Pubdate: Tue, 08 Aug 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Andrea Woo
Page: A4

B.C. EYES PATTERNS IN OPIOID CRISIS

Province's new plan to fight overdose deaths requires coroners to log
extensive information on victims

A new mandate in British Columbia to collect comprehensive information
on all fatal overdose victims aims to provide a fulsome look at why
people use illicit drugs - from past medical issues to economic status
- - to help curb problematic drug use and prevent overdose deaths.

The BC Coroners Service's new Unintentional Drug Overdose Protocol
requires coroners to fill out an 11-page document for every person who
dies of a suspected overdose. The data gathering is the most ambitious
in the country. Last week, B.C. released data showing 780 people died
of opioid overdoses between January and June this year. The province
has been the hardest hit by the opioid crisis that is rapidly
spreading across Canada.

On top of fields in a standard coroner's report - postmortem and
toxicology exam details, location of death, physical clues at the
scene - the new protocol looks at residency type; occupation; previous
health diagnoses, including mental health; whether the person has
experienced trauma; drug-use history and previous treatment sought or
received.

The data could help answer questions such as how often drug dependence
starts with prescribed medications, how poverty factors in, or why
treatment - if sought - didn't work.

Chief Coroner Lisa Lapointe said the goal is to identify patterns and
trends, get a clearer picture of who is dying from illicit drug use
and why and ultimately inform practice and legislation and prevent
similar deaths.

"I'm not sure it will be absolutely definitive, but we know that
nobody else in the country is gathering this type of comprehensive
information," Ms. Lapointe said. "People who are dying - are they
representative of drug users generally? Of the general
population?"

To gather this information, coroners interview friends and family
members and work with partner agencies such as the Ministry of Health,
social services and BC Housing.

The new protocol will further explore why Indigenous people are
disproportionately affected by the overdose crisis. Data released last
week show that First Nations people are five times more likely to
experience an overdose - and three times more likely to die of one -
than non-First Nations people.

"We recognize the root cause of where we are today," First Nations
Health Authority (FNHA) deputy chief medical health officer Shannon
McDonald said last Thursday, "and that root cause rests in
colonization, displacement, connection that has been broken."

In partnership with the FNHA, the coroners service last year began
collecting data on whether an overdose victim identified as Indigenous
and, if so, First Nations, Metis or Inuit.

The BC Coroners Service's Drug Investigation Team began using the new
protocol in December, when a record 159 people died of overdoses in a
single month. It is aiming to release preliminary findings in the fall.

The new protocol is yet another way in which B.C. has plowed ahead in
its response to the overdose crisis. Faced with skyrocketing overdose
deaths, the province and its partner agencies opened around 20
"overdose prevention sites," expanded supervised injectable
opioid-assisted therapies and opened shared using rooms in social
housing buildings to encourage drug users not to use alone.

It also highlights the different paces at which provinces are
responding. Alberta, for example, recently started releasing quarterly
overdose statistics. That province's centralized data show that, of
the 343 people who died of apparent overdoses linked to fentanyl last
year, 24 per cent had filled a prescription for an opioid in the 30
days prior and almost 40 per cent were prescribed opioids from three
or more health-care providers. That highlighted the fact that
physicians and pharmacists could serve as crucial touch points in the
fentanyl crisis.

Ontario's most recent data, more than a year old, found that at least
412 people died of opioid overdoses in the first half of 2016. In
B.C., overdose deaths increased 66 per cent from first quarter 2016 to
first quarter 2017.

At least 780 people died of illicit drug overdoses in B.C. in the
first half of the year. Preliminary data suggest that fentanyl is now
being detected in about 78 per cent of all overdose deaths, compared
with 67 per cent last year.
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MAP posted-by: Matt