By Fran Yanor / Legislative Reporter

Northern Health has the highest rate of illicit drug overdose deaths in the province, with the Northeast, North Interior, and Prince George particularly hard hit, according to public health officials.

“At a time where some other health authorities might be seeing slight improvement, just slightly, with some decreases in their overdose deaths, we’re actually seeing an increase,” said Northern Health Medical Health Officer Dr. Rakel Kling. “Which is very troubling.”

For the second month since the pandemic began, the number of people who died of illicit drug overdoses in the province dropped, even as it continued to rise in the North, according to the B.C. Coroners Service.

The number of people who died of overdose had been reducing from peak levels in 2017 and 2018 until the pandemic hit. Overdose deaths in B.C. escalated from 73 people in February to around 180 people in each of May, June and July. August saw the first substantial decline of deaths – 147 people – since COVID-19 public health measures were implemented.

Although 60 per cent of the 8,091 people who have died in the province since 2010 resided in the Lower Mainland, the highest rate of people dying from illicit drug overdoses occurred in the North where a total of 476 people have died (40 people per 100,000 population). The province as a whole lost 31 people per 100,000.

The size of the circle indicates the number of overdose or suspected overdose events that were reported by Northern Health in each community between June 2016 and August 2020. Overdoses that did not involve an emergency room or health clinic were not included. Northern Health graphic

In Canada, between January 2016 and March 2020, 16,364 people have died of apparent opioid-related deaths. About 90 per cent of people who have died are aged 19 to 59 and around 80 per cent are men.

In 2019, one person died of an illicit drug overdose in the McBride and Valemount health service area. At that time, Prince George city central had the highest rates of overdoses in Northern Health.

Illicit drugs are defined as heroin, cocaine, MDMA, methamphetamine, illicit fentanyl, along with medications not prescribed to the person who overdosed, and combinations of street drugs and prescribed medication.

Fentanyl or its analogues have been detected in about 80 per cent of all illicit drug overdose deaths. Fentanyl is 50 to 100 times more powerful than heroin. Legal fentanyl is a common anesthetic used to relieve pain. Illegal fentanyl is often mixed with other substances, usually without the substance user’s awareness or consent. More than 90 per cent of all overdose deaths have been deemed accidental.

There are a range of reasons why someone might develop a substance use disorder, said Nick Rempel, Northern Health strategic lead for mental health and substance use.

“We know that lived experience or living experience with trauma is a major contributor to substance use and to addiction,” Rempel said. “As well as a myriad of socio-economic factors that play a role, and some genetic components as well.”

The isolation of a rural or remote lifestyle is another risk factor of Northern living, said Rempel.

Throughout the North, few communities have been immune. From June 2016 through Aug. 20, 2020, Northern Health reported 1,803 overdoses (fatal and non-fatal) in emergency rooms and health clinics across 22 Northern communities, with 984 occurring in Prince George alone. More than 118 overdoses were reported in Dawson Creek, at least 131 in Quesnel, and 77 or more in Fort St. John.

More people die of overdoses in B.C. than homicide, suicide and motor vehicle incidents combined. The number of overdoses dropped in 2019 but began increasing again during the pandemic in 2020. / BC Coroners Service

In 2017, fewer than five illicit drug overdoses were reported in Valemount. (In rural communities, small numbers of people who overdosed are listed as ‘less than five’ by BC Centre for Disease Control).

As drug overdose deaths increased during the pandemic, the Province expanded those who can prescribe opioid replacement treatment to include registered nurses, pharmacists and nurse practitioners. Treatment can also be accessed by calling 811.

Standard practice in Northern Health is to engage people in an alternative opioid treatment and provide take-home Naloxone, Rempel said.

Naloxone is an easily injected medication that can reverse an opioid overdose. Almost 800,000 Naloxone kits have been distributed in B.C., with more than 66,000 kits used to reverse an overdose.

One modelling study published by BCCDC in the Lancet estimated alternative opioid treatment, supervised injection sites and take-home Naloxone kits prevented more than 3,000 overdose deaths in B.C. between April 2016 and December 2017, with 93 overdose deaths averted in the North. Naloxone kits can be picked up for free from pharmacies, hospitals, health clinics and agencies, including the Valemount Health Centre, the McBride Health Unit, the Clearwater Health Unit, and Clearwater Pharmasave.

Fran Yanor / Local Journalism Initiative / [email protected]