Data showing no rise in life expectancy due to opioids need to be Canadian election issue, B.C. doctor says

Life expectancy rates in Canada have stopped increasing for the first time in four decades, says a Statistics Canada report that blames opioid-related overdoses for deaths in British Columbia, followed by Alberta.

Canadians concerned about young adults dying from overdoses should demand drug-policy changes by "holding politicians' feet to the fire," said an addictions specialist responding to the data released Thursday.

"I don't understand, truthfully, how governments are making decisions that pertain to this issue because we're hemorrhaging money with bad drug policy and poor health-care spending," said Dr. Keith Ahamad of the high rates of deaths.

Statistics Canada said life expectancy did not go up from 2016 to 2017 for either men or women after an upward trend from the mid-1990s to 2012, but overall gains then started to stall.

"In particular, the drug overdose crisis occurring in Canada was a major contributing factor in the change seen in life expectancy from 2016 to 2017, especially for men," the agency said in a report.

Life expectancy fell in B.C. in 2017 for the second year in a row, especially for young men between the ages of 20 and 44, it said.

"Although older men are living longer, the increase in deaths among young men almost completely offset these gains. A similar pattern occurred among women, although to a lesser extent."

Ahamad, who works at St. Paul's Hospital in Vancouver, said street drugs tainted with cheap and potentially deadly fentanyl and the more potent carfentanil, typically used to tranquilize elephants, call for a regulated drug supply because too many young people are dying.

Traumatic fallout

He said life expectancy between young men in Vancouver's poor Downtown Eastside and the west side differs by 17 years and men are dying 11 years earlier than women.

"It's absolutely mind-blowing," he said, adding Indigenous people are disproportionately affected by the overdose crisis that led the B.C. government to declare a public health emergency in 2016.

"We're doing a very bad job nationally with drug policy, combined with the fact that we're not looking after people from the lower socioeconomic groups," said Ahamad, who is also a researcher with the BC Centre on Substance Use, which advocates for evidence-based treatment with opioid substitutes such as suboxone.

Ahamad said it needs to be a federal election issue this fall.

"There's a traumatic fallout for people who are losing children and siblings and friends and parents. There is health-care-provider burnout at a level I've never seen before. My colleagues are absolutely burned out."

Statistics Canada said death rates due to overdose were 2.1 times higher for men and 1.6 times higher for women in 2017 compared with 2015 but those are likely underestimates because the cause of death in some cases has not yet been determined due to ongoing investigations.

Of the 4,108 overdose deaths recorded in Canada in 2017, nearly 1,100 involved people between the ages of 30 and 39, the agency said.

Decriminalize drug use

Dr. Bonnie Henry, British Columbia's provincial health officer, said the life-expectancy data reinforces the negative impact the overdose crisis is having on communities.

"I believe we need to continue to focus on this crisis and there is more to do including decriminalization of people who use drugs and providing people addicted to drugs and at high risk of dying with pharmaceutical alternatives to the poisoned street-drug supply," she said in a statement.

The First Nations Health Authority in British Columbia said 193 First Nations men and women fatally overdosed last year, a 21 per cent increase from a year earlier.

Compared with their counterparts in the general population in B.C., First Nations women are more likely to fatally overdose, the health authority said, adding about 40 per cent of women die from overdose versus 17 per cent of non-First Nations women.

Grand Chief Doug Kelly, chairman of the First Nations Health Council, which governs the health authority, said the legacy of the residential school system, ongoing racism and family violence have marginalized women.

The stigma of mental health and substance use among both women and men is an issue that needs to be addressed so the "grannies and aunties and uncs" understand the "swamp of addiction" and provide support for people who are suffering, he said.

"I think there needs to be a debate so we understand what's happening."