Expert panel urges safer supply, evidence-based system of care to reduce deaths from illicit drugs; reactions of parties

“We know that everyone who dies because of drug toxicity leaves behind family, friends and communities who grieve their loss”

[Reactions of B.C. Government, BC Liberals and BC Green Party below]

A panel of subject-matter experts convened by the BC Coroners Service is calling for increased access to a safer supply of drugs and creation of an evidence-based continuum of care to better support substance users and reduce the number of illicit drug-related deaths in B.C.

The recommendations are included in a report examining the circumstances around 6,007 deaths from illicit drug toxicity between August 1, 2017 and July 31, 2021. The report BC Coroners Service Death Review Panel: A Review of Illicit Drug Toxicity Deaths reveals that the primary cause of these deaths was the increasingly toxic and unpredictable illicit drug supply in the province, and that the current drug policy framework of prohibition is forcing substance users to access the unregulated market, leading to increased numbers of substance-related emergencies and deaths.

Illicit drug toxicity is the leading cause of unnatural death in B.C., accounting for more deaths than homicides, suicides, motor vehicle incidents, drownings and fire-related deaths combined.

“This report includes realistic, actionable recommendations that the panel believes will reduce the number of people dying due to toxic, illicit drugs in our province,” said Michael Egilson, death review panel chair. “We recognize that many of the timelines in the report are aggressive, but COVID-19 has demonstrated how swiftly policy-makers can act when lives are at stake – and we know that every month of inaction equates to hundreds more lives lost.”

The panel’s advice to the chief coroner included three recommendations:

1. Ensure a safer drug supply to those at risk of dying from the toxic illicit drug supply

2. Develop a 30/60/90-day Illicit Drug Toxicity Action Plan with ongoing monitoring

3. Establish an evidence-based continuum of care

The chief coroner has forwarded each of the panel’s recommendations to the relevant ministries and organizations.

Members of the panel were appointed by the chief coroner under Section 49 of the Coroners Act and included professionals with expertise in public health, health services, substance use and addiction, medicine, mental health, Indigenous health, education, income assistance, oversight and regulation, and policing. Regardless of their employment or other affiliations, individual panel members were asked to exercise their mandate under the Coroners Act and express their personal knowledge and professional expertise.

“I want to thank all of the panel members for their expertise and their shared commitment to preventing deaths from the toxic illicit drug supply,” said Lisa Lapointe, Chief Coroner. “We know that everyone who dies because of drug toxicity leaves behind family, friends and communities who grieve their loss. As we approach the sixth anniversary of the declaration of the public-health emergency into substance-related harms, co-ordinated, urgent action is needed to reduce the devastation illicit drugs have inflicted on so many people in our province. This report, by a panel of subject-matter experts, provides a roadmap. It is my sincere hope that their advice will be actioned.”

Findings reviewed by the panel show:

* deaths are increasing both in number and in rate;

* the drug supply has become increasingly toxic;

* more drug toxicity deaths occur among younger adults – the average age of death is 42;

* illicit drug toxicity deaths are ranked second after cancers for potential years of life lost;

* Indigenous Peoples are disproportionately represented in drug toxicity fatalities;

* individuals living in poverty and with housing instability are more vulnerable;

* people with mental health disorders or poor mental health are disproportionately represented;

* in addition to fentanyl, other substances were also detected in most deaths;

* people had frequently accessed medical services prior to an illicit-drug-related death;

* deaths are occurring throughout the province;

* while the highest number of deaths occur in large urban centres (Vancouver, Surrey, Victoria), this issue spans beyond urban areas; and

* smoking is the most common method of illicit drug consumption.


Sheila Malcolmson

MEANWHILE, Sheila Malcolmson, Minister of Mental Health and Addictions, in a statement said:

“I recognize the BC Coroners Service and panel members for their report on the devastating deaths in our province due to illicit toxic drugs. We know we must do more to combat the illicit toxic drug crisis, and our government is working hard every day to end this public-health emergency.

“This report confirms the urgency of the work underway by our government. Specifically, it calls on government to build an evidence-based continuum of care to deliver mental-health and substances services, including safer supply. And that is exactly what our government is doing.

“We are making historic investments into mental-health and substance-use services to build a system of care where there wasn’t one in 2017. This work is critical and is well underway.

“We agree that one of the most important actions we can take to save lives is to separate people from the toxic drug supply. That’s why B.C. implemented in 2020, and expanded in 2021, a safer supply program – the first and only province in Canada to do this.

“Since the federal government regulates controlled drugs and substances, we are focused on what we can do within our provincial jurisdiction – a prescribed safer supply model implemented through health authorities.

“The panel also found that the current drug policy of prohibition was contributing to an increase in substance-related emergencies and deaths. We agree. We are treating substance use and addiction as a health-care issue, not a criminal one. We are the first and only province to apply to decriminalize people who use drugs. Decriminalization will reduce the fear and shame that keeps people silent and leads so many to hide their drug use and avoid treatment and support.

“There is more to do along the entire continuum of care to end the poisoned drug crisis, including treatment and recovery, harm reduction and mental-health supports. We won’t stop working until we turn this crisis around.”

Trevor Halford

THE B.C. Liberals said that the NDP’s response to British Columbia’s toxic drug crisis is a resounding failure.

“I’d like to acknowledge the 6,007 families in B.C. who lost a loved one to an overdose and continue to feel the impact of their loss. Six years into a public health emergency, the BC Coroners Death Review Panel report has concluded the NDP’s response to the overdose crisis has failed and that much more must be done urgently,” said Trevor Halford, Opposition Mental Health and Addictions Critic. “There is a clear and pressing need for the NDP government to take action based on the recommendations in the report, which include a 30-60-90-day timeline for emergency action. I urge John Horgan and his government to immediately accept all 23 of the panel’s recommendations and act to ensure a coherent, province-wide strategy is adopted throughout B.C. so that when someone reaches out for help, they can immediately get the services they need and are not restricted by cost. Inexcusably, we still aren’t getting that from this government.”

Critically, the Panel’s report stated, “with illicit drug-related deaths continuing to increase, it has become clear that the current response to this emergency is not working.”

“Five years after the creation of a specific ministry for mental health and addictions, people in need are no better off as they face deadlier street drugs, months-long waitlists for treatment, a lack of beds for withdrawal management, and unaffordable privately-run services,” said Halford. “The NDP’s patchwork approach is not working. As the report outlined, ‘initiatives have not been sufficient to stop the rising death toll.’ When will enough be enough? It’s hard to have confidence in a Premier and government that ignored the key recommendations of the last death review report released in 2018. But it’s time for John Horgan to prove his government finally takes this crisis seriously. They must step up to meet these new deadlines, and ultimately, save lives.”


Sonia Furstenau
Photo: Twitter

SONIA Furstenau, B.C. Green Partly Leader, said in a statement:

“From August of 2017 to July of 2021, over 6,000 people died from our toxic illicit drug market. These were preventable deaths. This crisis intersects with our mental health crisis, our housing crisis, and our affordability crisis. The supply of street drugs is getting deadlier, it is killing younger people, and it’s hitting everyone – those with substance use disorder, and those who use drugs recreationally.

“The Death Review Panel declared safe supply as the first priority for people who use drugs. Anyone who is paying attention to people who use drugs – researchers, advocates, and experts – knows this is the way to stabilise the chaotic and deadly illicit drug supply. Month after month, and year after year, the call is the same. It is heartbreaking to watch the consistent message of non-medicalized safe supply be ignored by this government, while the death rate climbs.

“This government talks of stigma as a barrier, but we have safe supply in B.C. Alcohol is regulated. Tylenol is regulated. Marijuana is regulated. It is a matter of political will to introduce non-medicalized safe supply, and we have to start wondering who in this government is resisting this necessary harm reduction approach to an increasingly deadly crisis.

“The Death Review Panel called on the BC NDP government to implement a safer drug supply by May 9. I will be following this government’s actions closely and holding them to that timeline.”