Fentanyl a growing problem with more overdose deaths in Kootenay-Boundary in 2016
By Timothy Schafer
The deadly problem with fentanyl overdoses grew in 2016 in the Kootenay-Boundary, but it is still lower than the regional and provincial rate, says an Interior Health official.
Gillian Frosst, epidemiologist with Interior Health, said the fentanyl problem is growing more common in the Kootenay-Boundary region, and it increased in 2016.
“The incidence of illicit drug overdose deaths has significantly increased across B.C. in 2016, including in the Interior Health region,” she said. “Within the Interior Health region, the highest incidence rates are in the Okanagan and Thompson Cariboo Shuswap regions. However, deaths have also occurred in the Kootenays.”
The B.C. Coroners Service publishes monthly reports of illicit drug overdose (OD) deaths and fentanyl-related overdoses. From Jan. 1 to Oct. 31, 2016, a total of five illicit drug overdose deaths have been reported in the Kootenay Boundary (KB) health service delivery area.
From 2011-2015, between two to four deaths occurred each year in the Kootenay-Boundary region, said Frosst. While deaths have occurred, he added, the incidence rate for the Kootenay-Boundary (7.8 per 100,000 population) is lower than for the Interior Health region as a whole (17.5 per 100,000population) and provincially (15.8 per 100,000 population).
“Of the five illicit drug overdose deaths reported … in 2016, four were confirmed to be fentanyl-related,” Frosst said. “Provincially, more than 60 per cent of illicit drug overdose deaths reported this year have involved fentanyl.”
There is some action on the part of Interior Health to combat the problem, said Frosst.
“Interior Health is very concerned about the significant increase in fatal and non-fatal overdoses in our communities and responding to this public health emergency is a priority,” she said. “Interior Health has established an Emergency Incident Management Team to provide direction and coordination of activities to respond to the provincial drug overdose public health emergency.”
The team’s priorities are: enhanced fatal and non-fatal overdose surveillance; increased accessibility to harm reduction tools including Take Home Naloxone (THN) kits; exploring safe consumption services (SCS) in the highest risk communities; scaling-up substance use services for people who use drugs that are at highest risk of overdose; and population-based education and prevention.
Across the province in 2016 a total of 555 people died from illicit drug overdoses by the end of September — exceeding the total of 508 lives lost to drug overdoses in all of 2015. Figures for the entire year were not available.
And the culprit is fentanyl. The drug continues to be detected in about 61 per cent of fatal drug overdoses, according to the latest statistics released by the B.C. Coroners Service.
The 302 cases in which fentanyl was detected is more than triple the number for the same nine months of 2015.
More overdose deaths happened in the Fraser Health region — 195 so far in 2016 — than Vancouver Coastal (128), Vancouver Island (107) or the Interior (93).
The top cities where deaths occurred were Vancouver (110), Surrey (71), Victoria (44), Kelowna (31), Abbotsford (26), Kamloops (25) and Maple Ridge (22).
A response strategy has been underway since the province declared a public health emergency in April and created a dedicated task force in July.
Efforts include making naloxone much more widely available to reverse overdoses in progress.
The strategy also aims to block fentanyl production and distribution, increase harm-reduction options, foster greater public education and increase the number of addiction recovery beds.
On Oct. 13 regulations under the Health Professions Act and the Emergency Health Services Act were amended to enable all healthcare professionals, first responders (e.g. police, firefighters), social workers and citizens to administer naloxone outside of a hospital setting.
This was done to prevent further loss of life from opioid overdose, to the extent possible, by enabling anyone to administer naloxone to someone appearing to be suffering from an opioid overdose.
The amendment is also extended to all citizens, which allows people employed in places where overdoses are more likely to happen but where not a lot of health care workers or emergency responders are regularly employed, such as shelters and certain mental health and substance use centres.
As part of the $5 million in funding to support strategies identified by the Joint Task Force, work is also underway to develop a tool kit to assist community partners with organizing and hosting community forums. The tool kits will include resources to help foster discussion and engagement among community stakeholders on overdose prevention.
Intranasal naloxone is being distributed to RCMP detachments and some municipal police departments in the Lower Mainland, as part of the $5 million to support the work of the joint task force. Following Health Canada’s approval of the sale of intranasal naloxone in Canada on Oct. 3, 2016, both intranasal and injectable naloxone is now available for purchase without a prescription in British Columbia.
Following the announcement of $5 million in government funding, work is also underway on additional priority areas identified by the Joint Task Force.
This includes:
- equipment and supplies for the RCMP clandestine laboratory
- enforcement and response team to support B.C.’s police with drug testing
- enhanced enforcement activities targeted at illicit fentanyl traffickers
- enhanced file investigation for overdose deaths by the B.C. Coroners Service
- renovating and equipping new spaces or purchasing mobile units to expand supervised consumption services
- purchasing drug identification equipment for B.C.’s Provincial Toxicology Centre at the BC Centre for Disease Control
- enhanced surveillance work on overdoses by health authorities and the BCCDC
Health Minister Terry Lake said there is no quick and easy solution to the problem, but the province is spending more than $43 million to support the work to solve it.
He pointed to harm reduction measures like expanding access to naloxone, establishing overdose prevention sites, stationing the province’s Mobile Medical Unit in Vancouver’s downtown Eastside and working with the federal government to interrupt the supply of drugs coming into the country.
“However, there is also significant work taking place on the longer-term solutions required to ensure we have a more co-ordinated and accessible system of care for addictions treatment,” Lake said.
He added that the province has committed to opening 500-substance use beds — including eight in Nelson — and t is expected to reach that goal in 2017.
Health authorities are opening a significant number of beds in January, and Lake expected to have met the 500-bed commitment by the end of March.