Pubdate: Fri, 15 Apr 2016
Source: Globe and Mail (Canada)
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Authors: Sunny Dhillon and Karen Howlett
Page: A1

B.C. DECLARES PUBLIC HEALTH EMERGENCY AS OVERDOSES SURGE AGAIN

British Columbia has declared a public health emergency after another 
surge in drug-related overdoses and deaths, making it the first 
province in the country to take such a step as others, including 
Ontario and Alberta, work to combat the effects of fentanyl.

"This is, frankly, a crisis," provincial health officer Perry Kendall said.

Dr. Kendall's decision comes after B.C. recently suffered its highest 
monthly total of overdose deaths in nearly a decade.

"We in Canada have been watching with dismay as the number of 
overdose deaths associated with opioid drugs, in fact all illicit 
drugs, increases," Dr. Kendall said, adding that despite the efforts 
of B.C. officials, the number of deaths has continued to climb.

A recent Globe and Mail investigation found that online suppliers 
have exploited gaps at the border to get illicit fentanyl into 
Canada, devising ways to conceal the drug and skirt inspection rules. 
Fentanyl was developed as a prescription painkiller, but gained 
popularity as a street drug after OxyContin was removed from the 
market in 2012. B.C. had 76 illicit drug overdose deaths in January, 
the highest total in a single month since at least 2007. At its 
current rate, the province could have 600 to 800 overdose deaths this 
year, Dr. Kendall said in a news conference on Thursday. B.C. had 474 
such deaths last year, a significant increase from 211 in 2010.

The number of B.C. illicit drug overdose deaths linked to fentanyl, 
an opioid up to 100 times more potent than morphine, has also surged, 
from 5 per cent in 2012 to about 31 per cent last year. Of the 201 
overdose deaths in B.C. so far this year, 64 were associated with fentanyl.

Declaring a public health emergency - the first time B.C. has ever 
done so - allows officials to collect real-time data on all 
overdoses, Dr. Kendall said. Overdose information is currently 
released only when a person dies.

Dr. Kendall, who was joined at the news conference by B.C. Health 
Minister Terry Lake, said compiling real-time data was a key 
recommendation in a recent report by the B.C. DrugOverdose and Alert 
Partnership, which is led by the B.C. Centre for Disease Control.

"We have determined that in order to assist us in providing an 
enhanced response, a key need is for more information and more 
detailed information on the who, the where, the when of these tragic 
incidents," he said.

Dr. Kendall said knowing more about overdoses more quickly will allow 
health officials to provide a better response. He stressed the 
medical information will be treated confidentially.

The emergency declaration did not immediately spur other provinces 
that have been hit hard by fentanyl to follow suit.

A spokesperson for Ontario Health Minister Eric Hoskins referred 
questions to the province's chief medical officer of health, who 
could not be reached for comment on Thursday evening.

Health-care workers in Ontario said the province should treat the 
increase in overdose deaths with the same urgency as B.C. is doing. 
Several communities have sounded the alarm in recent weeks about a 
spike in overdoses from street drugs that appear to have been laced 
with fentanyl.

"If this isn't a public health emergency, then Ontario needs to 
redefine what constitutes an emergency," said Michael Parkinson, 
community engagement coordinator with the Waterloo Region Crime 
Prevention Council, which has issued local alerts about the 
prevalence of illicit fentanyl.

The most recent information on fatal opioid overdoses in Ontario is 
from 2014, when 173 people died of fentanyl overdoses, accounting for 
one in four opioid fatalities.

A spokesperson for Alberta's minister of health said the province 
sought legal advice last fall to determine whether a public health 
emergency should be declared. The spokesperson said the government 
decided a declaration was not necessary to move forward with attempts 
to combat fentanyl and other opioids.

A statement attributed to Alberta Health Minister Sarah Hoffman said 
her government has taken steps to address the illicit use of 
fentanyl, including more than doubling the province's supply of 
take-home naloxone kits.

Hakique Virani, an assistant clinical professor in public health and 
addiction at the University of Alberta's Faculty of Medicine, has 
called fentanyl the No. 1 public health concern in the province. He 
said B.C.'s announcement was welcome, although he would like to have 
seen such action sooner.

Dr. Virani said it was unclear if other provinces will be encouraged 
to do the same.

"Why now is it more of an emergency after B.C. has called one than it 
was last month, when we were still losing somebody every single day . 
to opiate overdose? It would be a difficult thing, I think, for a 
minister or a chief medical officer of health to explain, 'Well, now 
it's an emergency because B.C. said it was.'

"It's been an emergency for years."
- ---
MAP posted-by: Jay Bergstrom