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Spike in overdose deaths could be tied to changing drug supply chain

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The COVID-19 pandemic may be impacting the illegal drug supply chain and contributing to a recent spike in the number of deaths, an Interior Health medical officer says.

The overdose crisis appeared to be waning in 2019 with a sharp drop in deaths from its peak in 2018, but according to the B.C. Coroners Service, the number of deaths this March returned to near-peak levels right across the province.

“It’s really hard to know how the COVID-19 pandemic might be impacting overdose rates," Karin Goodison, medical health officer with Interior Health said. "A number of things have changed as we’re all noticing. We’re trying to physically distance which can impact how people interact with each other and how they access services.”

The coroner's service recorded 113 illicit drug deaths in B.C. in March, passing the 100 per month mark for the first time since March 2019, and while March 2020 is down three per cent from the same period a year ago, it’s up 60 per cent from February, 2020.

READ MORE: New drug checking technology available in Penticton

“We definitely suspect that (the pandemic) could have an impact on this. We also recognize that our drug supply continues to change and it will respond to various impacts… we are suspecting that something has changed in the drug supply that is leading to more overdoses and more overdose deaths,” Goodison said.

In Vancouver, for instance, tests are showing more positive samples of benzodiazepine. Mixing benzodiazepine with opioids increases the risk of an overdose, Goodison said.

“Both impact our respiratory system and slows us down,” she said.

The Kamloops-base ASK Wellness Society has a pilot program funded by IH that tests for illicit drugs using a portable spectrometer.

In February, they started a “milk run” to do a road trip every two weeks to Merritt, Penticton, Kelowna and Vernon to perform drug testing, but that was cut short due to the pandemic, said Kile McKenna, an operational technician with ASK Wellness.

The other effect of the pandemic is that fewer people are going in to get testing done. In part that’s due to COVID safe distancing rules because the facility they use provides other services so both programs can’t run at the same time because of space constraints, he said.

Because of the limitations on the spectrometer’s testing, he can’t say if the quality of drugs is changing but they have noticed there are more fillers.

“The amount of unidentifiable leftovers is increasing,” McKenna said.

“There are more impurities in the drug supply, which could be directly related to higher toxicity.”

Impurities might be things like sugar, caffeine and other adulterants.

They are not seeing an increase in deaths amongst the homeless because they are usually using drugs in a group setting and they all know how to deal with overdoses. It’s the single men at home alone who are more likely to die, although, having a spouse or friend home more because of COVID may be helpful in that way, unless they're trying to hide their use so have to slip out to use drugs, he said.

Goodison said they can only hypothesize why men are more at risk of dying from an overdose.

“We do find certain types of work are correlated with a higher risk of overdose and we do know that men work in those types of work such as construction and transportation industries,” she said, adding other factors could include people’s likelihood to seek support, and who is more likely be home alone whose more likely to be home alone in a home setting.

The main culprit of B.C. overdose deaths is fentanyl, which was present in nearly 70 per cent of overdose deaths this year, although its numbers have decreased from previous years. Once again, men were predominantly affected with 76 per cent of overdose deaths among males, which has been consistent with recent years, according to the latest coroners’ report.

The Interior Health region has the second-highest rate of illicit drug-related overdose deaths based on population compared to other health authorities at 23 deaths per 100,000 population.

READ MORE: Interior Health has second-highest rate of overdose deaths in 2020

“I do recognize in our more rural areas, it’s sometimes more challenging to enable us to have overdose prevention services for everyone everywhere because of distance, I suspect that may be one factor. There could be a number of contributing factors (as to why Interior Health has the second-highest rate),” Goodison said.

Interior Health is undertaking a review of all the overdose prevention programs to ensure access to essential services are available during “this challenging time,” she said.

- With files from Rob Munro

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