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Indigenous population hit hard in overdose crisis

254 First Nations people died of drug overdoses in 2020, compared to 116 in 2019.
fentanyl pills
Fentanyl is the main reason why overdose deaths have risen so dramatically during the past few years. The cheap, but powerful drug is often added to cocaine and heroin to increase a dealer's profit margin, often without the user's knowledge.

Fatal overdoses disproportionately affected B.C.’s Indigenous population, particularly women, as illicit drug deaths spiked in 2020 amidst the COVID-19 pandemic.

According to statistics released by the First Nations Health Authority (FNHA), 254 First Nations people died of drug overdoses in the province last year — the highest total since 2016 when the opioid epidemic began.

That number is a 119 per cent increase over the 116 Indigenous individuals who died of drug overdoses in 2019.

Indigenous peoples have been over-represented in the public health emergency, accounting for about 15 per cent of toxic drug deaths in 2020, while making up just 3.3 per cent of B.C.’s population. That statistic is up from 2019, when First Nations peoples comprised 11.8 per cent of fatal overdoses.

The rate First Nations people died also increased — at 5.3 times the rate of other B.C. residents in 2020, up from 3.9 times in 2019, according to the FNHA. It’s also the widest gap seen since 2016.

Last year saw the highest-ever number of toxic drug deaths among both First Nations women and men — 172 men and 82 women. First Nations women were especially affected, accounting for 32 per cent of drug deaths for First Nations people, which is double the rate of non-First Nations women in B.C. last year, according to the FNHA.

Dr. Nel Wieman, FNHA’s acting deputy medical officer, said the opioid crisis had been improving with reduced numbers for both the province as a whole and B.C. First Nations until the COVID-19 pandemic hit last year.

Public health measures to reduce exposure to COVID-19, she said, are believed to have resulted in more people choosing to use drugs alone and made it more difficult to access harm-reduction sites and services. It also comes at a time when street drugs are increasingly more toxic through the use of cutting agents such as fentanyl and carfentanil.

“The significant reduction in toxic drug deaths amongst B.C. First Nations in 2019 was erased in 2020 and the death rate from toxic drugs began to rise,” Wieman said during a recent press conference.

Wieman said in addition to the pandemic, First Nations are disproportionately represented in illicit drug deaths because they often face barriers such as insufficient access to culturally safe mental-health and addiction treatments, systemic racism in accessing health care and intergenerational traumas leading to high degrees of stress and, subsequently, substance use.

To address some of the challenges posed by COVID-19, the FNHA launched a virtual substance-use and psychiatric service, supported expanded access to prescription alternatives and opioid agonist therapy, developed a harm-reduction policy and expanded harm-reduction education around B.C. in 2020.

The FNHA also dispensed more than 18,000 doses of nasal naloxone spray through pharmacies and more than 4,000 nasal naloxone kits to more than 90 First Nations communities in B.C. that year. Naloxone is medication that temporarily reverses the effects of an overdose.

Asked by KTW what local governments and First Nations bands can do to assist, Wieman said the FNHA works closely with its regional directors, who are in constant communication with community members and leaders, including band chiefs and health directors.

“It’s kind of a two ways of working together,” Wieman said. “Communities that have ideas around things that would be helpful for the, we try to support them in getting those things in place.”

The FNHA has regional data for fatal overdoses amongst Indigenous populations, but has yet to distribute that information to local First Nations partners — something it intends to do soon before releasing it publicly.