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Not just a big city problem

Dene Moore: The Lower Mainland and Victoria get the most attention – and resources – but per capita, the overdose crisis is more lethal in rural BC.
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Could be literally anywhere in BC. (EJ Nickerson /

Fathers, mothers, sons, wives, cousins, friends.

It’s an unfortunate but maybe understandable defence mechanism to forget when we read about the overwhelming number of drug overdose deaths in B.C. that we’re talking about someone’s parents, someone’s children, someone’s friends.

That we’re talking about people who were loved. Maybe in spite of themselves sometimes, but loved.

In July, 175 people died of illicit drug overdoses in B.C. That amounts to 5.6 preventable deaths per day.

Earlier this week Provincial Health Officer Dr. Bonnie Henry issued a public health order that will allow registered nurses and registered psychiatric nurses to prescribe pharmaceutical alternatives to street drugs, in addition to physicians and nurse practitioners.

B.C. is the first jurisdiction in Canada to do so, but then again B.C. is the epicentre of the country’s deadly overdose crisis. Out of necessity, this province must put itself at the fore in finding new ways to combat a very old problem.

It has, in the past, forging new ground with safe consumption sites over the protests of the then-federal government.

While the vortex of this epidemic is certainly in Vancouver’s struggling Downtown Eastside neighbourhood, the impact on less populated regions gets lost in the discussion.

B.C. has the most acute overdose crisis in Canada. In 2016, the year the province declared a public health emergency, there were 991 deaths. As of the end of July, there have been 909 deaths already this year.

Certainly, Metro Vancouver, with its huge proportion of the province’s population, has by far the largest number of deaths. It also has, by far, the greatest concentration of health care resources and services.

Vancouver has suffered 223 deaths so far this year; Surrey, 113.

But when you look at the death rate per 100,000 people, it is Northern Health that tops the list, with 35.4 deaths per 100,000, compared to 35.1 deaths per 100,000 in Vancouver Coastal Health.

Northern Health serves about 300,000 people, including dozens of First Nations.

When the coroners service breaks illicit drug deaths down by local health area from 2018 to 2020, the highest rates per capita were in Hope, Lillooet, Vancouver, Grand Forks, and Peace River North, in that order.

The North Health Authority covers more than 617,000 square kilometres of the province, from Quesnel north to Atlin, Haida Gwaii in the west to Fort St. John in the east. The only overdose prevention site in the region is in Prince George. There are about two dozen hospitals.

By expanding the ability to prescribe drug treatment, the province is giving health care workers in resource-strapped smaller cities, remote and rural communities an invaluable tool to save lives.

In addition to expanding prescribing powers, the province is finalizing an updated policy directive for prescribers and health authorities that will, among other things, add to the types of alternative medications that can be prescribed and the locales allowed to dispense medications to health authorities and community pharmacies.

Yet there is more that has to be done.

Treatment must be available on demand for those suffering the disease of addiction. Over the summer, the Canadian Association of Chiefs of Police endorsed decriminalization of simple possession and diversion of drug users away from the criminal justice system and into the health care system.

“Health is best positioned to address problematic substance use and not the police,” says a report from the national association. “Enforcement resources and strategies will continue to be targeted at organized crime groups and individuals who import, produce or distribute illegal drugs throughout our communities.”

The number of deaths from illicit drugs in B.C. has surpassed deaths from suicide, motor vehicle accidents, homicides and prescription drugs combined.

In the communities and families where British Columbians are dying, the loss is felt acutely, regardless of numbers.

Dene Moore is an award-winning journalist and writer. A news editor and reporter for The Canadian Press news agency for 16 years, Moore is now a freelance journalist living in the South Cariboo. Moore’s two decades in daily journalism took her as far afield as Kandahar as a war correspondent and the Innu communities of Labrador. She has worked in newsrooms in Vancouver, Montreal, Regina, Saskatoon, St. John’s and Edmonton. She has been published in the Globe and Mail, Maclean’s magazine, the New York Times and the Toronto Star, among others. She is a Habs fan and believes this is the year.