British Columbia had 128 fatal overdoses in November, the highest recorded number in more than 30 years, and other provinces are looking to B.C. for guidance in the crisis that is spreading across the country.
On Monday, the B.C. Coroners' Service said the tally released on Monday means 755 people have died of illicit-drug overdoses from Jan. 1 to Nov. 30 – a 70 per cent increase over the same period last year. By comparison, 428 people died across Canada during the 2009 flu pandemic that led to a massive public-health response. The SARS crisis in 2003 led to 44 deaths.
Perry Kendall, the provincial health officer, said in an interview that British Columbia's overdose disaster has exacted a far greater toll than either of those public-health emergencies.
Fentanyl, a powerful synthetic opioid, has been detected in 60 per cent of this year's deaths. Carfentanil, an even more toxic opioid found in four provinces, is suspected in another recent overdose surge.
Dr. Kendall said his alarmed counterparts in other provinces are asking what British Columbia is doing to deal with a situation they are seeing to a lesser degree at home.
"We may be a forerunner," Dr. Kendall said. "We're hearing from our colleagues in other provinces and territories as they see fentanyl overdoses climbing. They are becoming alarmed when they look at their data and see similar points emerge. They want to learn from what we're doing."
He noted that public health officials across Canada, including chief medical officers of health, have set up a strategic advisory committee to manage the overdose situation, echoing the joint approach to the flu and the 2014 threat of Ebola.
Dr. Kendall said Prime Minister Justin Trudeau has asked him for a briefing on Tuesday during a one-day visit to British Columbia. "I want to say to him that this is a serious national issue," Dr. Kendall said, adding he will thank Mr. Trudeau for Health Canada's move, through legislation, to reduce barriers Stephen Harper's Conservatives introduced to opening and operating supervised drug-consumption sites.
Public-health officials, police, municipal and provincial politicians and others in British Columbia have rallied to fight a situation the province has declared a public-health emergency. For example, 18 overdose prevention sites have been opened in the Lower Mainland, Okanagan and on Vancouver Island. Training programs are under way for first responders. The B.C. Liberal government, under fire for being too slow, is moving to increase the number of treatment beds, among other measures.
However, officials conceded they are barely holding their ground.
Earlier on Monday, Dr. Kendall told a news conference in Victoria the overdose crisis has caused vast misery. "Hundreds of families are now suffering losses and grieving," he said. "Our front-line responders and volunteers are valiant, but they're stressed, and our health-care systems and services are frankly strained."
Chief B.C. coroner Lisa Lapointe, who also attended the news conference, said some victims are making the fatal error of assuming they are not vulnerable to illicit drugs.
"These are people in all communities across the province, all walks of life – teachers, doctors, university professors, students. People think they're somehow immune because perhaps they don't live in the Downtown Eastside," Ms. Lapointe said, referring to the poverty-stricken neighbourhood in Vancouver that has been hard-hit over decades by illegal drugs.
"That is just not the case. We're seeing deaths everywhere," she said.
Ms. Lapointe said people are using toxic and unpredictable drugs alone, without anyone to provide aid, including the anti-overdose drug naloxone.
Officials said on Monday a downturn in fatal overdoses is unlikely in the short term. Ms. Lapointe said December is looking "like a very bad month" given that 13 people died in a single day last Thursday, including nine in Vancouver.
"We are quite fearful that the drug supply is increasingly toxic. It's increasingly unpredictable, and it's very, very difficult to manage," she said.
Dr. Kendall said he is hearing of people having multiple non-fatal overdoses in a day. He told reporters one man overdosed seven times in a day, and asked for opioid-substitution treatment after he was revived for the seventh time.
"I wish I knew what the answer was, but this is a fairly complex issue," Dr. Kendall said.
BY THE NUMBERS
Here is how the number of overdose deaths in B.C. this year compares with other public-health emergencies and causes of death:
Fatal overdoses in B.C. in 2016, as of Nov. 30: 755
Suicides in B.C., 2012: 509
Canadians who died during the 1953 polio epidemic: 481
Fatalities in Canada during the 2009 H1N1 influenza pandemic: 428
Motor vehicle accident deaths in B.C. in 2015: 300
Homicides involving firearms in Canada, 2014: 156
Deaths during Canada's SARS outbreak in 2003: 44
Sources: B.C. Coroners Service, Health Canada, Statistics Canada