Amber Streukens is the harm reduction peer navigator at ANKORS. Photo: Tyler Harper

COLUMN: Join us on International Overdose Awareness Day

Amber Streukens writes about how the toxic drug crisis has changed over seven years

by Amber Streukens

International Overdose Awareness Day, coming up on Aug. 31, is an annual global event to increase awareness and reduce stigma around drug overdose. Here in British Columbia, in the seventh year of this public health crisis, the day is a time to gather as a community, to raise awareness, and to commemorate and honour those we have lost to toxic drug poisoning.

On Wednesday Aug. 31 from 1 to 3 p.m., Nelson Fentanyl Task Force, ANKORS, REDUN, Freedom Quest, Circle of Indigenous Nations Society, Mental Health and Substance Use, and other community partners will hold a community vigil event and provide educational booths at Cottonwood Falls Park in Nelson. Everyone is invited in our community.

There will be speakers, resource tables, naloxone training, memorial celebrations, a prize draw, and on-site community support. Please come down, check out local resources, and connect with community members dedicated to ending this tragic crisis.

Since the declaration of this emergency, the landscape has shifted. Policy change and healthcare pilot projects have not kept up with rising fatality rates. Partly, this is the pace of government as well as the evolution of the toxic drug crisis. Right now, six people are dying due to toxic drug poisoning every day in B.C.

In last few years, there have been shifts within our populations’ method of consumption of substances. In the 2021 Medical Health Officers Report (Part 1), The Toxic Drug Crisis in B.C.’s Interior Region, inhalation is noted as the most common method of substance consumption. Since 2017, fatalities associated with injection use have dropped, and fatalities associated with inhalation consumption have risen. Unfortunately, our overdose prevention sites in B.C. remain injection focused, which excludes a large population of people. We need more inhalation-focused overdose prevention sites to save lives.

The COVID-19 pandemic has had huge impacts on overdose response and prevention, and the drug supply in B.C. Since 2020, the presence of benzodiazepines in deaths has risen from 15 per cent in January 2020 to 59 per cent in May 2021. The ANKORS drug checking program reports benzodiazepines in the majority of opioid samples collected in the West Kootenay region.

Benzodiazepines are long-acting sedatives and, in combination with opioids, increase the risk of overdose and death. Benzodiazepines commonly found include flualprazolam, flubromazolam, and analogs like etizolam.

Benzodiazepine contamination in opioids can create more complex dependencies and severe withdrawals for people. Long-lasting sedative effects may place people at risk of harm, theft, or sexual assault. Meanwhile in the United States, and to a lesser degree in Canada, the contamination of opioids with xylazine, a veterinary tranquilizer with analgesic and muscle relaxant effects, creates a new host of complications.

Without a regulated drug supply, avoiding unwanted contamination is nearly impossible for people who use drugs. Since 2019, the rate of fatal toxic drug poisonings that have involved high concentrations of fentanyl has increased threefold.

We also continue to criminalize, stigmatize and abandon people who use drugs. Health exemption pilot models of decriminalization only capture the least criminalized people. Safer supply projects reach only a few people and meet the needs of even fewer. Health care systems are not adequately culturally safe, or trauma informed. Prohibition will continue to increase the toxicity of the drug supply, for as long as substance use remains criminalized.

Here in the West Kootenays, there is a strong community of advocates and health care workers who are committed to making change within our systems of care, to reduce deaths and to improve compassionate response.

Please come join us on Aug. 31 as we mark International Overdose Awareness Day. Let’s continue to share resources and educate our community, to reach out to family and friends, and to push for adequate culturally and trauma informed care in B.C.

Amber Streukens is the harm reduction peer navigator at ANKORS.