The Overdose Emergency and Covid-19 in British Columbia, Canada
This post was written on the territories of the xʷməθkwəy̓əm (Musqueam), Skwxwú7mesh (Squamish), and sel̓íl̓witulh (Tsleil-waututh) Nations.
This is going to be primarily about the overdose crisis in British Columbia, but can relate to the crisis more generally.
I am not a medical professional. I will be drawing all this information together from the best sources I could find, but the information may be incomplete or become obsolete over time.
We are living in a time of grief and death, of rapid change and looming disaster, an era with multiple crises pulling us in different directions. Even before the worldwide pandemic, there was structural racism and climate change, as well as the danger to democratic values by authoritarian leaders. But in the face of such forces, we must not lose focus on the overdose crisis, which affects some the most vulnerable of our communities.
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Question
There are three parts to the question: How did Covid-19 affect the overdose crisis? First, there is the comparative aspect. When viewed together, how does the overdose crisis compare to the pandemic, and what does that comparison mean? Second, how does Covid-19 affect drug users? Third, how did the pandemic response affect drug users?
Covid-19 and the Overdose Emergency
The first thing to make clear is that this is a crisis. According to the BC Coroners Service, since 2010 (until July 2020), 7,934 people have died in BC from an illicit drug overdose. By health authority:
Interior (1,201)
Fraser (2,708)
Vancouver Coastal (2,294)
Vancouver Island (1,723)
Although this time period extends almost a decade, this amount of death is staggering and unacceptable. To have 7,934 people die from preventable deaths is why the Washington Post calls the situation a crisis. This is not a new or unexpected crisis. It is a crisis that has been compounded and made worse by indifference.
Between January and July 2020, 909 people have died from illicit drug overdoses in British Columbia, while 203 people have died from Covid-19 so far (August 26th). All death is terrible, and it is not my intention to compare deaths and say that one is worse than the other, but I do want to highlight that we are living in the midst of multiple health crises.
Covid-19 is an unambiguous crisis and the province has treated it as such. The number of deaths caused by Covid-19 in British Columbia has fallen, at least for the moment. On the other hand, the number of people dying from overdoses has increased compared to last year, and has plateaued compared to the coronavirus deaths. While overdose deaths were falling, especially comparing 2019 to 2018, to even consider 984 deaths an improvement is a sign of overall failure.
The two lessons I draw from this data is that the government has not fought against the overdose crisis with the same intensity as it had with Covid-19, and that the pandemic has made the overdose crisis worse.
As well, since 2010, the 5 worst months of the overdose crisis have been, in order:
June, 2020 (177)
July, 2020 (175)
May, 2020 (174)
Dec, 2016 (161)
Mar, 2018 (157)
The 3 worst periods (Jan — Jul) of the overdose crisis have been:
2017 (956)
2018 (917)
2020 (909)
Data Cleaned and Graphed by Steve Tornes
This just all goes to show that the pandemic has been worsening the overdose crisis. Never has the overdose crisis been as bad as it is now, despite its reduction in 2019 and the early months of 2020.
The Effects of Covid-19 on Drug Users
The European Monitoring Centre for Drugs and Drug Addiction has provided some guidance on the effects of Covid-19 on drug users. To summarize the reports, using drugs can put a strain on peoples’ lungs, heart, and immune system, putting them further at risk from Covid-19. Also, drugs users are already at risk of other diseases, such as HIV, HEP, and liver cancers, which can weaken the immune system. Sharing needles or inhalation devices could spread the disease. As well, if a person overdoses, their breathing rate falls, which could be made worse by Covid-19, which means that having Covid-19 could increase the risk of dying from an overdose.
I highly recommend people read the article’s references, but we should keep in mind that we are still learning about the disease and that things could change as we learn more about the effects of Covid-19 on drug users. However, it is reasonable to assume, given previous research, that drug users are at a particular risk from Covid-19, being more likely to be infected and if infected, suffer from worse effects. Intervention is needed.
The Effects of the Pandemic Response on Drug Users
It is likely that the pandemic response has led to an increase in overdose deaths. People are going to be taking drugs regardless of whether there is a pandemic or not. If they stop taking drugs, then they will begin feeling the terrible effects of withdrawal. Because of the pandemic, people were unable to access overdose prevention and supervised consumption sites (locations where people could take drugs under supervision which limits the risk of overdosing, and which can test the drugs to make sure that it is not tainted).
The sites have been successful at reducing the risk of overdose. In fact, in British Columbia, “No deaths have been reported at supervised injection sites or drug overdose prevention sites.”. I think that the large drop in visits to overdose prevention sites has led to an increase in overdoses in 2020.
The good news is that the province is making it a bit easier for drug users to have access to prescription drugs, by permitting the ability of pharmacists to extend and renew prescriptions, to transfer prescription to other pharmacists and to permit prescribers to verbally prescribe prescriptions with controlled substances. Of course, the longer goal is to provide a safe supply for people, but this is a good, first step.
If you want to read more about the overdose crisis in general, here is another blog post.
