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Isolation, drug toxicity lead to spike in First Nations overdose deaths amid pandemic: FNHA

Deaths increased by 93% between January and May
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FILE – Shannon McDonald, deputy chief medical officer of the First Nations Health Authority, and B.C Chief Coroner Lisa Lapointe discuss ways to improve services to Indigenous youth at risk. (Black Press Media)

Fatal overdoses among Indigenous peoples in B.C. spiked by 93 per cent during the first five months of 2020, according to the First Nations Health Authority.

In Monday (July 6) announcement, the FNHA said overdose deaths among First Nations, Inuit and Metis peoples went up by 93 per cent between January and May 2020, compared to the year prior. The news on Indigenous deaths came as B.C. recorded its deadliest month in May since the overdose crisis began more than four years ago, with 170 deaths. Among Indigenous peoples, 98 people died during the first five months of 2020, compared to 46 in 2019.

READ MORE: B.C. records highest ever number of fatal overdoses in May with 170 deaths

“When I’m talking about these numbers, I’m speaking about people,” said Dr. Shannon McDonald, acting chief medical officer at the FNHA.

A “significant” portion of those deaths were due to fentanyl, which has infected B.C.’s drug supply.

McDonald said the pandemic brought along with it an increase in drug toxicity in the illicit substances available to First Nations communities. Although 6,315 Naloxone kits have been delivered to First Nations sites and Aboriginal Friendship Centers, when people use alone it’s more difficult to get help before it’s too late.

“COVID-19 has also forced people into isolation. We have asked people to maintain their distance from others.”

Furthering the isolation, McDonald said some people are choosing not to use supervised consumption sites during the pandemic, while others have no choice as the sites have temporarily closed.

“Without having somebody with you… people are dying before they are reached.”

First Nations peoples, McDonald said, were disproportionally represented in overdose deaths prior to the pandemic as a result of intergenerational trauma and a lack of culturally safe services. First Nations, Metis and Inuit people make up 3.4 per cent of B.C.’s population but in 2019, they made up 9.9 per cent of fatal overdoses between January and May. In 2020, that percentage went up to 16 per cent.

“The problem is getting worse, not better,” she said. In 2019, Indigenous people were 3.8 times more likely to die as a result of an overdose. In 2020, that went up to 5.6 times more likely.

McDonald said the FNHA has been fighting since the start of the crisis to bring in services for Indigenous people, including at supervised consumption sites and within First Nations communities.

Provincial health officer Dr. Bonnie Henry said it’s clear that “issues with systemic racism” prevent Indigenous people from accessing care in a culturally safe way.

“First Nations women are much more likely to die from a toxic drug overdoses,” she said.

“It’s a challenge right now, more than ever. We know the toxicity of the street supply has gone up more than ever, exponentially,” she said.

Henry said the province was looking at how they could continue responding to the pandemic without increasing fatalities due to B.C.’s other public health crisis.

“It was the measures that we took to try and prevent transmission of COVID-19… that had that unintended consequence of forcing people away from where they had support,” she said. Measures that shut down or altered the services at supervised consumption sites, closed shelters and lead to lost jobs and homelessness disproportionately affected First Nations people.

“If you don’t have a home, or you’re in a recovery home… it makes it riskier when COVID is circulating in the community.”

B.C. chief coroner Lisa Lapointe said that although fentanyl, which entered the B.C. illicit drug supply in 2015, had increased deaths, it was not the only substance to blame.

Lapointe said 50 per cent of fatal overdoses involved cocaine, 24 per cent involved methamphetamine and 30 per cent involved alcohol.

“It is driven by fentanyl… but nobody is safe,” she said. Lapointe said judgment and stigma when it came to drug use were barriers in seeking help, and encouraged the government to work to reduce both factors.

Acting deputy chief medical officer Dr. Nel Wieman said grief, trauma and racism experienced by First Nations people can exacerbate factors that lead people to use illicit drugs.

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“We know that substance use disorder can be a symptom of a person’s distress,” Wieman said. “People really stood up and got behind the public health measures for COVID-19… but when it comes to the ongoing opioid crisis, that’s got all kinds of stigma associated with it.”

The majority of overdose deaths among First Nations people happen in urban areas, where the chair of the First Nations Health Council said community members can lose touch with their support systems.

“It’s been easier for our people to leave home and disappear in Downtown Vancouver… that disconnects them from our communities,” said Charlene Belleau.

“Our leaders have called for ongoing support at the community level so we can bring our people home.”

McDonald said eight urban centres had a significant proportion of First Nations overdose deaths: Prince George, Kamloops, Chilliwack, Surrey, Vancouver, Campbell River, Nanaimo and Victoria.

McDonald said opioid agonist treatment, which uses methadone or buprenorphine (Suboxone), has helped. So far, seven communities are delivering Suboxone, with an expansion to seven more planned for 2021-2021.

Many advocates have called for legalizing small amounts of currently illicit substances to help people who use avoid fentanyl.

Henry said “access to a supply that is not going to kill you” was key in slowing down overdose deaths.


@katslepian

katya.slepian@bpdigital.ca

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