Tucked into a stretch of Kelowna’s downtown, where the street-entrenched population tends to congregate, Urban Health Outreach has been doing brisk business on a variety of fronts, including offering supervised injection services.
The trouble with the latter service, however, is the way people are using drugs in the Okanagan, and B.C. in general has changed.
“We are seeing a shift in the consumption patterns,” Dr. Silvina Mema, deputy chief medical officer, said. “In that shift, we are seeing the inhalation and smoking of illicit substances increase, and injections decrease.”
The last survey done by Interior Health showed that 65 per cent of people who use illicit substances choose to smoke or inhale them, in contrast with 12 per cent of those who choose to inject them, Mema said.
“We are seeing that not only is it the preferred mode of consumption, but also the deaths that have occurred are overwhelmingly due to inhalation of substances,” Mema said.
“For example, in the Interior region in October, 80 per cent of people who died had used substances by inhaling or smoking them, so it is a needed service.”.
Unregulated drug toxicity is the leading cause of death in the province for people between 10 and 59, accounting for more deaths than homicides, suicides, accidents, and natural diseases combined.
In October, 189 individuals died from the poisoned drug supply. More than 13,200 people have died because of poisoned drugs since the crisis was declared in 2016, according to the Coroner’s Service.
Supervised consumption is one of the ways health officials are addressing the onslaught of deaths. In the case of inhalation supervision, it means providing a room where individuals can use their substances in a safe environment, not unlike safe injection services.
“There is ventilation and there is negative pressure that prevents the fumes from that substance from impacting other individuals around them,” Mema said. “At the same time, people can be monitored after that consumption.”
Services of this kind aren’t new in B.C,. and at times they take on new forms.
In the Northern Health region, there are mobile overdose prevention sites and people can smoke their drugs in a monitored situation in tents, and the like.
“About 25 per cent of the deaths are occurring in Vancouver and then the rest are occurring across B.C. and that includes our small and medium-sized towns, which, you know, creates a ripple effect in the community,” Mema said.
Smaller communities, she said, are disproportionately impacted by deaths from the toxic drug supply.
“Every death is a tragedy and unfortunately, after the pandemic, we’ve been seeing an increase in the number of these deaths and you know, we are trying to do what we can to prevent even more,” she said.
While safe consumption services are part of what’s being offered, Mema said that it’s not all that’s being done to save lives.
“In order to address the needs of people who use substances … a continuum of services is required,” she said. “Not everybody will need all of the services but we need to tackle this issue from multiple fronts and have multiple interventions to address it.”
Some individuals may need a detox bed and go through treatment that way, she said.
“However, for people who use substances, opioids in particular, the first line of treatment is to provide them with opioid agonist therapies and that can be done that can be prescribed by physicians without the need to completely detox the liver,” she said.
It’s information that is readily available at locations where safe consumption is offered.
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