Alberta commission to tackle overdose crisis

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Alberta has launched a new commission, equipped with a $30-million budget, to guide its response to the overdose crisis. But while the provincial government described the steps as an "aggressive" approach to a soaring number of overdose deaths, details on any new or immediate actions remain scant.

The 14-person commission, announced Wednesday, includes representatives from health, justice, government, people with lived experience, Indigenous communities and community advocacy groups. Karen Grimsrud, Alberta's chief medical officer of health, and Elaine Hyshka, an assistant professor with the University of Alberta's School of Public Health, will co-chair.

"[Associate Minister of Health Brandy] Payne has assembled a strong group which, critically, includes the perspectives of people who use drugs, families affected by substance use and front-line service providers," Dr. Hyshka said.

"I am very mindful of the scale and the absolute urgency of the task we have in front of us. The overdose crisis that we are experiencing is historically unprecedented. It is killing Albertans at an alarming rate and it is leaving many people and families struggling."

Illicit fentanyl and other chemically similar drugs have caused fatal overdoses to skyrocket, particularly in the Western provinces. New numbers released Wednesday show that B.C. is on pace to 1,400 deaths this year, while Alberta's fentanyl-related deaths in the first quarter of 2017 are 60-per-cent higher than the same period last year. Opioid overdoses in Ontario, where the most recent data are a year behind, increased 11 per cent in the first half of 2016 compared with the same period the year before.

Alberta's commission is expected to meet at least monthly, beginning in mid-June, and will submit proposed plans and budgets to Ms. Payne for approval. Approved plans then go back to the commission for implementation.

Dr. Hyshka said some of the commission's first priorities will include providing rapid access to treatment and expanding public coverage of opioid-replacement drugs such as methadone and buprenorphine-naloxone, also known as Suboxone. (Currently, they are only covered for people who are on income support or have coverage through their employers.)

According to an Alberta Health report issued this month, only about 2,300 people began treatment with methadone or Suboxone from Jan. 1, 2014, to March 31, 2017; a major barrier is a shortage of physicians offering it.

Ongoing initiatives include opening supervised-consumption sites – a total of five applications are being completed for sites in both Edmonton and Calgary – and expanding a program that distributes naloxone kits to people who use drugs.

In the first quarter of 2017, 113 people in Alberta died of apparent overdoses related to fentanyl, compared with 70 in the first quarter of 2016. In all, the province recorded at least 443 confirmed drug-overdose deaths last year, with 68 per cent (303) of them being linked to fentanyl or another opioid.

Health officials and advocates have called for a declaration of a public-health emergency, as has been done in B.C., but the province has maintained it would not make available any additional powers to address the crisis.

"When I hear people calling for a public emergency, I hear that people want to see the government taking decisive action, and that government is using a co-ordinated approach," Ms. Payne said. "I think that the commission … that we set out today really helps to address a lot of that."

Hakique Virani, a public-health and addiction medicine specialist at the University of Alberta, said the diverse group of experts selected to guide Alberta's response is important and long overdue. But, he noted, there are still no timelines for various initiatives or particularly bold ideas such as 24-hour treatment on-demand.

"We've not seen or heard that kind of language yet, but I'm hopeful that having folks like [Marliss Taylor, acting chair for the Canadian Drug Policy Coalition] and [Dr. Hyshka] and some of the people with lived experience on the commission will lead us down that path," he said.

Dr. Virani also emphasized the increasingly urgent need to offer supervised injectable opioid-assisted treatment, such as heroin-assisted treatment, and to decriminalize drugs, as a growing number of illicit fentanyl analogues are detected in street drugs.

Statistics released Wednesday show that British Columbia recorded its second-deadliest month on record, with at least 136 people dying of suspected drug overdoses in April. (The deadliest month was December, when 144 people died.)

With at least 488 confirmed fatal overdoses in the first four months of 2017, B.C. is on pace to surpass 1,400 deaths this year.