The number of B.C. illicit drug deaths dropped in June to a level not seen since September 2020, the BC Coroners Service said in the latest statistics released Aug. 16.
Still, 146 people lost their lives, down 26% from the number of deaths in May 2022 (197) and a 17% drop from June 2021 (175) .
The number of illicit drug toxicity deaths in June 2022 equates to about 4.9 deaths per day, again a decrease over previous months where the death rate was more than five per day. Drug deaths significantly outstrip other so-called unnatural causes of death such as suicide, motor vehicle incidents and homicide.
"Tragically, in the seventh year of this public heath emergency, as we are experiencing increasing numbers of deaths in July, our province has now lost more than 10,000 lives to illicit drugs since April 2016," B.C.'s chief coroner Lisa Lapointe said in a statement.
Communities experiencing the highest number of illicit drug toxicity deaths this year are Vancouver, Surrey and Greater Victoria.
In 2022, 73% of those dying were aged 30 to 59, and 78% were male.
The annual death rate has been steadily increasing in the past decade with 270 people dying in 2012.
The death rate jumped in 2016 to 993 from 529 the previous year and has continued its fatal upward trajectory since with 2,264 in 2021. Some 1,095 people died of an overdose in 2021, a grim record.
The illicit drug toxicity category includes the following: street drugs such as heroin, cocaine, MDMA, methamphetamine and illicit fentanyl — medications not prescribed to the decedent but obtained or purchased on the street.
By health authority, the highest number of illicit drug toxicity deaths was in Fraser and Vancouver Coastal Health Authorities (352 and 297 deaths, respectively), making up 59% of all such deaths during 2022.
Northern Health and Vancouver Coastal Health recorded the highest rates, at 53 deaths per 100,000 people and 47 deaths per 100,000 people, respectively. Overall, the rate in B.C. is 42 deaths per 100,000.
In 2022, 84% of illicit drug toxicity deaths occurred inside. That breaks down to 56% in private residences and 27% in other inside residences, including social and supportive housing, single-resident occupancy spaces such as hotels, shelters, other hotels and other indoor locations. Some 15% occurred outside in vehicles, sidewalks, streets or parks.
In Vancouver Coastal Health, other residences (45%) were the most common place of illicit drug toxicity deaths followed by private residences (36%) between 2019 and 2022.
No deaths have been reported at supervised consumption or drug overdose prevention sites. There is no indication that prescribed safe supply is contributing to illicit drug deaths, the BC Coroners Service says.
The proportion of deaths that are 50-plus years of age has steadily increased year after year for the past six years, the data shows. In 2022, 37% of decedents were at least 50 years old.
Preliminary 2022 data has found that fentanyl or its analogues have been detected in 83% of all illicit drug toxicity deaths. In 2021, fentanyl or its analogues were detected in 86% of deaths.
Post-mortem toxicology results suggest a greater number of cases with extreme fentanyl concentrations in November 2021 to June 2022 compared with previous months. From November 2021 to June 2022, approximately 17% of cases had extreme fentanyl concentrations as compared to 13% from April 2020 to October 2021 and 8% from January 2019 to March 2020.
Between November 2021 to June 2022, 18% of fentanyl-detected illicit drug toxicity deaths in Fraser and Vancouver Coastal Health had extreme fentanyl. concentrations.
The BC Coroners Service says carfentanil has been detected in 61 suspected illicit drug toxicity deaths in 2022 and 189 in 2021.
It notes the detection rate of benzodiazepines has rapidly increased from 15% of samples in July 2020 to 52% of samples in January 2022. It has since decreased to 33% in June 2022.
Between July 2020 and June 2022, etizolam was found in 39% of illicit drug toxicity deaths that have undergone expedited toxicological testing. Etizolam is a benzodiazepine analogue and non-opioid sedative that does not respond to naloxone and creates life-saving challenges for first responders.
Anger expressed by harm reduction advocates
Moms Stop the Harm co-founder Leslie McBain and Guy Felicella, Vancouver Coastal Health and BC Centre on Substance Use peer clinical advisor, expressed disappointment and anger after hearing the latest numbers.
McBain called government action a "catastrophic failure of drug policy forcing users to obtain drugs from the black market of organized crime."
"Those who must access the toxic supply brush up against death every day knowing they might die," she said. "Where is the justice? Where is the compassion?"
McBain said government must move away from a century-old prohibition mindset. She said safe supply and other changes might reduce the death toll.
"We have lost a generation of people," McBain said.
Felicella said B.C. is in the same place it was six years ago in terms of getting safe supply and health treatments for those wanting help, whether that help is a place to detox or a treatment bed.
"These deaths represent somebody's somebody," he said. "They died from a combination of toxic drugs and failed policies. Stigma is allowing them to die alone and in despair."
He added: "We are not doing enough and it is killing people. If you haven't been personally impacted by this crisis, you soon will be."
In a statement, Minister of Mental Health and Addictions Sheila Malcolmson said investments to combat the crisis continue throughout the province
"The coroner's report shows how important our work is to reduce the risk of drug poisonings and to save lives," Malcolmson said. "Clearly more is needed because increasing illicit drug toxicity has outstripped B.C.'s unprecedented addition of new overdose prevention services."
She said the province continues to confront the emergency "from every angle."
"Although progress on building a system of care is being made, we know there is more to do. We won't stop working until all British Columbians can access the services they need and deserve."
Children and youth
Jennifer Charlesworth, B.C.'s representative for children and youth, echoed that B.C. is not where it should be in confronting the crisis.
She said the number of deaths among children and youth — people up to 29 years old — is horrific. So far in 2022, 16 people under the age of 19 have died while deaths among those 19-29 are at 140, according to the coroner's data.
Charlesworth stressed harm reduction measures must be part of aiding young people in stopping their drug use. She said "we have to blow up the myth" that harm reduction is either a condoning or an encouragement of the use of drugs. She called it a way of keeping people alive while beginning to help them with their issues.
"We are nowhere near where we should be," she said.