Overdose deaths in the Interior Health region have increased nearly 800 per cent in less than eight years, said a medical health officer with IH.
“The majority of these overdoses are related to fentanyl,” said Dr. Kamran Golmohammadi during a presentation to the Cariboo Regional District board at its regular meeting Friday, Feb. 8.
“IH has the highest rate of overdose deaths per capita after Vancouver Coastal Health and we are hoping with the help of communities and stakeholders we can make an impact and some progress on this front.”
Amanda Lavigne, substance abuse practice lead for IH, said there is a higher rate of overdose deaths among the male population, making up 78 per cent of the deaths.
The age of people dying of overdoses ranges between 15 and 66, and the majority of overdose deaths are occurring in private residences.
Kelowna has the highest rate, she said, noting Kamloops has seen a significant spike since 2018 and the second highest rates are in Vernon and Penticton.
“In the Cariboo Chilcotin the area experienced seven reported [overdose] deaths between May and October 2018,” Lavigne said. “Fentanyl is the highest substance in these deaths.”
She also said there was a significant spike in Emergency Health Services B.C. responses by ambulance to illegal drug overdoses in the Cariboo-Chilcotin in 2018.
Interior Health committed to developing a substance use strategy in 2016 and hired an external contractor to assess its substance use services and provide recommendations to guide services going forward.
“We received a draft in late 2018 and are currently in the process of reviewing it and engaging stakeholders. What has been established over the last year is our Substance Use Planning Team,” Lavigne said, noting IH will be expanding substance use services in Williams Lake, Grand Forks and Revelstoke.
Dr. Andrew Gray, medical health officer for Northern Health, who joined the meeting by teleconference said there have been 13 overdose deaths in the Quesnel area in the past two years.
“Things are much worse than they were five years ago,” Gray said, noting 100 naloxone kits are being shipped to Quesnel monthly to be prepared to manage overdoses and that approximately 20 kits are being used each month for actual overdoses.
Alyshia Morgan, manager of mental health and substance use in the Cariboo-Chilcotin, said IH has been increasing efforts to focus more on Aboriginal mental wellness, continuum of service and reducing disease transmission.
“Interior Health offers services for moderate to severe mental health and substance abuse disorders that include assessment, treatment, counselling services, referrals to detox and residential facilities,” Morgan said.
“We have a 14-day stay, five-bed community facility based out of Cariboo Memorial Hospital that offers crisis stabilization.”
There is also a community crisis response team that is available between 8 a.m. to 8 p.m. seven days a week to support clients who are in crisis or communities that are experiencing crisis related to mental health or substance abuse, Morgan added.
Area G Al Richmond asked what proactive measures are being taken around the health authorities to help educate and prevent drug overdoses for future generations.
Dr. Golmohammadi said if communities accept that mental health and addictions are no different than a chronic condition then impacted people might get the support they need.
“We have made great strides but still we need to work hard in our communities so that by removing the stigma we will have more people seeking help,” he said.
Gray said curricular resources are being developed at a regional level around substance abuse and addiction for schools, but noted developing self-esteem is very important.
In most cases people are using drugs to get through pain, childhood trauma and abuse.
“We need to get at why people are using drugs,” Gray said.
Dr. Golmohammadi said people who overdose and end up in the emergency wards are monitored afterwards to help them find help.
Several directors, including Area L director Willow MacDonald, raised concerns that first responders are being directly impacted by the growing number of overdose calls.
“I definitely see that the burden of the disconnect is actually on our first responders,” MacDonald said.
“They are the ones who are consistently showing up at homes every time there is an overdose or a fentanyl issue and we need to do something there because they are the ones that are dealing with it and they are ill-prepared of overworked, however you want to say it.
Fentanyl replacing heroine
Wells Mayor Gabe Fourchalk said he was shocked with the amount of fentanyl-related deaths.
“Fentanyl has been used for quite a few years and now all of a sudden there is this spike in overdoses on it,” Fourchalk said.
“Has it become more accessible to the public? It would seem to me if we were to alleviate that accessibility it would get rid of the fentanyl overdoses.”
In response, Dr. Gray said the short answer is the black market has figured out that fentanyl has replaced heroine effectively.
“Heroine is not an opioid, it’s not as strong a fentanyl, and it requires bigger physical packaging,” Gray said.
“Take a three-pound bag of heroine — you could pack the same amount of dope in an envelope of fentanyl that you could send through the mail.”
The prominence of fentanyl is an adaptation by the market to the efforts to try and control opioids, Gray added.
“We try to crack down on heroine and the black market figures out how to make something even more potent that they can smuggle in even more effectively and cheaper,” he added.
“This is what we have seen all through history with prohibition. You go back to alcohol prohibition in the 1920s and people were making things that were really potent and undrinkable.”
Dr. Golmohammadi said when fentanyl is part of criminal activity, distributors do not necessarily follow standard diluting protocols.
“You will have diluted batches in hundreds of bags and some of them will contain more of those particles and some of them less,” he said.
“The ones, unfortunately, that will have more particles will literally kill and be the cause of overdoses.”