Departing coroner says there is no data to determine whether B.C.’s treatment facilities are working

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Lisa Lapointe, British Columbia’s long-time chief coroner, is making a final push for the province to put in place data collection standards for drug treatment and recovery services, ahead of her retirement next month.

Ms. Lapointe made her case in a wide-ranging interview on Thursday with The Globe and Mail. Her comments coincided with an announcement from the provincial government that it would add 180 new publicly funded substance-use treatment and recovery beds throughout B.C.

One day earlier, the BC Coroners Service had announced that 2,511 people died from illicit drugs last year, a grim new record eight years after the province declared toxic drug deaths a public-health emergency.

The chief coroner, who was first appointed to her role in 2011 and will step down in February after 13 years, has long called for the province to develop regulations that would set standards for public and private treatment facilities to report patient outcomes to the provincial government. There are currently no such standards in place.

“What we find are announcements of ‘beds,’ which sound good, but what we don’t know are what are the outcomes of those beds,” Ms. Lapointe said.

“When we announce a bed, does that mean one person goes through treatment and is still alive six months later? Or one year later? Or five people? Is nobody still alive? Without regulations that require reporting, we just don’t know,” she said.

The recommendation is one of several put forward over the years by expert panels convened by the BC Coroners Service in response to soaring drug deaths.

These panels have also recommended that the province rapidly expand access to traditional treatments for opioid use disorder, such as methadone and Suboxone, as well as pharmaceutical alternatives to illicit drugs, an intervention commonly referred to as “safer supply.”

Asked at a news conference Thursday how the province can measure the success of its treatment and recovery services with no reporting requirements, B.C. Minister of Mental Health and Addictions Jennifer Whiteside acknowledged the lack of standards and suggested the province is looking to develop them.

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“We can talk to organizations like the Canadian Institute for Health Information to encourage them to adopt benchmarks and criteria by which we can measure our success, because we don’t have any of that,” she said.

“The kinds of frameworks and data tools that we have for cardiac health, or for diabetes, or for other chronic diseases, do not exist when it comes to addictions. And that’s work that we are doing – that is happening amongst doctors and nurses and health care experts to really build that out.”

Premier David Eby, who was also present at the news conference, acknowledged that data collection is needed. “It’s critically important for us to know that public dollars that go into addiction treatment … actually produce the results of people getting better out the other side,” he said, adding that the province is working to build out a system to deliver metrics.

Of the 180 treatment and recovery beds announced Thursday, 98 are beds in private facilities that will be converted to publicly funded beds and 82 are new beds. Of the latter, 16 opened this month and the rest are expected to be in place by summer. As of Jan. 15, there were 3,596 publicly funded adult and youth substance-use treatment and recovery beds across B.C., according to the government.

Ms. Lapointe said the province lacks a comprehensive plan for responding to the toxic drug crisis. She said such a plan should have clear goals, such as a 50-per-cent reduction in deaths by a set date.

“There are estimates, in our province, that 225,000 people use drugs,” she said, noting that about 100,000 of those people are believed to have opioid use disorders.

“How many beds would we need to invest in, on an annual basis, to provide treatment?” she asked. For people not diagnosed with any substance use disorder, she added, “Are we going to prescribe safe supply? How many clinicians would we need? If we need 300 clinicians to be prescribing, where are we going to find them?”

An expert panel struck by the coroners service recommended in November that the province expand access to pharmaceutical alternatives to illicit drugs without prescriptions, an idea the government rejected. The Premier reiterated that rejection on Thursday.

“I do not believe that the distribution of incredibly toxic opioid drugs, without the supervision of a medical professional, in British Columbia, is the way forward, and the way out of the toxic drug crisis,” Mr. Eby said. “We just disagree on that fundamental issue.”