“More people are dying of illicit drug overdoses in B.C. than due to homicides, motor vehicle incidents, suicides and COVID-19 combined.”
On #InternationalOverdoseAwarenessDay (IOAD2020) I am equal parts enraged and dismayed. You should be too. This day is supposed to be about commemorating those we’ve lost and raising awareness about overdose—instead, we are at a point where life-saving harm reduction services are facing defunding and/or closure.
Here in Canada, our efforts to respond to this devastating crisis have taken backseat to a number of other issues, despite overdose deaths surging in every corner of this country.
We’ve taken major steps backwards at the worst possible time. The collateral impacts of the global pandemic combined with an exponentially worsening drug supply has led to unprecedented death rates.In Alberta, the UCP has systematically gaslit supervised consumption services (SCS) and endeavoured to weaponize paternalistic and antiquated treatment services as an alternative to harm reduction.
Tomorrow, Alberta’s (and the world’s) busiest consumption site is closing down. It sees over 800 visits a day, and is being replaced by a mobile van that has capacity for two people at a time. There are deaths on the horizon because of this decision. But the Alberta government won’t even release their overdose stats, and likely hope that we won’t notice the incoming carnage.
This is the same government that produced a methodologically flawed report on SCS, that leaned on the expertise from TV interventionists and failed to consult anyone who worked at or accessed an SCS. This report has had far-reaching and devastating effects on the future of these services.
In British Columbia, the deaths are all around us. While first responders and community organizations bear the brunt, we have a premier who moralizes overdose by suggesting it is a matter of choice, not failed drug law. This is at a time where BC is at its third consecutive month of 170+ deaths from overdose. Breaking all the wrong records.
Whether you’re witnessing the massive surges in overdose deaths in Ontario, or decrying the closure of Nova Scotia’s only supervised consumption service, the writing is on the wall. We are losing ground.
For this #IOAD2020, I’m asking every one of my friends willing to read this post to share in our outrage. These are our children, parents, siblings, friends, and chosen family. If you want to help, then write to your mayor, MLA, and MP—tell them the time is now for:
(btw. i had been asking the BCCSU and the drug checking research team for almost TWO YEARS for the data week-by-week, so that i could confirm the changes in the overall supply and its relation to the economic cycle. [‘evidence’]
i was told that they couldn’t/wouldn’t do that, that that was not what their research was about, that my concern about this was irrelevant, and then they flat-out refused to work with me.
let’s also remember how they were funded with five million dollars in the summer of 2016 by Christy Clark, as the the Drug Users Resource Centre was closing down, after the emergency was declared in April of that year, and what else that money could have done other than build those MFs’ careers out of the deaths of our friends. and never ONCE did they consider using a bit of their institutional and social power to take a real risk for drug users. not fucking once.
on the july coroners update on overdose deaths in BC.
i want to give people some information about this update from the provincial coroner on tuesday. it’s your information, actually, and sometimes facts are hard to come by. i’ll do separate posts because nobody likes one that goes on forever.
first here’s a few things the coroner said.
“The number of people dying in B.C. due to an unsafe drug supply continues to surpass deaths due to homicides, motor vehicle incidents, suicides and COVID-19 combined,” said Lisa Lapointe, chief coroner.
or 5.6 deaths every day. average.
july was the third month in a row when there were 170+ Illicit Drug Toxicity Deaths -> using “illicit” to mean that they *socially* not permitted, so people use alone – and not just illegal. different. and toxicity -> poisoned, not overdose. because you use what you use but there’s not way of knowing this.
this is from the coroner’s service statement:
“Once again, post-mortem toxicology testing data published in this report suggest an increase in the number of cases with extreme fentanyl concentrations (exceeding 50 micrograms per litre) in April, May, June and July 2020 compared with previous months.”
how concentrated is that? compare smooth peanut butter vs crunchy. but you can’t see the crunchy bits.
those tiny numbers at the bottom of this are number of deaths per 100,000 – a measurement to compare. right now what matters is that we’re at 30.5/100,000. in 2018, we were 31. remember 2018?
the next thing the update looks at is the location of death. this is one thing where the vancouver region is really different from other parts of the province.
the red slice in the two pie charts is for supportive/social/SRO housing.
Private Residence – includes driveways garages, trailer homes and either decedent’s own or another’s residence. Other Residence – includes hotels, motels, rooming houses, SRO (single room occupancy, shelters, social/supportive housing etc.) Medical facility – includes hospitals, community care facilities, etc Occupational site – includes locations where the decedent was at their place of work. Public buildings – includes restaurants, community centres, businesses, clinics, etc. Outside – includes vehcles, streets, sidewalks, parking lots, public parks, wooded areas, and campgrounds
so, there were DOUBLE the % of overdose deaths in supportive, social, SRO, and hotels, shelters etc in the VCH region than province-wide! Doesn’t that seem like something that could be directly addressed? Instead, operators lie to the public and to funders about “community” and “looking out for one another” and meanwhile abuse their staff who in turn abuse the residents. demolition by neglect.
And “meeting people where they’re at” or even “wrap-around supports” is obviously not identical single-resident units. when homeless people refuse to live in such housing, it is clearly a signal that the housing is not adequate.
if you are living in an encampment and managing ok, and use drugs, and prefer living to being dead, it’s the rational choice.
but obviously these are shitty choices.
just to make the shittiness clear, here’s the two articles from late last year about how no one even bothers to keep track of how many people die in vancouver’s supportive housing, numbers are going up, an its super fucked up.
“If it were daycares or hospitals or prisons, and if there were one or two or three deaths, we would have reached a stage that triggered an investigation,” Gagnon argued. “People are dying in these spaces, no one is doing anything about it. No one is even looking into it.”
continuing on the housing problem (no one wanting to live in the housing/ everyone being dead)
as i’m finding, there isnt A Solution to this: there are many, and “the solution” is always for People to Have Real Choices, which is very simple and outrageously revolutionary at the same time. you should see the looks i get – i might change my name to WTF.
(also whenever someone who has any power at all says “this is how it is down here” – tells you to accept the unacceptable and get used to it – they are not On Your Side, and now you must fight even harder, often alone, because its real.)
on average, 20% – 40% of regular drug users prefer to / will only use alone: it’s their thing. should they be prioritized for safer supply access?low-income/supportive housing needs to have harm reduction built right into it – not be the same as ever, now! with naloxone.
harm remains a feature of operation: how power is deployed when someone has even a tiny bit.such housing must have using rooms, units for couples, units for street families, drug checking and dealers.
housing that acknowledges that drug users exist, in design and policy.formal accountability structures and a complaint process THAT IS DOCUMENTED, and collaborative management between operators and residents. resident committees. yeah low-income co-ops and resident self-management
did you know that not everything needs to become a total clusterdumpsterfire before you can try to fix it? or do something else?
we must dump this idea that 100% shelter rate is only housing worth working for. i would very much prefer to live in the world. what do you think? people out there have often never met people like any of us. i have found that if you give them a chance, most of the time everyone is surprised. and frankly we’re not going to change things any other way.
its like we’ve been behind a wall for 20 years.
the next part of the coroner’s report is on the day/week when the most overdose events occur. let’s talk about what to do about cheque week.this chart is of deaths per day for the province – cheque day is the same day everywhere, but the supply is local. or in transit, from one market to others. as you can see, cheque day seems to be starting to look like other days by the end of 2019 – or was it?
it definitely was not.
the peaks in the lines are cheque week. this chart is of 911 calls for ODs.in 2019, deaths were down by 1/3. calls for serious overdoses were almost exactly the same. as ive said before, it was the changing supply – the benzos. people were very messed up and some will never be ok, but they didnt die.
in the last three months, calls have increased dramatically.
from the gov’t release:
“Paramedics are responding to and reviving overdose patients about 80 times a day, every single day in B.C.,” said Jon Deakin, paramedic practice leader with BCEHS. “It’s a lot. It’s the highest number of daily overdoses BCEHS has ever seen.”
This graph is from the BCCDC – the blue line at the top represents 911 calls throughout the province and the five line nearer the bottom represent the five health regions.
Oh here’s a chart of the % of benzo content in the local down, week by week, since january.
here are those two charts on top of each other. the blue Xs are cheque week.
we can’t allow the government to continue dumping all the legit money on all the poor people in the province on the same day. when you think about it that way, it’s ridiculous.
so here’s my idea: what if you could decide yourself when and how you’d get your assistance on the regular? work it out, depending on what you want to be doing. twice a month, every week, twice a week, thirty bucks a day, whatever. keep cheque day if you’re lazy. yes, you must get a bank account. do you like getting ripped off? yes, we need our own bank, if pigeon bank isnt working out for you.
the point is for you to make choices for yourself – which is all i hear from people everyday, that’s all they want.
this is the only way that i can imagine that would break this fucked up cycle for real. what do people think?
In reports about the 2019 BC coroners report on illicit drug toxicity events the emphasis has been on the decrease in deaths of about one-third province-wide. However the number of calls for an EMS response to an overdose have gone slightly up. And those calls are an undercount of events, as often overdoses are responded to without a 911 call.
But, fewer deaths. 981. 19 per 100,000. 5,010 since 2016.
why? how? yes, harm reduction is in effect. In December 2016 the BC Health Minister Terry Lake signed a order authorizing overdose prevention services. Of course that’s quite a euphemism: overdoses happen frequently. But someone had eyes on you and brought you back. Thousands of deaths have been prevented. Would anything be different now if they were called Death Prevention Sites?
Now, there are many such sites, except where people don’t want them, or regional health authorities won’t fund them. Yes, not having that happen is the purpose of declaring a Public Health Emergency.
Another mitigating factor is the non-opiate contamination in the mix: benzodiazepines, cannabinoids, veterinary tranquilizers… a wide range of psychoactive substances in the supply which can produce what Dr. Kendall describes as a “traumatic brain injury that will last a lifetime.” Young people, rendered psychotic by the poison sludge, wander the streets for days or weeks and die in unspeakable ways. These losses are not counted in this report.
This isn’t about fentanyl, and it’s an opioid crisis only at the moment.
The decrease is not due to everyone already being dead. There isn’t a finite pool of users; the pipeline to the coast is open and flowing.
Not Dead Is Not Enough
A brief comparison of the comments made by the province’s leading Health officials and the statement released by the minister of mental health and addictions might be helpful to illustrate where precisely the problem lies.
The coroner’s report, Illicit Drug Toxicity Deaths, is accurately titled, but it’s an enumeration of just that: deaths, rather than catastrophic events. The situation is not actually improving; the supply is continuing to degrade. This is the part of the Coroner’s statement that I stared at intently:
“͞Collectively, we continue to urge for greater access to safe supply for those in our community who are experiencing, and struggling to live with, substance use disorder.”
and noted that it’s not “struggling with substance use” but “struggling to live with substance use.” It’s living that’s the issue here (and disorder is really subjective).
Provincial Public Health Officer Dr Bonnie Henry (who submitted a special report to the provincial legislature under the authority of the Public Health Act last March called Stopping The Harm which recommended the decriminalization of people who use drugs and therein thoughtfully provided our elected leaders with several options for doing so, all within their jurisdictional purview – the report was aggressively ignored and its recommendations were never debated in the legislature) stated:
“ And in the meantime, we need to change our approach so that people who use drugs are able to seek help without the fear of being charged criminally and with access to a pharmaceutical alternative, instead of what is clearly a toxic street-drug supply.”
And Dr Perry Kendall, who declared the emergency almost four years ago:
“We must also acknowledge that overdoses are still occurring at an equal or greater rate than ever as a result of the toxic drug supply, posing a significant public health threat that will impact a generation of British Columbians.
Lives are being saved, but saving lives alone is not nearly enough. We must now turn our attention toward implementing strategies to prevent overdoses from occurring in the first place — which must start with a legally regulated drug supply.”
Legally regulated, as if drugs were pop or lettuce or ridesharing or busking or banking or housing. OR DRUGS. Here’s the problem we seem to be encountering:
We know how to do this. Stop saying that individuals need help with their problems when our problem is a political massacre a generation in the making, driven by a century of prohibition. And rather than recognizing our collective moral imperative to address it directly, people complain that the corpses are bad for business.
Minister of Mental Health & Addictions, Judy Darcy:
“I want to extend my deepest gratitude to first responders, peers, families, health-care professionals and community workers who are dealing with the deeply emotional toll of doing everything they can to save lives and connect people to care time and time again. Our province owes you a debt we can never repay.
“The way we act and speak can make a life-changing difference for someone who is living with addiction, to find a pathway to hope and to healing. We cannot afford to stop caring. It really will take all hands on deck to stem this terrible tide and reduce the stigma that leads to so many people using and dying alone.
“As we look to the year ahead, we will continue to work closely with and listen to the valuable advice of our partners, including people with lived experience to save lives and build a better, more connected continuum of care options for people living with addiction.”
Two separate issues are being avoided interchangeably here – individual struggles shouldn’t be confused with the tide of death, and the solutions are distinct. The solutions for the second thing are safe supply, decriminalizing the person, restructuring social assistance into guaranteed income, and rapidly expanding public housing.
This deathspiral was not your creation, but it’s your responsibility now.