Overdoses dip over six-month period in Alberta and B.C., but the reasons are wide-ranging

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The drug toxicity crisis that has claimed the lives of thousands of Canadians is showing early signs of slowing in Alberta and British Columbia but experts suggest it has less to do with their divergent drug-related policies and is instead a result of fewer COVID-19 disruptions.

Monthly death tolls in both Western provinces hit unprecedented highs last winter, as the fifth wave of COVID-19 gripped Canada. But recent data released by both provincial governments show deaths have overall decreased in the first half of the year, with some monthly fluctuations.

In June, B.C. recorded 146 deaths, which is a 31-per-cent decrease from its monthly record of 212 in January. During the same time period, Alberta logged a 42-per-cent reduction.

Deaths rates remain above prepandemic levels.

The provinces, though connected by border, are a distance away from one another when it comes to addressing the deadly crisis. While Alberta’s United Conservative Party has transitioned to a recovery-focused approach after taking office in April, 2019, B.C. has long been a pioneer for harm-reduction services, such as supervised consumption sites and safer supply programs.

Mike Ellis, associate minister of mental health and addictions in Alberta, has attributed the downswing in unintentional overdose deaths to the province’s recovery-oriented strategy, pointing to investments in detox, treatment and recovery programs. In a statement, Mr. Ellis said they are “cautiously optimistic that this trend will continue.”

Public-health experts say it’s still too soon to tell, especially with a volatile drug market.

Elaine Hyshka, assistant professor at the school of public health at the University of Alberta, said if Alberta’s strategy was highly-effective, there would have been a less severe increase in deaths during the pandemic considering it was implemented at the same time. She said the simultaneous reduction in fatalities in B.C. and Alberta, despite contrasting approaches, signals there is another driving factor.

“I would suspect that it’s actually fluctuations in the illegal market,” Dr. Hyshka said. “The removal of public-health restrictions, the increase in travel and opening the borders again I think certainly is influencing what’s available for sale in the illegal market.”

She pointed to an Alberta Health Services report on Calgary’s Safeworks supervised consumption site that shows there has been a decrease in non-fatal overdoses at the facility in recent months. Eighty-seven overdoses occurred from 3,162 drug consumptions in July, which comes to 2.5 per cent. That percentage nearly hit 8 per cent in December, 2021. Dr. Hyshka said this suggests the drug supply is getting “more predictable and less toxic.”

B.C. Addictions Minister Sheila Malcolmson said, in a statement, “the toxicity of the supply has increased faster than the government has been able to stand up new services.” She said the concentration of fentanyl detected in drug-related deaths has increased to 27 per cent in June, from between 4 and 8 per cent in early 2020.

Monty Ghosh, an addictions physician and assistant professor at the University of Alberta and University of Calgary, said the removal of COVID-19 restrictions has also restored access to services, like supervised consumption sites that had to limit intake for public safety, while leading to a probable decrease in the prevalence of substance use.

“One thing we saw during the pandemic is that there was a higher level of substance use overall. Not just opioids, but other things like alcohol and cannabis mainly because people’s mental health was deteriorating, things were shut down and people were isolated,” said Dr. Ghosh. “There is a likelihood that less people are isolated and, therefore, less people using alone at home.”

He also drew attention to a range of programs that differ between provinces. While B.C. might have more access to specialized injectable opioid agonist therapy, for example, Dr. Ghosh said Alberta had more robust detox services. There are so many factors at play, said Dr. Ghosh, but what is true for both provinces is the need to do more.

“There needs to be as much funding in the country for the opioid crisis than there has been for the COVID-19 pandemic,” he said. “In terms of having patient-centered care, we need to have all options available for whatever they need at the time.”

In Alberta, more than 7,300 people have died in overdoses since the province began collecting data in 2016. In B.C., 11,670 people have died since 2012.

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