The Collision of Two Public Health Emergencies

COVID-19 has permeated daily life in profound ways. For a long time, it seemed like the pandemic was all people could talk about; whether in conversations on health and safety, the hardships of physical distancing requirements, economic ramifications, or travel plans, the pandemic has become a core element of contemporary discourse. 

And there’s a good reason for it. In BC, we’ve seen 5,372 people with confirmed cases of COVID-19 to date, our provincial economy was expected to shrink by 7.3% in 2020, and most harrowing, 204 people in BC alone have lost their lives due to the virus. 

The impacts of the global pandemic have been vast, and while felt by all, they have been most pronounced for vulnerable people who already struggled to meet their basic needs before COVID-19 came into our midst.

What’s more is that COVID-19 has collided with another public health emergency that also most deeply impacts vulnerable people: the overdose crisis.

Declared a public health emergency in April 2016 in response to the sharp increase of overdose deaths driven by the introduction of fentanyl into the drug supply, the overdose crisis has taken more than 4,800 lives since. 

There is no part of BC that has been left untouched by the overdose crisis, and a range of stakeholders including people with lived and living experience using drugs, families, service providers, and decision makers have called for action to prevent overdoses. These include creating a safe drug supply, decriminalizing drug use, and providing person-centered wraparound services that tackle root causes.

As an organization that serves some of our community’s most vulnerable people, who are at heightened risk of using drugs due to concurrent barriers such as homelessness, mental health challenges, poverty, and criminal justice experience, we have seen the effects of this crisis since the beginning.

We have also worked to tackle the crisis through harm reduction and trauma informed models of care, the creation of peer mentor services, the provision of Naloxone training for all of our staff, and by advocating for systemic change at local, provincial and federal levels.

While many with direct exposure to the overdose crisis have been urging for necessary changes and comprehensive strategies for some time, this is needed now more than ever, with COVID-19 exacerbating the mortality rate of people who use substances.

In July alone, 175 people died due to an illicit drug overdose in BC – making it the third consecutive month where overdose deaths surpassed 170. Throughout 2020, we’ve seen the number of deaths due to illicit drug overdoses consistently exceed the highest monthly totals ever recorded.

COVID-19 has led to immense changes in how we go about our day to day life and has had a profound effect on the number of overdose deaths. Physical distancing directives, disruptions in supply chains, border closures, and other COVID-19 related social changes are key factors in the spike in overdoses.

Using drugs in isolation, or alone can increase the likelihood of an overdose. This has become increasingly likely because of COVID-19 restrictions and emphasis placed on isolating during the pandemic.

A key harm reduction technique which helps to reduce the likelihood and effects of overdose is using drugs in the company of others (preferably someone with overdose intervention training) in a safe space that is familiar. Whether that be with trusted people in a private residence or visiting a safe consumption site, doing drugs with people around who can support  in the event of an overdose is very important.

COVID-19 requires us to remain physically distant from one another while also having drastic impacts on the availability of services that vulnerable populations depend on, such as safe consumption sites, food banks, and community drop-in centres. As a result, more people are using drugs alone.

In addition, while the reliability of the drug supply has always been precarious at best, with COVID-19 closing borders and slowing down supply chains, the cost of drugs are higher and the quality is far worse.

BC’s Minister of Mental Health and Addictions, Judy Darcy, released a statement on June 11 that indicated that the illegal drug supply is more toxic and poisonous than ever before due to the pandemic.

As a result of COVID-19, there has been a reduction in the supply and increase in cost and adulteration of drugs, at a time when people who use drugs may be experiencing greater isolation, impacts on mental health, decreased income and more limited access to direct services and supports.

The collision of these two health emergencies has resulted in a drastic spike in overdose deaths in recent months. As an organization we have lost service users and residents, and many members of our community have lost friends and loved ones to overdose.

Today is International Overdose Awareness Day. This day calls on our collective global society to remember those that we have lost, acknowledge the grief of those left behind, and fight to #EndOverdose. It is important to reflect, remember, and have discussions in order to reduce stigma, break down barriers people face in receiving support, and address the impact that COVID-19 is having on vulnerable populations.

Today and every day, we remember the people that have been lost to overdose and stand in solidarity with people and communities as we strive to raise awareness, reduce stigma, and #EndOverdose.