Yukon needs new approach to worsening opioid crisis, officials say

As illegal drugs continue to kill more and more Yukoners, some people in the territory — including the chief medical officer of health and the head of the local RCMP — are calling for a new approach to the ongoing opioid epidemic.

Last week, the territory's chief coroner said there had been three fentanyl-related deaths in the territory since mid-January, and a fourth person was also suspected of dying from a drug overdose. The number of overdose deaths was also up significantly through 2020, the coroner said.

Chief Medical Officer of Health Dr. Brendan Hanley said it's a crisis that's getting worse.

"What we've seen over the years is these fluctuations in numbers of overdoses. But we definitely saw a much worse year in 2020. And I'm certainly worried about what we're seeing so far in 2021," Hanley said.

He says the COVID-19 pandemic seems to have made things worse, by adding to the stresses many people are facing. That can lead to unsafe drug use, he says.

"So we've definitely had effects on people accessing health care, economic hardships, more people in vulnerable situations, unstable housing, loss of income of course," he said.

He also says the pandemic has likely affected the supply of drugs in Yukon, and people's access to their usual sources.

Hanley suggests it may be time for Yukon to consider a "safe supply" approach, wherein users are able to access prescription opioids such as hydromorphone as an alternative to potentially toxic and dangerous street drugs. It's a concept that's being tried out in other jurisdictions, including B.C.

"I do think we need to pursue this more actively, to figure out how it might fit in our setting and to take a serious look at it," Hanley said.

"Of course, we do require people to be connected to treatment for this to work. So getting people to access services is really a fundamental part of this."

Another option would be to provide safe, supervised places for people to use drugs, Hanley said. The most recent overdose deaths in Yukon were all people who were using drugs alone.

"I think we need to take a more formal look at supervised consumption and see what the role is that can play in Yukon. In Yukon we do have an exemption process that can allow us to do this, but we haven't formally explored or piloted that as yet."

'Absolutely tragic,' says RCMP

Yukon RCMP Chief Supt. Scott Sheppard agrees that something needs to change. He called the latest numbers from the coroner "shocking, to say the least ... it's absolutely tragic."

Sheppard also says that RCMP see what's happening — firsthand. Police officers are often the first to the scene of a crisis.

"We're administering naloxone before, you know, the experts arrive, the paramedics. And that's a different part of the business for us ... repeatedly going to these scenes where people are either on death's door or have passed on."

In a joint news release last week, Sheppard said that between April and December of last year, Yukon RCMP officers administered naloxone — a drug that counters the deadly effects of opioids — to people on 23 separate occasions, and attended another 46 separate calls where fentanyl use was suspected.

"What really needs to happen is people need to realize that this is a societal problem. It's a community problem. And first and foremost, it's a health problem," Sheppard said.

He says some members of the public advocate for a hard-line approach to drugs, and cheer the police for laying drug charges. But Sheppard says the drug problem is not just a matter of crime and punishment — it's often about helping vulnerable people find the help they need.

"Quite often people say, well, that's a very soft, you know, 'give everyone a blanket and a hug' kind of approach. But, you know, we've been using the hammer-and-nail technique for decades now and we see the results. So I think it's time we all learned something new."

Unreliable sources

Sheppard says drug users don't always know what exactly they're putting in their bodies. Street drugs can be contaminated with different substances, and their provenance murky. Some street-level dealers can be in the dark too, about what exactly they're selling.

"Whether people are selling crack or methamphetamine or what have you, you know, we're not talking about people who observe clinical standards in the processing and dispensing of the drugs," he said.

"Unfortunately, the customer really is in no position to know whether their source, quote unquote, is reliable or not, because the source doesn't even know."

Blood Ties Four Directions, a non-profit organization in Yukon, operates several harm-reduction programs for drug users — such as offering testing so people know what's in their street drugs.

Program manager Jill Aalhus says her organization supports the "safe supply" approach that Hanley says should be considered in Yukon.

"We really think it's a necessary step in preventing these overdose deaths and ultimately saving lives here in Yukon," Aalhus said.

"Safe supply would ensure that people know what's in their drugs, and are able to use safely."