This year is on track to be one of the deadliest of the opioid crisis across the province, according to data from the BC Coroner.
But there hasn’t been a single overdose death in a safe injection facility or overdose prevention site, places where users can take illegal drugs under the supervision of trained staff.
In Campbell River, one of those facilities began operating last May. By Sept. 27 this year, it had reversed 19 overdoses.
“That’s 19 times people were kept alive that may have died,” said Sarah Sullivan, manager of AIDS Vancouver Island (AVI) in Campbell River and Courtenay.
Both of those AVI facilities include an overdose prevention site, or OPS. Across B.C., overdose prevention sites and safe consumption facilities have yet to see a single fatality, reversing hundreds of overdoses.
The Campbell River OPS is a modest facility. On the wall is a rack holding pamphlets on topics like HIV prevention. The furniture looks like it came from a thrift store, except for a metal table in a corner, brightly lit by an overhead lamp.
That’s where users take their drugs, monitored by a member of the AVI’s small crew of staff.
“They inject or snort, and then we invite them to stay for 15 or 20 minutes afterwards, just so we can observe them,” said Sullivan.
On a busy day, 15 people may use the site, said Sullivan.
People who use drugs at the OPS get supplies like clean syringes. Staff can also provide health-related information, including safer ways to shoot up, and help people connect with other social services.
But surviving an overdose is the key function of the OPS. And it’s working.
|Naloxone kits, like the one shown here, can save the life of someone overdosing on fentanyl and other drugs. AIDS Vancouver Island keeps a stock of the kits on-hand, and they’re free for members of the public. Photo by David Gordon Koch/Campbell River Mirror|
Sullivan took out an oxygen tank from a shelf. In case someone overdoses, the key is to keep them breathing, she said.
“We put the oxygen on them and we’re prompting them to breathe, we’re reminding them to breathe.”
If that doesn’t help, staff immediately call 911 and administer naloxone.
It’s a medication that can save the life of someone overdosing on fentanyl and other drugs. AVI keeps a stock of the kits on-hand, and they’re free for members of the public.
But help with breathing until an ambulance arrives is usually all it takes to save someone’s life, Sullivan said.
“Naloxone is an amazing drug, and it’s extremely safe, but you can still save a life without naloxone,” she said.
As well as operating the OPS, workers at the facility – there are at least two on-site during AVI’s daily operating hours – provide a range of services. Examples include counselling for people with HIV/AIDS and education on safer drug use.
The goal is for people to be healthier while struggling with drug addiction.
“We believe that everyone deserves to be healthy and well,” said Sullivan. “A person can use illicit drugs and still deserve to be healthy and well.”
Slight drop in deaths
The latest figures from the BC Coroner – which tracks all unintended overdose deaths caused by illicit drugs, both confirmed and suspected – show that fatalities are down slightly compared to last year.
With more than 1,450 deaths, 2017 was the worst year on record.
In August of this year, there were 98 deaths, a 20 per cent decrease compared to August 2017, when 122 people died.
Sullivan said the progress is encouraging, and she attributed the change in part to OPS services that have emerged across the province.
“I am sure that the [overdose prevention sites] and the education that’s getting out there is really making a huge impact,” she said.
In December 2016, the provincial health ministry ordered authorities to offer overdose prevention services. That year saw nearly 1,000 deaths, including 23 in the North Island.
Unlike supervised drug consumption sites, which require an exemption from federal drug laws, OPS services can be set up without a long application process.
There are OPS services for several urban centres on the Island, including Victoria, Port Alberni, Nanaimo and Duncan.
In total, there are 21 standalone OPS services province-wide, including mobile sites, according to the Ministry of Mental Health and Addictions.
Similar services also exist within 22 supportive housing settings, and there are nine supervised consumption sites in B.C.
|Most illicit drug overdose deaths between January and August this year happened in the home. Image from the BC Coroners Service.|
In Campbell River, the OPS began operating last May, with funding from Island Health. By September 22 this year, the site had seen 925 visits.
And while OPS services appear to be making a dent in the fentanyl-fueled crisis – fentanyl has been detected in roughly 81 per cent of this year’s illicit overdose deaths, according to preliminary data – 2018 is on track to rival last year for the worst ever. By the end of August 2018, 972 people had died across B.C.
“We still have a long ways to go,” said Sullivan.
Community action team
In February, the province announced that 18 of the communities hit hardest by the overdose crisis – including Campbell River – would receive funding to set up “community action teams” to deal with the fallout of the crisis.
AVI is receiving part of the funding to provide mobile services beginning this month, Sullivan says. It’s a way of addressing a problem of access: many low-income people may have difficulty reaching the OPS or don’t feel comfortable going there due to stigma. Instead, they use drugs in the home.
That’s where the majority of illicit drug overdose deaths occur, according to the BC Coroner.
“Not everyone has access to a vehicle, transportation is not always great,” Sullivan says. “We’ll have regularly scheduled routes and also be able to do home visits.”
|The North Island had the fifth highest per capita rate of fatal overdoses in the province last year, with roughly 30 deaths per 100,000 people. This year, the rate has declined to about 20 per 100,000, but it remains several times higher than before the onset of the opioid crisis. Images and data from BC Coroners Service|
AVI staff will deliver supplies such as clean syringes and naloxone kits to people in the community and provide support to those using drugs in their homes, said Sullivan.
The project also aims to build connections in communities so that people including neighbours and family members can help prevent overdose death.
Sullivan urged people to talk about drugs with friends, family, co-workers and community members, to help banish the cloud of stigma surrounding addiction.
“It’s only through having open and trusting, supportive conversations that we can build a stronger community,” she said. “People are not going to reach out for help if they feel like they’re going to be punished for sharing about their substance use.”