A recent drop in toxic-drug overdose deaths is likely because of a change in the supply, not government policy, some Island addictions physicians say.
On Monday, the province reported its lowest monthly number of overdose deaths from street drugs in just over four years. The B.C. Coroners Service said 1,925 people died of overdoses in the first 10 months of this year, a drop of nine per cent from the same period in 2023.
Dr. Ryan Herriot, a family physician specializing in addictions medicine, said the statistics are “hopeful” but don’t necessarily suggest a long-term trend.
Herriot said what often kills people taking fentanyl is a higher potency of the drug than anticipated and the drug cartels by now might have figured out how to deliver better consistency.
People also accidentally overdose because they believe they are taking a stimulant that is instead littered with opioids they never intended to consume, he said. “The people who terrify me, frankly, are the people who use stimulants and have no notion whatsoever their supply might be contaminated with fentanyl.”
While it’s hard to know what’s going on in drug cartels, they are organized and capable of changing what they are producing very quickly, he said. “Decisions were taken in some backroom somewhere to change the supply and what motivates that I have no idea.”
Herriot said he doubts illicit drug traffickers care whether users die and suspects they have just become better at producing the drugs, or better suppliers have come on the scene.
“But there’s no guarantee that’s going to continue to the next month or the next month.”
Fentanyl continues to be detected in more than 80 per cent of drug deaths.
In October, 155 people died from drug poisoning, down from 183 in September. That amounts to about five deaths per day in October, down from a high of almost seven a day.
Vancouver had the highest number of unregulated-drug toxicity deaths in the month at 39, followed by Surrey at 16, and Greater Victoria at nine.
The B.C. Coroners Service said it doesn’t have data to explain the drop in deaths, but “it is consistent with reporting from other jurisdictions” and officials are working to understand the change.
Dr. Alexis Crabtree, public health physician with the B.C. Centre for Disease Control’s harm reduction and substance use services, said the reduction in drug deaths is “really encouraging” but it’s too early to say if it’s a lasting trend.
Crabtree said one hypothesis is lower fentanyl concentrations, but that doesn’t explain why deaths among women are rising. Other theories range from fewer people being able to access the illegal drug supply due to large seizures by drug enforcement officers, to more people entering treatment, and greater use of the overdose-reversing drug naloxone.
Fewer people of high school age are using drugs, she said, adding another contributing factor could be in part that so many people have already died.
Dr. Jess Wilder, a Nanaimo family physician and addictions specialist, suspects the dip in drug deaths is just a “blip” from a scientific standpoint.
“I would love to see this continue and become a confirmed trend, but as of right now, scientifically, it’s meaningless,” Wilder said.
Despite the improvement, unregulated toxic drugs remain the leading cause of unnatural death in B.C. for those ages 10 to 59, accounting for more deaths than homicides, suicides, accidents and natural disease combined.
Herriot, who with Wilder advocates for more supervised consumption sites and a safer pharmaceutical supply for people who use illicit drugs, said any time law enforcement knock out a large supplier, it causes some people who use drugs to lose connections with their supply, but that’s temporary.
He rejected any suggestion that the province’s decision to limit decriminalization to drug use in one’s home or shelter has any connection to the reduction in toxic-drug-overdose deaths.
“I’m not sure that the recriminalization of drug use and drug possession in public spaces has necessarily made it harder to use — I don’t think there’s any evidence of that.”
If anything, he said, people are more likely to disappear into alleyways and bushes, where they’re at greater risk of dying alone.
The B.C. Coroners Service said 22 per cent of those who died as a result of toxic drugs in October were female. This year, the rate of deaths among women and girls more than doubled from five years ago.
Herriot said drug deaths are highest in white men in the trades, but on a per capita basis, marginalized populations are at greater risk, including women — especially Indigenous women.
He said the doubling of illicit-drug-overdose deaths involving women is likely the result of women using alone for their own safety. “You can imagine the incredible sexual vulnerability of using drugs at an altered level of consciousness,” said Herriot. “That would be my insight, that it’s probably women locking the door for the privacy they need and they’re dying of overdose.”
There were no deaths of people under 19 due to unregulated drugs in October.
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