Vancouver's mayor is calling for the decriminalization of illicit drugs and an expansion of injectable treatment options such as medical-grade heroin after newly released statistics showed more people have died of illicit drug overdoses so far this year than in all of 2016.
Mayor Gregor Robertson said the worsening crisis is "horrendous and absolutely heartbreaking" and urged the province and federal governments to take new steps to push back against the overdose epidemic.
"We can't be complacent and let the number of deaths from this public-health crisis be the new normal," said Mr. Robertson, who noted first responders have handled an average of 135 overdose calls a week this year.
In addition to drug decriminalization and the expansion of treatment such as prescription heroin, Mr. Robertson said there must be more supportive housing for drug users and more overdose-prevention sites so staff or volunteers can provide the overdose-countering medication naloxone.
On Monday, the city said 232 overdose deaths have been recorded since the beginning of the year. The BC Coroners Service reported 231 fatalities for Vancouver last year, many involving the opioid painkiller fentanyl. In a statement, the city said it expected more than 400 deaths by the end of the year. Cocaine, heroin, methamphetamine and fentanyl were the top drugs linked to overdose fatalities in 2015 and 2016.
The city's social-policy director, Mary Clare Zak, said the worsening overdose crisis has been traumatic in Vancouver's Downtown Eastside. "It's absolutely heartbreaking," a weeping Ms. Zak said.
Yet she acknowledged the addiction crisis is larger than one class or neighbourhood.
"Half the people who have died are in the Downtown Eastside, and half are outside of the Downtown Eastside," she said. "There are people who are middle-class, recreational drug users. They're certainly not all people who are poor or heavily addicted. They don't fit the stereotype. It's an illness that affects across class."
Over all, British Columbia is on pace to lose more than 1,500 people to drug overdoses this year, compared with an average of about 200 from 2000 through 2010. Fentanyl has been detected in 78 per cent of overdose deaths so far this year, up from 67 per cent last year.
Cities elsewhere in Canada are also grappling with the overdose crisis. Toronto is launching an interim supervised drug-use site – the first such officially sanctioned facility in Canada's most populous city – in response to a spike in suspected overdoses. One weekend last month saw four deaths and more than 20 overdoses in the city's downtown core. Three permanent sites are in the works but won't open until the fall. Supervised drug-use sites are also under review in such other Canadian cities as Ottawa, Calgary and Edmonton.
The crisis in British Columbia comes as Judy Darcy, Minister at the new Mental Health and Addictions Ministry, is considering options to deal with the situation. On Monday, the minister was in Victoria meeting staff at services dealing with the overdose crisis. "The feedback I am getting from people working on the front lines, people who are living with addiction, and important partners like the City of Vancouver, is guiding actions we are taking now and will take going forward," she said in a statement, without elaborating.
Jane Thornthwaite, the opposition critic for mental health and addictions, said the former Liberal government did what it could by declaring a state of emergency around the situation, and that one measure needed is to crack the stigma around mental health and addictions so users and their families will seek help.
"All levels of government have a role to play to ensure those who need supports can easily access them," she said in a statement.
Last week, the BC Centre for Disease Control issued a series of recommendations to deal with the overdose crisis that included providing drug users with clean opioids to take home and inject or allowing them to grow their own opium.
The officer of federal Health Minister Jane Philpott issued a statement declaring Canada is in a "national public health crisis" and said she is committed to using every possible lever to deal with the situation.
In Quebec City, Ms. Philpott told the annual general meeting of the Canadian Medical Association on Monday that the federal response to the "unprecedented national public-health emergency" of rising rates of deaths linked to opioid use has included a commitment to harm reduction, facilitating access to supervised consumption sites and making naloxone available without prescription.
With a file from The Canadian Press
Ian Bailey