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Fentanyl continues to drive B.C. overdose spike: coroners service

Randy Shore, Postmedia Network

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The synthetic opioid fentanyl is driving a massive increase in overdose deaths in British Columbia and men are dying in droves, according to a report from the B.C. Coroners Service.

More than 83 per cent of the victims in the first three months of this year were men.

While overdose deaths excluding fentanyl have been stable at about 293 a year since 2011, deaths due to overdose spiked to 922 last year and the trend shows no sign of letting up in 2017.

"Illicit fentanyl-detected deaths appear to account for the increase in illicit drug overdose deaths since 2012," the report says.

Samples of cocaine, heroin, and methamphetamine tested by Health Canada routinely contain fentanyl.

The coroner estimates 339 people have died of overdose in the first three months of 2017. The 120 deaths in March represent the third highest death toll for a single month on record in the province.

Chief Coroner Lisa Lapointe said harm reduction measures are reversing thousands of overdoses, but long-term measures needed to stem the tide must include education at an early age and evidence-based treatment.

More than 20 overdose prevention sites for supervised IV drug use were set up across B.C. in December and January, attracting 67,000 visits. Up until March, more than 1,000 overdose events were managed without a fatality, according to the B.C. Centre for Disease Control.

The death rate for men appears to be higher than the proportion of men in the opioid addict population which ranges from 65 to 80 per cent, according to Michael Krausz, a psychiatrist and UBC-Providence leadership chair for addiction research.

Men represent about two-thirds of people who abuse alcohol and most other substances, but the highest proportion of men is among IV drug users.

"We know that 10 to 15 per cent of overdoses are related to suicide attempts," said Krausz. "Women attempt suicide more often and have more suicidal ideation, but men more often succeed.

"Even when men are not actively suicidal they have a tendency for despair that puts them at greater risk of death," he said. "They just don't care if they die."

Male IV drug users are also more likely to live alone and use drugs alone, which may contribute to the high proportion of deaths. About half of all overdose deaths occur in private residences, according to the coroner.

"The level of isolation among men with mental health and addiction issues is higher than among women and we know that more men than women will be battling both," said Krausz.

Unfortunately, the available data does not make it clear whether the people dying of overdose were in treatment for mental health issues or if they have attempted suicide before.

Last year, more than 3,900 people entered replacement therapy — programs that prescribe methadone or suboxone — for a total of about 19,000 in treatment.

"When women engage in treatment they are more likely to be successful than men. They stick to the rules and are not injecting street drugs on the side so much," he said.

Understanding why men become addicted and die at higher rates than women is essential to creating effective treatments and interventions for men at risk of overdose, Krausz said.

With files from Canadian Press