Patient went to ER 180 times, says Eby, as he names science adviser on drug crisis

In Vancouver's Downtown Eastside, one person made 180 hospital visits last year, according to Premier David Eby, who said the patient was part of a crisis of repeated emergencies among people with overlapping health and addiction problems.

They include people with brain injuries from overdoses who show up in British Columbia hospitals far more often than most, he said.

Eby called the situation one of the "biggest challenges" facing the province, as he announced the appointment of a chief scientific adviser to address this "rapidly emerging group" of people with the concurrent disorders who need specialized care.

"As the toxic-drug crisis changes, we're facing new challenges and grappling with a growing group of people who are very sick and struggling in our streets and emergency rooms," he said in a news release on Wednesday.

"The current situation is not working for these people and it's not working for our communities."

Eby said about 15,000 people in B.C. have died from toxic drugs since a public health emergency was declared in 2016. Many more survived an overdose, but Eby said some were left with life-altering brain injuries that affect their ability to function.

Figures from the BC Centre for Disease Control show that 79 per cent of people who overdosed between January 2015 and December 2021 lived.

Eby cited data from 2023 that found patients with overlapping needs who live and get care in Vancouver's Downtown Eastside often suffer repeated health emergencies. In addition to the patient who made 180 emergency room visits last year, four patients went to ER more than 140 times, while 612 others went 10 times or more, he said.

"The current situation is clearly not working for these individuals and it is having a very serious impact on our health care system, which is not addressing their needs," he told a news conference. "One of the biggest challenges we face is that the particular needs of this growing group of people is not understood as well as it should be."

He said that is why the province decided there was a need for an adviser.

Dr. Daniel Vigo becomes B.C.'s first chief scientific adviser for psychiatry, toxic drugs and concurrent disorders and has a goal to improve care for people with complex mental-health and addiction challenges.

Vigo, who's a psychiatrist and a public health specialist, told the news conference there is a high prevalence of brain injury in overdose survivors.

"For every overdose death, there are a number of overdose-related permanently injured brains," he said.

"Overdose produces brain injury, and when that injury is severe enough to be diagnosed, preliminary evidence indicates that person has a 50 per cent chance of dying in the immediate future, and the survivors (have) an additional 30 per cent chance of dying in the near future."

He said such injuries can also impair insight, judgment and ability to consent, "all of which make treatment-as-usual ineffective."

"We need a whole new approach, one based on the best insights our evidence can produce," he said.

Eby noted these people are also "often involved with police, with ambulance response, with emergency rooms. They're in and out of jail and shelters."

To address the problem, the premier said Vigo would analyze existing mental health and addiction services, while reviewing data and best practices from elsewhere to determine what could be done in the province.

He said Vigo would work alongside the provincial health officer, health authorities, Indigenous partners and people with lived experience.

"He'll advise us on new tools and give us advice to help this very specific group of people so they get the help they need, and our communities are safe and healthy for everyone," Eby said.

This report by The Canadian Press was first published June 5, 2024.