The recent spike in overdose deaths in B.C. is disproportionately affecting First Nations, according to health officials.
Of 554 suspected illicit-drug toxicity deaths in B.C. between Jan. 1 and May 31, 16 per cent were First Nations, Métis and Inuit people — even though they make up only 3.4 per cent of the province’s population, said Dr. Shannon McDonald, acting chief medical officer for the First Nations Health Authority. That’s up from 9.9 per cent during the same period in 2019.
At an online news conference on Monday, McDonald said the 89 illicit-drug-toxicity deaths involving First Nations, Métis and Inuit in the first five months of the year represent a 93 per cent increase from the same period last year, and those numbers continue to rise, with a significant portion of the poisonings including fentanyl. “The problem is getting worse, not better.”
So far this year, First Nations, Métis and Inuit individuals have died at 5.6 times the rate of other B.C. residents between January and May, up from 3.8 last year, said McDonald. “That gap between First Nations people and other B.C. residents is widening.”
Charlene Belleau, chairwoman of the First Nations Health Council, said COVID-19 pandemic restrictions are creating challenges for those struggling with addiction, and “properly resourced” treatment centres and culturally appropriate harm-reduction strategies are critical to turning the situation around.
Border closures have disrupted the drug supply in the province, while COVID-19-related restrictions have reduced or eliminated access to shelters and treatment centres, resulting in more people using drugs alone, where they are at higher risk of a fatal overdose. The pandemic has also resulted in some people who were living paycheque to paycheque becoming homeless.
“COVID-19 precautions have made it harder to support vulnerable people and we’re hoping that we can change that in the next few months,” said McDonald.
Lisa Lapointe, B.C.’s chief coroner, said B.C.’s drug supply is dangerously toxic, and the data shared Monday is a clear signal that all levels of government must improve access to a safer supply and better supports and services for users.
Prior to the COVID-19 pandemic, the number of opioid overdose deaths in B.C. had been dropping, from 1,546 in 2018 (including 201 First Nations, Métis and Inuit individuals) to 979 in 2019 (including 113 First Nations, Métis and Inuit individuals).
The fact the death toll fell under 1,000 last year was almost celebrated. “And that’s not right because we can’t normalize the number of people who are dying,” said Lapointe.
Illicit fentanyl is driving the poisonings — either unexpectedly lethal amounts or through fentanyl contamination of other drugs, such as cocaine or heroin.
“So all of those who use substances are at risk now in this province and it’s quite frankly terrifying,” said Lapointe.
Provincial health officer Dr. Bonnie Henry called the latest increase in overdose deaths in B.C. “deeply concerning.”
More than 170 people died of illicit-drug toxicity in the month of May alone, she said.
Henry said at the same time as the pandemic has created greater challenges in tackling the overdose crisis, with more people using drugs alone, some First Nations don’t feel it’s safe to access help because of stigma and systemic racism.
Yet they are disproportionately affected, she said, with Indigenous men overrepresented in the province’s correctional facilities for drug crimes, and First Nations women more likely to die from a toxic drug overdose than other women in B.C.
First Nations women died from drug overdoses at 8.7 times the rate of other women in the province, according to the First Nations Health Authority.
“So we need to do better at supporting Indigenous women and Indigenous people in being able to break that cycle … and get the support they need in a culturally safe way,” said Henry.
The province is also working to provide safe pharmaceutical alternatives to people who use drugs, seeking an exemption under the Controlled Drugs and Substances Act that will allow nurses and other health professionals to prescribe those safer alternatives.
In many cases, substance use is related to chronic trauma, said Dr. Nel Wieman, acting deputy chief medical officer for the First Nations Health Authority, who argues that with two public-health emergencies — a pandemic and opioid-overdose crisis — it’s even more important to increase mental-health and wellness supports for B.C. First Nations people.
McDonald said many Indigenous people are self-medicating with illicit substances because they have limited access to culturally safe mental-health and addictions services, quoting Grand Chief Doug Kelly, formerly of the First Nations Health Council: “We don’t have a drug problem. We have a pain problem.”