B.C. toxic drug deaths ‘largely preventable,’ coroner says, amid push for expanded safer supply access

The BC Coroners Service is urging the province to “immediately pursue” expanded access to safer supply as a new report on toxic drug deaths finds many of them have been “largely preventable.”

The report was released Wednesday. The Coroners Service says in a statement that it is pushing the government to increase access for those who are at risk of “significant injury or death” to receive the safer supply without a prescription.

“This report is the result of a tremendous amount of collaboration and problem-solving,” said Michael Egilson, coroner panel chair. “The experts on the panel were thoughtful, committed, and practical in identifying an approach that we feel can guide future efforts to expand access to viable alternatives to an illicit supply of substances that is only increasing in volatility and toxicity.”

“Our goal was to demonstrate a way forward that reflects a sense of urgency that is commensurate with the scale of the crisis – a way that can be rolled out quickly in order to save lives now. I believe this report accomplishes just that,” he continued.

The Coroners Service says the unregulated toxic drug supply is the leading cause of death in B.C. for people aged 10 to 59. At least 13,112 people have died in B.C. from unregulated toxic drugs since the public health emergency was declared in April 2016.

“[It accounts for] more deaths than homicides, suicides, accidents, and natural disease combined,” the Coroners Service explains.

In its monthly update on drug deaths released Wednesday, the BC Coroners Service says at least 175 people were killed due to unregulated toxic drugs in September.

The death review panel was put together by Chief Coroner Lisa Lapointe in December 2022, after a sustained increase in deaths due to toxic drugs was recorded. The panel was mandated, the service says, to pull together recommendations that “could be quickly implemented on a scale that could reduce substance-related fatalities in B.C.”

“Current safer supply initiatives in B.C. exist within a medical model and primarily serve individuals with an opioid-use disorder who already have access to the health-care system. There are limits on the types of medications that can be prescribed, and any expansion of the programs would place an additional burden on an already strained health-care system in which more than 20% of British Columbians do not have a primary-care provider,” the panel said in its statement.

“The panel noted that, while as many as 225,000 British Columbians are estimated to use unregulated substances, fewer than 5,000 per month receive safer supply prescriptions,” the statement continued.

“The panel affirmed the need for a comprehensive and timely approach to the crisis and recommended, in the short term, the fastest way to reduce deaths is to reduce dependence on the unregulated toxic drug supply. This requires creating access to a quality controlled, regulated supply of drugs for people at risk of dying.”

The panel is making four recommendations for the province to implement. They include having the provincial minister of mental health and addictions apply to the federal government for a “class exemption” to the Controlled Drugs and Substance Act to allow access to opioids and stimulants without a prescription for people at risk of dying due to the toxic drug supply.

It also includes having the ministry develop a plan to distribute the regulated substances; having the ministry engage with people with lived experiences of substance use; and further fund Indigenous-supports and engage with Indigenous leadership to identify “Indigenous solutions to the crisis.”

“The panel recognized that many communities in B.C. have expressed concerns regarding public health and safety. The report strongly advocates for a system of checks and balances to ensure that the goals of the program are met and that public concerns are adequately addressed,” the panel said.

It adds a “robust system of monitoring and evaluation” is required in order to many any adjustments needed quickly.

“The drug-toxicity public-health emergency is now in its eighth year and the devastating death toll in communities across the province continues to grow,” Lapointe said.

“While the concept of safer supply may be challenging for some to understand, the expert members of the panel have provided a thoughtful and careful way forward and out of this crisis. It is clear that safer supply is only one piece in a necessary continuum of care for British Columbians at serious risk of death.

“While that continuum of care is being developed, thousands more of our family members, friends and colleagues are at risk of dying. As the panel found, urgent access to a safe alternative to the current toxic, unregulated, and ever-growing illicit drug market is necessary to keep people alive.”

225,000 British Columbians at risk of dying every day, Lapointe says

Speaking at a news conference Wednesday, Lapointe said toxic drugs have no respect for age, neighbourhood, income, or education, adding that anyone who uses drugs from the illicit drug market is at risk.

“In 2022 alone, BC Emergency Health Services reported over 33,000 paramedic-attended drug poisoning events — an average of 92 per day. Many of those who survived those toxic drug events now live with the long-term severe effects of this drug poisoning. And there are more poisonings, more harms, and more deaths occurring every day,” Lapointe said.

She understands that the issue of safer supply raises “alarm bells” for some, explaining that the idea of providing access to controlled drugs to people already experiencing harm “can feel like a contradiction.”

“I understand that. If you’d asked me several years ago, I too would have been skeptical about the value of that kind of initiative. But here’s what I’ve learned in the past seven years of this horrific public health crisis: it’s estimated that as many as 225,000 people in our province use unregulated drugs. Approximately 100,000 people in our province have undiagnosed opioid use disorder.

“It is a fact that people are using drugs and for a multitude of reasons, oftentimes it’s self-medicating for physical, emotional or psychological pain. Occasionally, it’s for recreation. Every one of these people is at risk of serious harm and death,” she explained.

Lapointe describes safer supply as not a “radical” initiative. “It’s a means to keep people alive, and to support them to wellness, to reduce our loved ones’ dependency on a toxic, profit-driven illicit drug market.”

“[Safe supply] is life support,” Lapointe said.

Chief coroner weighs in on DULF raid

The chief coroner made pointed remarks Wednesday regarding the raid of the Drug User Liberation Front (DULF) in Vancouver earlier this week.

The Vancouver Police Department executed search warrants on the community-based advocacy group, which the VPD claims has “publicly admitted to trafficking controlled substances.”

According to police, the department “executed multiple search warrants as part of an ongoing investigation” into the organization’s operations.

Speaking to the raid, Lapointe says she’s heard a “great deal of rhetoric and ideology” but the Coroners Service looks to evidence, adding “our recommendations are always grounded in evidence.”

“Organizations like DULF are certainly committed to reducing the harms that they see on a daily basis. And I think it’s hard to appreciate the level of trauma in communities and frontline service providers when they see real people dying in front of them day after day after day,” she said. “[It] is just traumatizing. We have investigated more than 13,000 deaths in the last seven and a half years and it is traumatizing.”

Lapointe says while she’s unable to comment on the raids specifically, she alluded to understanding the organization’s motives.

“I suppose I would say that if you see somebody in a burning house, you feel somewhat justified to smash the window,” she said.

“This crisis is massive — 225,000 people are still at risk of death every day. So, we have strongly recommended a number of initiatives including safer supply to prevent deaths and that is our focus. And that is our mandate as the BC Coroner Service.”