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A man stops to read messages attached to shoes hung on the Burrard Bridge in remembrance of victims of illicit drug overdose deaths on International Overdose Awareness Day, in Vancouver, on Aug. 31, 2020.DARRYL DYCK/The Canadian Press

Paramedics in British Columbia responded to an average of nearly 100 overdose calls every day in 2021, a 31-per-cent increase over the previous year as the province’s toxic drug crisis continues unabated.

The final tally from BC Emergency Health Services (BCEHS) of 35,525 overdose calls, released Wednesday, is the most on record, with call volumes having climbed every year since 2015, when there were 12,263 overdose calls.

The Vancouver Coastal and Fraser Health regions, which together serve about half of B.C.’s population, recorded the most calls, at 11,204 and 10,573, respectively. The cities with the most calls were Vancouver (9,993), Surrey (3,674), Victoria (1,952), Kelowna (1,588) and Abbotsford (1,368).

The cities that saw the largest increases from 2020 to 2021 were Courtenay (a 127-per-cent rise, to 467), Cranbrook (84 per cent, to 191) and Mission (82 per cent, to 397). Surrey saw a 49-per-cent increase, to 3,674. Meanwhile, Fort St. John and Quesnel saw decreases of 22 per cent (to 97) and 25 per cent (to 157), respectively.

At the BCEHS communications centre in Vancouver, paramedic specialist Brian Twaites receives an alert on his computer every time someone in B.C. calls 911 to report an overdose – a highest-priority, code-purple event. In 2021, that meant an average of 97 alerts a day just for overdoses, on top of other purple responses such as serious motor-vehicle accidents and cardiac arrest.

“I can hear it in the back of my head right now,” Mr. Twaites said in an interview on Wednesday. “It’s sort of like an inbox. You tap the call open, you see it’s a drug overdose, Narcan’s been given, or no Narcan is available. You see those flurries when there’s lots of them going on, and it’s alarming. I can’t describe it.” Narcan is a brand name for naloxone, a drug used to reverse the effects of an opioid overdose.

Mr. Twaites, who also works in the field, said the culmination of higher call volumes, the COVID-19 pandemic, extreme weather events, and the worsening overdose crisis have made the job more physically and mentally taxing for paramedics. He recalled the additional challenges of responding to events during the pandemic at the height of the heat wave last summer.

“You’re wearing a respirator, you’re wearing a face shield, of course you’re wearing plastic gloves, and wearing a plastic gown. Even in regular weather, that’s very taxing, but imagine during the heat dome what it would have been like,” he said. “That sort of plays into your mind, too, because people are upset – ‘Come on, hurry up, help’ – but you’ve got to protect yourself, too.”

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The BC Coroners Service reported separately that a record 1,782 people had died from illicit drug toxicity in B.C. in the first 10 months of 2021, making last year the deadliest year on record with two months left to be tallied. At least 201 people died in October alone.

The synthetic opioid fentanyl, detected in less than 5 per cent of drug deaths in 2012, has consistently been found in about 85 per cent of deaths since 2017, with concentrations increasing during the pandemic.

Meanwhile, expedited toxicology results on a subset of deaths found that benzodiazepines, a class of drugs commonly used to treat sleep and anxiety disorders, were detected in 53 per cent of drug deaths in October, up from 15 per cent in July, 2020. Benzodiazepines increase the risk of overdose when combined with opioids, and can result in people being unconscious for hours.

Mr. Twaites said that on top of needing to administer significantly more naloxone to overdose patients, the growing prevalence of benzodiazepines has further complicated already high-acuity overdose calls.

“We’re trying to ventilate and support these people’s respiratory status, they’re deeply unconscious and quite often they’ll vomit and so we have a huge risk of aspiration we have to deal with as well,” he said.

People who remain unconscious from benzodiazepines must be transported to hospital to be monitored. When hospitals are busy, paramedics sometimes wait with patients in the hallway for a bed to be cleared, Mr. Twaites said.

He said there are two types of overdose calls that stick out to him. One is when paramedics don’t arrive in time to resuscitate a patient, knowing the cascade of events that will follow, the heartbreak that friends and family members are about to experience.

And the other is when he sees an overdose patient who was keen on getting help overdose again down the road, and they remember him.

“I remember one fellow just looking at me and just nodding his head: ‘I just had a slip. I just had a slip,’” Mr. Twaites recalled. “You feel for people like that because they’re fighting their demons. Calls like that will stick out.”

Proponents of safe supply say it’s a way to curb the growing number of Canadians dying each year to a street drug supply saturated with dangerous substances such as fentanyl. Safe supply programs offer pharmaceutical alternatives and studies show they can prevent overdoses and other crime, while critics worry that recipients may sell their prescribed drugs to buy other substances.

The Globe and Mail

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