- According to the BC Coroners Service, fentanyl was detected in approximately 60% of overdose (OD) deaths in BC from January 1 to June 30, 2016. ~22% of these fatal ODs occurred in VCH; 85% of them were in Vancouver.
Overdoses in VCH urban areas
- From January 1 to July 16, 2016 there were 3196 illicit or unknown drug overdoses presenting to VCH emergency departments (ED). Nearly one quarter of them (769) were opioid related. The majority (70%) of these overdoses presented at St. Paul’s Hospital.
- The substance isn’t known for almost half (45%) of all presenting overdoses. When the substance was known the most commonly patient-reported substance was heroin (21%).
- The majority of overdoses occurred in males (68%) and those aged 19 to 59 years.
- Approximately 9% of overdose patients were admitted to hospital while 74% of patients were discharged from the ED and 17% left against medical advice.
- Most presenting overdoses were among VCH residents (60%) and of those, 80% were from Vancouver, 8% were from Richmond, 9% were from Coastal Urban, and 3% were from Coastal Rural. The majority of Vancouver residents were from City Centre and the Downtown Eastside.
Overdoses in VCH rural areas
- In VCH rural hospitals (Bella Coola General Hospital, RW Large Memorial Hospital, Sechelt Hospital, and Powell River General Hospital) OD reporting began in June 2016. Since then there have been 7 ODs reported, of which one was opioid related. Of these 7 OD events, 3 were admitted, 2 were transferred, 1 was discharged and 1 resulted in death.
Naloxone use by paramedics
- The BC Emergency Health Services (EHS) receives 250 to 400 calls related to ingestion poisoning per week, across the province. When an ambulance is dispatched to respond to a call, there are instances when ambulance crews administer naloxone at the site of the injury. Across the province the rate of naloxone administrations by EHS crews ranges:
- Vancouver: 129.3 events/100,000 population
- Richmond: 19.6 events/100,000 population
- North Shore Coast Garibaldi: 20.7 events/100,000 population
Vancouver Coastal Health and Providence Health Care are extremely concerned about the high number of overdoses and overdose deaths in our region and throughout the province and continue to take steps to respond.
VCH and its partners are taking a number of steps to reduce opioid/fentanyl-related overdoses, including:
- opening a new Substance Use Treatment and Response Team (START) which provides rapid access to at-home detox for those who need help stopping or stabilizing their substance use.
- having take-home naloxone kits available at several First Nations communities have with the goal of all 14 communities to have them.
- changing BC College of Physicians and Surgeons regulations to allow physicians to prescribe Suboxone without a methadone license on July 1, 2016. Details here.
- creating a webpage devoted to overdose information – www.vch.ca/overdose.
- creating a shareable graphic with the steps of how to use naloxone
- distributing a news release to media outlining actions to date – click to read
- having take-home naloxone kits at all 14 urgent care centres and emergency departments across the region for doctors and nurses to give to clients to take home. Currently the kits are available in three of the 14 so far.
- increasing the number of take-home naloxone kits throughout the community. We’ve added 11 sites this year. There are currently a total of 58 sites people can access them across VCH/PHC.
- working with partners to make take-home naloxone kits available at homeless shelters and supported housing facilities. So far approximately 200 staff at Lookout Emergency Aid Society have been trained to administer naloxone.
- working to expand supervised injection services. We are planning to embed supervised injection services in facilities already providing care to injection drug users.
- having opened the St. Paul’s Rapid Access Clinic in June 2016, which performs an immediate assessment of substance dependant patients in the emergency department and links them to care such as opioid replacement therapy.
- developing a new mental health and addictions hub at St. Paul’s Hospital, along with the City of Vancouver and Vancouver Police Department. The hub will provide quicker psychiatric and substance use response service in a culturally appropriate, trauma-informed way.
- planning to develop 131 additional spaces for addictions treatment (ie detox) across VCH/PHC.
We are also finalizing several other strategies; details will be released in the coming weeks and months.