2023 sees record number of toxic drug deaths in B.C.: coroner

There’s been another grim milestone in B.C.’s ongoing unregulated toxic drug crisis, with the province recording an unprecedented number of deaths in 2023.

The BC Coroners Service says there were 2,511 suspected unregulated toxic drug deaths, marking “the highest number of suspected deaths ever recorded in a year.”

That figure is five per cent higher than the number of deaths recorded in 2022, which was 2,383.

Speaking at her last public address in her role as Chief Coroner before retiring at the end of the month, Lisa Lapointe urged the province to come together.

“Let’s save lives,” she said, adding each and every single death was preventable.

“Their loss, your loss, is our collective loss.”

Since the province declared a public health emergency in April 2016, close to 14,000 people have been killed as a result of drug toxicity, Lapointe says.

“They’ve left holes in our lives, our families, and our communities. They are loved and they are missed,” she said.

The coroners service says the number of deaths reported in November and December 2023 amounts to about 7.2 deaths a day, with 220 and 219 fatalities respectively.

According to the agency, the majority of people — 70 per cent — who were killed by toxic unregulated drugs in 2023 were between the ages of 30 and 59, while 77 per cent were male.

Lapointe explains 80 per cent of recorded deaths occurred indoors and in private residences, while 19 per cent happened outdoors, including in vehicles.

In the entire year, only one death was reported at an overdose prevention site, she added.

There is no indication that prescribed safer supply is contributing to unregulated drug deaths, Lapointe says, as hydromorphone was only detected in three per cent of toxicology tests.

The province estimates 225,000 people use unregulated toxic drugs, with about 100,000 having an opioid-use disorder. Lapointe says given the toxic drug supply and its “unpredictability,” each of those individuals is at risk of death for decades.

“Those using or dependent on substances governed by Canada’s Controlled Drugs and Substances Act have been criminalized for the non-prescribed use of the substances the Act covers. Our country has historically responded to drug use with punishment, imprisonment, fines, court orders, and criminal records,” Lapointe said.

“This response has resulted in lost jobs, lost families, lost dignity, and lost hope. It has required huge investments in the criminal justice system, police, courts, probation officers, and prisons. What if, instead of continuing to revert to policing and punishing for public safety, we focused instead on addressing the underlying reasons people use substances or become dependent on substances, pain, trauma, physical or mental health challenges?

“What if we focused on developing a meaningful continuum of care for those experiencing harms from controlled and illegal drugs or developed evidence-based standards for evidence-based treatment and recovery?” she asked.

“What if instead of watching people die by the thousands in our province and across our country as a result of an unregulated poisonous illicit drug market, we provided those at risk of serious harms with safer regulated alternatives.”

Lapointe says almost a year ago, B.C. embarked on a three-year trial of decriminalizing small amounts of controlled drugs for personal use. The goal of decriminalization is to help reduce stigma, Lapointe explains, and to help encourage people who use drugs to seek life-saving services and care. “It’s to reduce harms. This idea is not radical.”

“Decriminalization is not responsible for these deaths,” she said. “Illicit fentanyl is responsible for these deaths.”

Lapointe explains there is no evidence to suggest that the general public is at risk from public drug use.

“It’s not comfortable seeing people use drugs in public. But who’s most uncomfortable? Is it those of us who get to return to our warm homes and beds and showers at the end of the day? Or is it those living unhoused, who are trying to cope the best way they know?”

She says the goal of decriminalization is also to remove the stigma so that people can access supports.

“We don’t have those supports in place. There is not an infrastructure for people to get the support and help they need, when and where they need it. Everybody’s at a different stage and we have a big province. People live all over the province. The treatment and recovery services are not there,” Lapointe said.

“But the supply is still highly toxic, highly unpredictable, and poisoned. As long as people are dependent on a toxic supply — 225,000 are estimates by those in our province who research these things — then they will continue to die, and the politicization is really, really unfortunate.

“We are talking about human beings, we are talking about people’s lives, and using this issue for political fodder is extremely disappointing.”

Lapointe notes while small pilot programs are available for safer supply, only about 5,000 people are accessing these safer supply programs in B.C.

“[Current] prescribed safer supply is simply not able to address the scale of the public health emergency in which we find ourselves. Current treatment services are simply not able to address the scale of the public health emergency in which we find ourselves. One million people in our province don’t have access to a family doctor, never mind the focused and specialized expertise needed to address a public health emergency of this magnitude.

“Unless we are willing to act thoughtfully, carefully, and with courage to provide a safer supply for the tens of thousands of people at risk in our province. We will continue to count the dead.”

Lapointe reiterated that the 2023 Death Review Panel Report, along with the death review panels of 2017, 2021, and the 2022 all-party provincial committee on health, have called upon both provincial and federal governments to address the drug crisis, by implementing evidence-based access to a legal, regulated supply.

“Let’s save lives.”

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