Overdose victims trending younger as drug supply grows ever more toxic, death review panel finds

A new report by the B.C. Coroners Service examining four years of illicit drug-related deaths says an increasingly toxic supply in the province is leading to increased deaths and that efforts to prohibit illegal drugs are only making the crisis worse.

The report, entitled B.C. Coroners Service Death Review Panel: A Review of Illicit Drug Toxicity Deaths, reviewed 6,007 deaths from illicit drug toxicity between Aug. 1, 2017, and July 31, 2021. It calls on the province to develop a policy to distribute a safer supply of drugs and offer better health supports with a plan that would see action taken within the next 90 days.

"Although a number of provincial initiatives have been undertaken in an attempt to address the drug toxicity crisis, these initiatives have not been sufficient to stop the rising death toll,'' the report said. "A new approach is required, one that includes a specific focus on the toxic drug supply.''

Illicit drug toxicity is the leading cause of unnatural death in B.C., accounting for more deaths than homicides, suicides, motor vehicle incidents, drownings and fire-related deaths combined, according to the coroner.

B.C. declared a public health emergency in April 2016 when the powerful opioid fentanyl created a surge in deaths. More than 8,800 people in B.C. have since died from suspected fatal overdoses. 

In 2021, there were 2,224 suspected overdose deaths in the province, a 26 per cent jump over the previous year. 

The new report found that deaths from illicit drug-related overdoses are increasing both in number and in rate, the drug supply has become increasingly toxic, and the average age of death is trending younger. It is now at 42.

6 deaths per day

Currently six people are dying everyday in the province from illicit drugs, said the new report.

Indigenous Peoples are disproportionately represented in the fatalities and individuals living in poverty and with housing instability or with poor mental health are more vulnerable, it said.

The report makes several recommendations, including ensuring a safer drug supply and having provincial ministries involved in the crisis develop 30-, 60- and 90-day action plans to provide better monitoring of how and why deaths are occurring and plans to address them.

The report set a deadline for May 9 for the government to create a safer supply policy in collaboration with the B.C. Centre for Disease Control and the B.C. Centre on Substance Use.

"We recognize that many of the timelines in the report are aggressive, but COVID-19 has demonstrated how swiftly policymakers can act when lives are at stake and we know that every month of inaction equates to hundreds more lives lost," said the report's authors, who include death review panel chair Michael Egilson.

The panel was appointed by the chief coroner and included professionals with expertise in public health, health services, substance use and addiction, medicine, mental health, Indigenous health, education, income assistance, oversight and regulation, and policing.

'Urgent action is needed' 

Chief coroner Lisa Lapointe has forwarded each of the panel's recommendations to the relevant ministries and organizations.

"As we approach the sixth anniversary of the declaration of the public-health emergency into substance-related harms, co-ordinated, urgent action is needed to reduce the devastation illicit drugs have inflicted on so many people in our province," Lapointe said in a release.

"This report, by a panel of subject-matter experts, provides a roadmap. It is my sincere hope that their advice will be actioned."

A similar review released in 2018 recommended increasing treatment and recovery programs, expanding programs offering prescription medication to those who are addicted, and more testing of illicit drugs.

The number of deaths started to decline in 2019, but officials have said it spiked again during the COVID-19 pandemic as more people were isolated in their homes and the supply of illicit drugs grew more toxic.

Garth Mullins was a heroin user for more than a decade before getting on a methadone program. He is now an advocate for drug users in Vancouver.

He says treatment programs are important, but will not stem the majority of deaths that continue to occur.

"There's a lot of talk about treatment and health care for individuals but the truth is, we've learned this from the coroner, half of the people who have died from drugs are just like recreational users," he told the CBC's Stephen Quinn.

"So, the longer these politicians keep in this mindset that 'this is an addiction crisis we've got to get people off drugs, it's about abstinence, or whatever,' they're missing the big picture, which is, this is not an addiction crisis, this is a death crisis."

Safe supply

Mullins says establishing a safe supply of drugs in B.C. would be the most effective response to the crisis.

B.C. has applied to the federal government to decriminalize the possession of small amounts of illicit drugs for personal use, in an effort to reduce and prevent future drug poisoning deaths.

Lapointe has called for that to be expedited and the new report asked that Ottawa approve the application by April 11 of this year.

Federal Public Safey Minister Marco Mendicino, who is in B.C. this week, told CBC News Wednesday morning that the report and its recommendations would be taken seriously by Ottawa.

He did not commit to when or if the federal government would provide decriminalization legislation.

"The government will work very closely with health-care experts to continue to support those measures as much as we can," he said. "At the end of day we need to get people who face those substance challenges the proper health care and treatment that they need and the government is committed to doing that."

Support groups see shifting demographics

Mental Health and Addictions Minister Sheila Malcolmson says the report confirms the urgency of the government's work related to a safer drug supply and the continuum of care.

"We agree that one of the most important actions we can take to save lives is to separate people from the toxic drug supply. That's why B.C. implemented in 2020, and expanded in 2021, a safer supply program, the first and only province in Canada to do this,'' Malcolmson said in a written statement.

Penny Douglass knows the heartbreak of losing a loved one to illicit drugs, and has also seen first hand how the overdose problem is growing.

Douglass lost her son to an overdose nine years ago. 

She says the peer-driven support group in Kamloops, B.C., that she's a member of has seen a surge in demand, but also a shift in demographics, with more grandparents seeking help as they assume care of their grandchildren. 

"These are parents whose children would be in that dangerous age group of 35 to 50," she said. 

Douglass says it can be "very scary for somebody in their 70s or late 60s to suddenly be handed an 11-year-old, a nine-year-old," while they are also coping with seeing their own children struggle with addiction. 

She says the group helps parents cope with overwhelming feelings of guilt.  

"We kind of focus on what we call the three Cs — as a parent, you didn't cause it, you can't control it and you can't cure it," she said. 

Douglass's son Simon died of a drug overdose at the age of 30 after more than a decade of struggling with substance use. He was once in intensive care for three weeks after overdosing.

"Four days after he came out of ICU and was discharged, he was back using," she recalled. 

She said prior to his death, he had been in the provincial jail system for nine months.

"When he was coming out, we had said to him, 'You can't come and stay with us. You have to figure it out,'" she said.

'We did the best that we could'

Douglass said she gave her son a hug, gave him a garbage bag containing his belongings, and he left. Days later, he died of an overdose in Kelowna, B.C.

"There's always your feelings of guilt, but we did the best that we could at the time," she said. 

Having a child with substance issues can be all-consuming, she says, so the group tries to get parents to focus on their own health and well-being while also trying to accept that they "can't fix" their children. 

"Sometimes when we stop trying to fix them, they do get help," she said. 

The group meets every Tuesday, 5-7 p.m. PT at the Kamloops Elizabeth Fry Housing Society.