Last year was B.C.'s deadliest on record for drug overdoses, with almost five people dying every day on average, according to the BC Coroners Service.
In 2020, 1,716 people died due to illicit drug use — a 74 per cent increase over 2019, when 984 people died.
Last year's staggering toll equates to about 4.7 deaths per day, which is two per day higher than in 2019.
It means more people died of drug overdoses last year than car crashes, homicides, suicides and prescription drug-related deaths combined.
Decades of criminalization, an increasingly toxic illicit drug market and a lack of timely access to treatment and recovery services contributed to the deaths of thousands of British Columbians, chief coroner Lisa Lapointe said in her most recent report.
COVID-19 further highlighted the precarious situation of those using drugs in B.C., she said, adding that urgent change is needed to save lives.
"People are dying in communities across B.C., from all walks of life, and leaving behind broken hearted families, friends and colleagues," Lapointe said.
"Thousands of years of life and potential are gone. We must turn this terrible trajectory around."
In December alone, 152 people died of suspected drug overdoses, a 130 per cent increase from the same month the year prior. It was a slight decrease from November 2020, when 158 people died.
Of those who died in 2020, 69 per cent were between the ages of 30 and 59, and 81 per cent of those who died were men.
The crisis affected every community in B.C., Lapointe said, but the communities that saw the highest number of overdose deaths were Vancouver, Surrey and Victoria.
Fentanyl was detected in more than 80 per cent of drug overdose deaths in B.C. in 2020. Cocaine and methamphetamine were the next most commonly detected drugs.
More than 80 per cent of drug overdose deaths occurred indoors: 56 per cent inside private residences and 28 per cent in other residences like supportive housing, single-residence occupancies, shelters and hotels.
The remaining overdose deaths happened outside, including in vehicles, on sidewalks, or on the street.
Overdose deaths among people aged 19 to 59 has trended downward over several months, according to the coroners service, while rates for those aged 60 and up have trended upwards.
Overdose death rates for those 18 and younger remains low.
No deaths have been reported at supervised drug consumption sites.
408 deaths in Vancouver a 'wake-up call': mayor
In October, city councillors in Vancouver voted unanimously to ask the federal government to decriminalize small amounts of illicit drugs for personal use.
On Thursday, Vancouver Mayor Kennedy Stewart said the loss of 408 people in the city to illicit drugs in 2020 was "another wake-up call in a long line of wake-up calls."
He called the longstanding drug crisis "one of the greatest policy disasters in the history of our province."
He said COVID-19 restrictions that have slashed shelter space, prevented guests in SRO rooms, and resulted in more homelessness and drug use behind closed doors is intrinsically linked to overdoses.
"At the same time, border closures amped up the lethal nature of the street drug supply," he said.
"We need to understand the connected nature of overdose deaths and COVID-19 in order to offer more effective solutions."
Kennedy said he will be spending time in the next few weeks looking at ways to expedite safe supply sites.
Province seeks approval for decriminalization
British Columbia's government created a safe supply program in March, allowing doctors and nurses to prescribe pharmaceutical alternatives to illicit drugs.
Now, the province is seeking approval from the federal government to become the first in Canada to decriminalize possession of small amounts of illicit drugs.
In a letter to her federal counterparts, B.C. Minister of Mental Health and Addictions Sheila Malcolmson says the pandemic has added urgency. She says an exemption to Section 56 of the Controlled Drug and Substances Act would reduce stigma — a barrier to treatment.
Mike Serr, chief constable of the Abbotsford Police Department, said police will continue enforcement efforts on those who import, produce and distribute illicit drugs.
Decriminalization is not enough on its own, he said.
Fundamental changes toward a more health-focused approach that supports individuals, families and their communities is needed to curb this public health emergency, he said.
"The deaths are staggering, considering the steps we have collectively taken over the last several years to try to disrupt this overdose crisis," Serr said.
"We need to continue to think and act differently when supporting persons who use substances and those who are managing addictions."
Progress made is just 'a drop in the bucket': advocate
Leslie McBain, co-founder of advocacy group Moms Stop the Harm, said she had more hope that things would change in 2016, when the province first declared a public health emergency due to the opioid epidemic.
But the steps taken since have been "incremental," she said, and stigma is among the biggest barriers to moving forward.
Along with decriminalization, the federal and provincial governments need to provide greater access to treatment, safe supply, and continued care, she said.
Governments need to consult with families affected by the crisis and with active and recovering drug users, McBain said.
"They're all good steps, but they are not enough. They're a drop in the bucket," she said.
"It's like turning the Titanic. It's so slow, people are falling off, people are dying in the meantime."