'THERE'S NO WAY WE'VE SEEN THE END OF THIS'
THOMPSON-OKANAGAN - When a community worker warned Kamloops locals last October their marijuana supply might be tainted with a drug called fentanyl, a drug that has caused numerous overdoses and deaths, his information came directly from clients.
We sought proof of his claims and found another startling truth: No one tracks overdoses — not B.C. Ambulance, not emergency rooms, not doctors and not Interior Health.
Now that Ask Wellness says similar reports on overdoses have come in, a local emergency room doctor is calling for a better way to track the ‘fentanyl crisis’.
Overdoses from illicit drug use is on the rise across Canada so much that this month, Health Canada proposed Naloxone — a drug that reverses the effects of an opiate overdose — be available without a prescription over the counter. But when it comes to determining if Kamloops is part of the nationwide trend of drug overdoses, it’s a matter of cobbling statistics and anecdotes from staff at health and social agencies because there is no formalized process to track the data.
Fentanyl became a household name since the opiate started appearing as an unwelcome addition to many illicit drugs causing an increase in overdoses and deaths. The drug is cheap, effective and 100 times stronger than heroin, which encourages suppliers to use it as an additive.
Drug users who are clients of the social agency reported suspicions their drug supply was laced with fentanyl when they fell asleep after taking small amounts.
“We’re having more and more reports of people going down. There’s a lot unreported. I’d be the last one to say there’s fentanyl-laced marijuana being sold on the street. We’ve got no evidence to show that,” Bob Hughes with the agency says. "What’s emerging is the relevant concern of fentanyl and its presence in the community is we could have or we need to have a more robust communication strategy in terms of what we see and what they see at the doors of the emergency room."
That communication between front line workers takes way too long to share, if it's shared at all. While Hughes acknowledges the social reports may differ from the medical reports, officials with Interior Health Authority say there is no data to suggest there is a higher amount of overdoses in Kamloops.
Dr. Ian Mitchell, an emergency room physician at Royal Inland Hospital, says social agencies likely have the best information on tainted drugs or overdoses in the city. Medical staff are not required to document overdoses.
“In many ways ASK Wellness probably has a better understanding of what’s going on as far as just getting reporting from the field and hearing what people are experiencing,” Mitchell says. “If there was a bit of an increase but there were different emergency doctors on every day, none of us would really coordinate or know there was an increase. There is no area where specifics are kept where we would coordinate. It would just be like ‘oh, you saw (an overdose) yesterday? I saw one, too.’ We don’t meet. We don’t coordinate all of these results — anything like that.”
Mitchell says each province tracks overdoses differently and none are mandated to keep records. In the United States, tracking overdoses is an official process. In Canada, he says there are two things he's ordered to report on — certain diseases and shootings.
“From a clinical perspective we would never do a test. It makes no difference what they’ve overdosed on. Fentanyl doesn’t last very long. For my purposes, it makes no difference to me what they’ve taken as long as it's an opiate because I treat them the same,” Mitchell says.
Right now, the current model of tracking overdoses relies upon staff at social agencies and medical locations in a community who are encouraged to report if and when there is an increase in overdoses. Those tracking the issue could be emergency room doctors, community agencies, harm reduction coordinators and — if the overdose is fatal — the B.C. Coroners Service.
“There definitely needs to be improvement on it. We just don’t have good national statistics for this to have some surveillance of what’s going on,” Mitchell says. "We haven’t had a big outbreak in Kamloops from my perspective. Vancouver Island had eight deaths over the Christmas period — mostly experienced IV drug users. That’s just a real aberration for that to happen. They knew fentanyl was out around there. We haven’t had that big outbreak of cases to report. I’m not sure what it would take for us to get that."
Monitoring would yield different dilemmas, Mitchell says. Currently physicians and emergency staff are loosely tracking overdoses on paper. He feels the public could benefit from a computerized system that would trigger an alert when there are more overdoses than normal. The cost would be a huge investment from the provincial government and doctors would have to consider whether to test each overdose or not — the blood tests would be hundreds of dollars each.
“If you don’t have reporting, if you don’t have the numbers, then you can’t really address the problem properly. I think we’re in a fentanyl crisis now. And scarier, there’s worse drugs on the horizon that are coming so we need to get much better statistics,” he says. “There’s this crazy series of drugs called the ‘W’ series. These are synthetic opiate drugs that were invented in Alberta. Currently they’re being sold on the street… one of them is apparently 100 times stronger than fentanyl. So, have we seen the end of this? There’s no way we’ve seen the end of this."
Dr. Sue Pollock, a medical health officer with Interior Health, says a provincial group and a regional group are both examining how overdoses are reported.
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