Toxic overdose deaths in Nelson set to ‘double’ as toxic drug crisis continues: IHA
By Timothy Schafer Local Journalism Initiative Reporter
The city could see a ‘doubling’ of fatalities this year over last year due to toxic overdoses, according to Interior Health Authority figures.
Even though the figures served up by the IHA are below the actual toxic overdose deaths occurring in the city — the IHA confirms four in Nelson since January — the number is exceeding the previous year’s total, said Jordan McAlpine, IHA decriminalization lead.
“Of course, as you are aware, there have been multiple reports and media coverage around potential other losses, too, but four is what we can confirm. It’s what the coroner can confirm at this point,” she said during the Tuesday night City council meeting. “As we continue at this pace we are looking at doubling our rate of fatalities in Nelson from last year.”
McAlpine said the deaths — 50 per cent occurring in private residence, 50 per cent occurring in public space — are not the typical
“We really want to keep in mind that there’s lots of folks that we work with every day that … use substances that we don’t know about. And we are also losing those folks,” she said.
The toxic drug crisis in Nelson (2023) sets the demographic of users at 80 per cent male, aged 30-64 years old, with an overdose death rate of 42.1 per 100,000, versus a rate of 46.8/100,000 for the entire health region (200 deaths).
Fentanyl was detected in the majority of the cases, said McAlpine. The drugs are toxic because it is unpredictable, and it is unpredictable because it is unregulated.
“It’s really easy for a tiny little mistake to be made along the trafficking line and it costs people’s lives. This is why decriminalization was, in part, to address the toxic drug crisis. It’s been one of our tools in our tool kit,” she said.
Cutting the tape
Decriminalization was an exemption by Health Canada to the Canadian Controlled Substances Act to decriminalize people who use substances implicated in the toxic drug crisis.
The exemption came into effect on Jan. 31, 2023 and continues for three years, with up to 2.5 grams in possession as legal.
“Decriminalization is a really large philosophical shift for us as a society, in general, and one that is moving away from criminalization and embracing public health,” said McAlpine. “And this approach is really different to how a lot of us were taught to think about substances and taught to think about the people who use them.
“It’s really acknowledging and endorsing that substance use can become a health problem, and that health problems need health solutions, not ones that are rooted in policing and criminalization.
Decriminalization matters
Decriminalization reduces barriers by shifting the approach to substance use as a health matter — not a criminal justice one.
It reduces the stigma around substance use so people feel more comfortable reaching out for help, addressing health and criminal justice inequalities and promoting pathways to care.
Source: IHA
Making it work
The risks of restricting public consumption of toxic unregulated substances displaces the problem underground, said McAlpine.
“People (would) use their substances in unsafe spaces and in unsafe ways, losing access to life-saving assistance,” she said.
Users would be unmonitored for unusual behaviours or effects of the substance, allowing a higher risk of injury to themselves and others.
There are inequitable impacts of the restrictions, including further marginalization of residents already disadvantaged by the housing crisis or poverty, especially indigenous communities, said McAlpine.
It “perpetuates stigma that prevents residents from seeking supports and treatment, even where such supports are available and accessible,” she said.
Punitive approaches
Punitive approaches do not reduce public substance use, rather it displaces people to less visible locations where provision of potentially life-saving interventions is less likely, noted an IHA bulletin.
It perpetuates “the harms, including shame and stigma, that the province is trying to reduce through decriminalization”: forcing people to conceal their substance use, and use alone; and increase the risk of fatal drug poisoning or injury.”
The punitive approach would disproportionately impact people with substance use disorder, low-income and unhoused residents, and indigenous peoples and communities. It can cause harm when adequate access to alternative spaces is unavailable.
Provincial approach
Province is currently undertaking engagement and policy work to support potential Fall 2023 legislation to regulate public substance use.
This legislation is intended to balance the complimentary goals of public health, public safety and other community interests.
The Province has “engaged directly with local governments to ensure that this legislation is responsive to local concerns. The Province is asking local governments to consider pausing public use bylaws or amendments until this legislation is introduced.”
Source: IHA
