BC records deadliest January yet as opioid crisis continues

By Province of British Columbia

March 2nd, 2021

BC records deadliest January yet as opioid crisis continues

Following a record-setting year in 2020, the BC Coroners Service reports 165 suspected illicit drug toxicity deaths in January 2021, the largest ever number of lives lost due to illicit drugs in the first month of a calendar year.

“These figures are heartbreaking, both in scale and for the number of families who are grieving the loss of a loved one,” said Lisa Lapointe, chief coroner, BC Coroners Service. “In the fifth year of this public health emergency, there is virtually no community in the province that hasn’t been touched by this devastating loss of life.”

An average of 5.3 lives were lost each day in January due to the toxic drug supply in B.C., a death rate of 38.1 per 100,000 residents. January is also the 10th consecutive month in which more than 100 deaths were attributed to suspected illicit drug toxicity.

Almost one in five of the suspected deaths (18%) in January noted extreme levels of fentanyl concentrations (greater than 50 micrograms/litre), the largest number recorded to date. Additionally, there were 14 deaths in which carfentanil, a more lethal analogue of fentanyl, was detected, an increase from the December total of nine and the largest monthly figure since May 2019.

The report also notes recent increases in the presence of unprescribed benzodiazepines and its analogues, including etizolam. Since July 2020, etizolam has been identified in 31% of illicit drug toxicity deaths where expedited testing was performed. In January, benzodiazepines and its analogues were detected in nearly half (49%) of all samples tested. The addition of etizolam to fentanyl increases the likelihood of overdose due to the combined respiratory depressant effects. Etizolam is not licensed in Canada. For more information about etizolam, visit: https://towardtheheart.com/assets/uploads/1609977106OOyN2HFTlkYYKxfbZi8XL6s1NfTlHl0ejSYqQnt.pdf

“We’re particularly concerned about the toxicity of the drugs detected in many of the deaths recorded in January,” Lapointe said. “The findings suggest that the already unstable drug supply in B.C. is becoming even deadlier, underscoring the urgent need for supervised consumption options, prescribing for safe supply, and accessible treatment and recovery services.”

Additional key preliminary findings are below. Data are subject to change:

The 165 suspected illicit drug toxicity deaths represent a 104% increase over the number of deaths in January 2020 (81) and a 7% increase over the number of deaths in December 2020 (154).
The number of illicit drug toxicity deaths in January 2021 equates to about 5.3 deaths per day.
Between April 2020 and January 2021, 18% of fentanyl-detected illicit drug toxicity deaths in Vancouver Coastal Health had extreme fentanyl concentrations (greater than 50 micrograms/litre), followed by 13% in Fraser Health and 11% in Interior Health.
Post-mortem toxicology results suggest there has been a greater number of cases with extreme fentanyl concentrations in April 2020 and January 2021 compared with previous months.
- From April 2020 to January 2021, approximately 13% of cases had extreme fentanyl concentrations, compared to 8% from January 2019 to March 2020.
Carfentanil was detected in 14 suspected illicit drug toxicity deaths in January 2021 and 64 deaths in 2020.
The detection rate of benzodiazepines has rapidly increased from 15% of samples in July 2020 to 49% of samples in January 2021.
No deaths have been reported at supervised consumption or drug overdose prevention sites.

Learn More:

Illicit drug overdose death report:
https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/statistical/illicit-drug.pdf

Illicit drug toxicity type of drug data report:
https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/statistical/illicit-drug-type.pdf

Toward the Heart: http://www.towardtheheart.com

Stop Overdose BC: https://www.stopoverdose.gov.bc.ca

BC Centre on Substance Use: http://www.bccsu.ca

Risk mitigation prescribing guidelines in the context of dual public health emergencies:
https://www.bccsu.ca/wp-content/uploads/2020/04/Risk-Mitigation-in-the-Context-of-Dual-Public-Health-Emergencies-v1.5.pdf

Lifeguard app: http://www.phsa.ca/about/news-stories/news-releases/2020-news/new-lifeguard-app-launched-to-help-prevent-overdoses

BC Centre for Disease Control overdose response indicators: http://www.bccdc.ca/health-professionals/data-reports/overdose-response-indicators

BC Centre for Disease Control factsheet on etizolam: https://towardtheheart.com/assets/uploads/1609977106OOyN2HFTlkYYKxfbZi8XL6s1NfTlHl0ejSYqQnt.pdf