VANCOUVER — British Columbia's chief coroner is hoping a recent decline in fatal overdoses after a record number of illicit-drug deaths is a positive sign but she says it's time the province developed a standard of care for substance users after the fifth year of a public health emergency.
"It’s one of the things that our inquest juries and death review panels have recommended over and over, that there needs to be an evidence-based continuum of care for those who are reaching out," Lisa Lapointe said in an interview.
The coroners service released data Wednesday showing 147 people fatally overdosed in August compared with 86 deaths during the same month last year. However, the monthly deaths are lower than the 176 confirmed for July and the record of 181 fatalities in June.
Data also show overdose deaths began increasing in B.C. just as the COVID-19 pandemic hit in March, when 113 people died, up from 73 in February.
Border closures have stopped the flow of drugs that typically come into the province and have been replaced by even more toxic substances, putting a greater number of people at risk of overdose, Lapointe said.
But gaps in services remain even as the province has increased the availability of the overdose-reversing medication naloxone and there are plans to soon allow certain nurses to prescribe safer drugs as an alternative to potentially deadly street drugs containing higher concentrations of fentanyl, she said.
"In terms of the bigger picture for treatment and recovery and the wraparound services people need, it’s pretty chaotic."
Someone who wants to detox from illicit substances can be on a wait list for two to three weeks while getting a treatment bed can take two months, Lapointe said.
"On the one hand there’s fingers pointed at those using substances and I think there’s some sentiment out there that they should be helping themselves. But on the other hand, the services just aren’t available to help them," she said.
Even those services that are available aren't bound by provincial standards, Lapointe added.
"If you break your leg there is a standard treatment. You'll get an X-ray, and presumably a cast and there will be some followup. And if you need physiotherapy for rehab that will be down the line. But there is no standard right now for treatment for those experiencing problematic substance use."
Multiple unregulated services have set up shop around the province and require staff to have minimal training of about 16 to 20 hours, Lapointe said.
"Families in this province have spent tens, hundreds of thousands of dollars for treatment and there’s no basis in evidence for it."
Lapointe said drugs shouldn't be used alone, especially during the COVID-19 pandemic.
"Right now is not the time to be pushing people away. If you have a family member or a good friend who's a substance user, they need the support because the toxic supply is lethal.”
Provincial health officer Dr. Bonnie Henry issued an order last week allowing registered nurses and registered psychiatric nurses to prescribe safer drugs as an alternative to those bought on the street.
The board of the BC College of Nurses and Midwives is scheduled to meet Thursday to discuss standards, which will then be published on the college's website. Spokeswoman Johanna Ward said suboxone, a medication that is currently prescribed by doctors and nurse practitioners, will be the one initially prescribed, likely in a month.
This report by The Canadian Press was first published Sept. 23, 2020.
Camille Bains, The Canadian Press