usually distribute the kits for free, but some started doing so to limit the number of people in hospitals and clinics during the pandemic.

Province 'investing heavily' in addictions: Premier

In March the province declined a request from Prairie Harm Reduction for $1.3 million in funding for its safe consumption site, which will still open but will be scaled back. 

Premier Scott Moe said earlier this month the province has been "investing heavily" in mental health and addictions. 

"These are concerning statistics, I'm not going to say any different … we have been focusing on outcomes, we have been sharing best practices with other provinces and we will continue to do all of that as we wage what is ultimately a real battle across this nation," said Moe when asked about the Regina overdoses at a news conference last week. 

CBC asked the Ministry of Health to describe specific measures it has taken in response to rising overdose numbers this year. 

All of the measures described, excluding $500,000 for Naloxone kits, were included in the June provincial budget.

The ministry said it has provided four pre-treatment and six post-treatment beds and 20 new inpatient beds for addictions in Estevan. 

It said it will pay for 28 additional detox beds across Regina, Saskatoon, Moose Jaw, Prince Albert and North Battleford, more addictions workers in emergency departments in Regina, Saskatoon and Prince Albert, and a new "Rapid Access to Addictions Medicine clinic for North Battleford".

Three similar clinics were funded for Regina, Saskatoon and Prince Albert in 2019. 

The ministry said additional medical supports will be provided to support patients experiencing the crystal meth detox process, "such as hiring registered nurses, licensed practical nurses and paramedics, to increase availability of medication and medical treatment."