Analyzing 10,000 deaths: More illicit drug overdoses on days after income assistance payments in B.C.

A just-released report from British Columbia's coroners shows that more people have died from illicit drug overdose in the first six months of 2022 than in any other year in the province, bringing the death toll of the crisis past 10,000.

Preliminary data made public Tuesday shows that 1,095 people died between Jan. 1 and June 30, a toll that is likely to grow as death investigations conclude.

That's two dozen more people than at this time one year ago. It's 958 more people than at this time 10 years ago.

And that's despite the fact that the monthly death toll was lower in March, April and June than it was in the same months in 2021.

According to the BC Coroners Service, 146 people died of suspected illicit drug toxicity in June 2022 – a 17 per cent decrease year-over-year, and 26 per cent fewer people than in May 2022.

While that number is lower than B.C. has seen at times in the years-long opioid crisis, it's still high, equating to an average of nearly five people dying from the province's toxic street drug supply every day of that month.

The July numbers have not been released, but the province's chief coroner suggested a similar trend last month.

"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," Lisa Lapointe said in a news release.

"These were men, women and youth from all walks of life. They lived in our neighbourhoods, worked in our workplaces and played on our sports teams. Some lived ordinary lives, while others faced enormous challenges. All of them fell prey to the lethal supply of illicit drugs that is omnipresent."

As it has been for some time, illicit drug toxicity is the leading cause of unnatural death in B.C. It is second only to cancer in terms of years of life lost, the provincial coroners say.

The overdoses included in the coroners' monthly report are those involving heroin, cocaine, MDMA, methamphetamine, illicit fentanyl and other street drugs, as well as medications obtained or purchased without a prescription and combinations of those drugs with prescribed medications.

EXTREME FENTANYL CONCENTRATION

As has been the case for years in B.C., fentanyl is a contributing factor in a high percentage of deaths. So far this year, illicit fentanyl was found in 83 per cent of investigations.

That's down from 86 per cent in 2021, but this year's data is subject to change as further toxicology results are received, according to Tuesday's report.

Ten years ago, illicit fentanyl was a factor in just five per cent of deaths.

What is going up is the percentage of deaths in which toxicology has uncovered an extreme concentration of the opioid.

The coroners say post-mortem testing suggests extreme levels (greater than 50 micrograms per litre) have been found in 17 per cent of cases in the last eight months.

In the previous testing period, extreme concentrations were found in 13 per cent of tests. Prior to that, just eight per cent of cases.

The presence of ultra-potent analogue carfentanil is down this year, to 61 deaths from 189.

Most deaths in B.C. involve fentanyl, cocaine, methamphetamine/amphetamine and other opioids. The coroners' report says the presence of meth is up from 14 per cent in 2012 to 41 per cent in 2021, while deaths from cocaine and other opioids (except fentanyl) have steadily decreased in that period. That being said, cocaine was still a factor in nearly half of deaths last year.

INCOME ASSISTANCE

Data presented by the coroners without comment showed that more illicit drug toxicity deaths occurred during the days immediately following income assistance payments (welfare) than on all other days in 2021-21.

The average this year on those days, Wednesday to Sunday, is 8.2 deaths per day. That's compared to 5.9 deaths per day the rest of the month, and a weekly average of 6.3.

The report did not provide any further information on this trend, or make any recommendations about response on those days.

WHERE AND WHO

The report on the first half of the year showed that the areas experiencing the highest number of deaths are also among the province's most populous: Vancouver, Surrey and Victoria. Sorted by health authority, the Lower Mainland accounts for nearly 60 per cent of fatal illicit drug overdoses – not entirely surprising given population.

But looking at rate per 100,000 individuals, Northern Health continues to see a disproportionate amount of deaths.

The rate in that health authority is 53 per 100,000, compared to the provincial rate of 42.

Areas hit hardest, when looking at rates, are Lillooet, Mission, Terrace, Cariboo/Chilcotin and Powell River, the coroners' data showed.

Most people (84 per cent) died indoors, not on the street, in residences including private homes, supportive housing, shelters and single-room occupancy hotels.

No one has died at a supervised consumption or drug overdose prevention site, the data from this year showed, and the coroners service says there is nothing to suggest prescribed safe supply is playing a role in these deaths.

The chief coroner reiterated Tuesday that she believes these types of programs are key when it comes to saving lives.

"It's only when we drastically reduce people's reliance on the profit-driven illicit drug trade that we will save lives and turn the trajectory of this crisis around," Lapointe said.

As for who is dying, most are men, and most are between the ages of 30 and 59.

According to the data, death rates among people of all age groups were down in June.

The proportion of deaths in those aged 50 and older "has steadily increased year after year for the past six years," including this year, where more than one third (37 per cent) have been in this age group.

Sixteen people have been under the age of 19 so far this year, two of whom died in June.

In a statement, the provincial minister of mental health and addictions listed investments the governing NDP has made since January, including expanding treatment and recovery options in some communities, "leading the country on decriminalization and prescribed safer supply," and opening complex care housing complexes.

Sheila Malcomson did not commit to future investments in her response Tuesday, but said in part that "clearly more is needed because increasingly illicit drug toxicity has outstripped B.C.'s unprecedented addition of new overdose prevention services."