The epidemic of fentanyl deaths sweeping our province has been blamed, in part, on illicit-drug shipments from China. But while there is no question that a major smuggling operation is underway, this is by no means the whole story.
That we are in the midst of an epidemic is unquestioned. The number of overdose deaths this year will rise to more than triple the total in 2008.
When the final numbers are tallied, more than 600 fatalities are projected across British Columbia. And 91原创 Island, led by Victoria and Nanaimo, has the highest death rate of any health region in the province. Other parts of Canada are also recording heavy fatalities.
So why are 91原创s caught up in this fentanyl crisis?
Aside from the U.S., which matches our numbers, no other region in the world has comparable death rates.
In Europe, fatalities from illicit-drug overdoses in 2014 were 18.3 per million population. Across B.C., the fatality rate stood at 100 per million in that year 鈥� five and a half times as many. In 2016, the total will rise to 130 per million.
But fentanyl is easily smuggled. Why is Europe not engulfed in the same crisis as we are?
Here is part of the answer. 91原创 physicians prescribe far more opioid painkillers than their European counterparts. Specifically, they write three times as many prescriptions for fentanyl, and five-and-a-half times as many for oxycodone 鈥� another powerful drug in this class.
Is this pure coincidence? Likely not. Studies in the U.S. have shown there is a direct correlation between the number of opioid prescriptions written and the number of overdose fatalities.
In essence, painkiller medications like these are the pathway through which many 91原创s become addicts. When their prescription runs out, they turn to street drugs.
And physicians in B.C. have played a part in this growing problem. Between 2005 and 2013, the volume of prescription opioids rose 31 per cent in our province 鈥� far higher than the population increase. And just as troubling, the narcotics being dispensed grew steadily more powerful and addictive.
B.C.鈥檚 College of Physicians and Surgeons has recognized the problem. This year, the college warned: 鈥淭he public-health crisis of prescription-drug misuse has developed in part due to the prescribing of physicians.鈥�
Tough guidelines were introduced to cut back on overuse of narcotics. These include a warning to physicians that opioids are not the preferred way to treat chronic, long-lasting conditions. Using heavy-duty narcotics in such circumstances invites addiction. Programs such as the Pain Program at Island Health were introduced to help patients cope with chronic pain without overuse of opioids.
So yes, our relative proximity to China is a problem. But so is the practice doctors have adopted of using addictive medications to treat conditions that don鈥檛 warrant it.
It is hoped the guidelines imposed by the college will resolve the crisis. Yet that will inevitably take time 鈥� perhaps years. The epidemic of fentanyl deaths could get worse before it gets better.
And here, a human evil must be noted. By far the most effective treatment for a fentanyl overdose is immediate application of the antidote naloxone. In many cases, this is the only hope.
Emergency kits have been provided to first responders and family members of addicts across the province.
But one person鈥檚 tragedy, shamefully, is another person鈥檚 opportunity. Over the past two years, one of the companies that manufacture naloxone has increased the price 500 per cent in the U.S. market.
That price hike hasn鈥檛 shown up here yet. But a special circle of Hell should be reserved for those involved in this obscene behaviour.
