Overdose crisis death toll would be more than double without harm reduction, study says

The overdose crisis has killed an astonishing number of people across Canada, and British Columbia has been hit especially hard. A new study published Wednesday in the journal, Addiction, found that without harm reduction efforts, the death toll would have been more than twice as horrific.

Researchers looked at nearly two years of data, beginning when the public health emergency was declared in B.C. in April 2016 and ending in December 2017.

According to the study led by the B.C. Centre for Disease Control (BCCDC), there were 2,177 people killed by overdose in the province in that time.

But more than 3,000 deaths were prevented.

"It was one of these things that — you almost had to go back and check the numbers to make sure they were correct — that they actually were that high," said Mike Irvine, a post-doctoral fellow at BCCDC who works with the Ministry of Mental Health and Addictions and the Mathematics Institute at the University of British Columbia.

Irvine said the impact of widely distributed take-home naloxone kits was the most significant, in terms of lives saved.

"In 2017, there were 60,000 kits that had been distributed, so this is paying tribute, really, to how much that program had ramped up and rolled out across the whole province," he said.

In contrast, from 2012 to 2015, about 5,000 naloxone kits were distributed.

In the period from April 2016 to December 2017, the study found there were:

• 1,580 deaths averted due to access to take-home naloxone kits.
• 230 deaths averted by overdose prevention and supervised injection sites (with 23 sites operating by the end of 2017).
• 590 deaths prevented by opioid agonist treatment or opioid replacement treatment (with 22,191 people receiving treatment in 2017, including methadone, Suboxone and hydromorphone)

According to Irvine, the three health interventions combined resulted in more overdose deaths prevented than they would have if each were carried out alone.

He said the team's research found that as the prevalence of fentanyl analogues like carfentanil began to increase in late 2016 and 2017, so too did harm reduction services.

"We know that this [crisis] is being driven by a toxic, highly variable street drug supply," said Irvine. "There's a huge number of deaths that were averted, in part because of the sheer volume and the scope of these services, but also the fact that the street drugs had become so toxic within that period."

Irvine said the study's findings are a reminder that health officials' response to the overdose crisis in the province is effective, but also that the deadly crisis is still a major challenge.

"Deaths are still very, very high, and so more can be done," he said.

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