The scope of the opioid crisis continues to escalate locally and across Alberta, and demand at the new Supervised Consumption Services (SCS) site in Lethbridge is already surpassing expectations, City Council members were informed today.
Meeting as Community Issues Committee, Council members received an update from representatives of the Executive Leaders Coalition on Opioid Use, a broad-based local coalition formed in 2016 to respond to the rapidly-growing opioid crisis.
According to Alberta Health Services (AHS) statistics, there were 589 fentanyl overdose deaths across Alberta in 2017, an increase of 69 per cent from the total of 349 deaths in 2016. Eighteen fentanyl deaths occurred in Lethbridge in 2017, and the death rate in this city was the third-highest among Alberta cities at a rate of 19 deaths per 100,000 people. Provincially, the number of fentanyl deaths has roughly doubled almost every year since 2011 when there were six.
In addition to fentanyl, the use of carfentanil – an opioid used by veterinarians on very large animals such as elephants – has also become more prominent in the past year. A lethal batch of carfentanil is blamed for 42 overdoses that occurred over a single weekend in Lethbridge in late February.
Presenting on behalf of the coalition were Gwen Wirth, Director of Communications for Alberta Health Services-South Zone; Chief Rich Hildebrand of Lethbridge Fire and Emergency Services; Insp. Tom Ascroft of the Lethbridge Police Service; and Stacey Bourque, Executive Director of ARCHES, a local agency which operates the SCS site and provides outreach, harm reduction services, education and support to people who use drugs.
Data from the first two months of operation indicates that the consumption and wraparound services provided at the SCS site are being well accepted and used by the vulnerable population it is intended to serve, Bourque said. By the end of April, 389 unique clients had registered to use the site, and about 75 per cent have used it multiple times. To date, there have been 70 overdoses by clients using the facility but no fatalities because supervising medical staff successfully intervened.
Bourque noted that the Lethbridge site averaged 175 visits per day in April by clients using the facility's six injection booths and two inhalation rooms. The peak number of visits in one day, so far, is 231. By comparison, the Calgary SCS site, which opened five months ago, is averaging 106 visits per day, and its busiest day to date has seen 143 visits.
Because the Lethbridge site is so busy, wait times for clients range from 10 to 90 minutes each day, she said, and as wait times increase, so does the likelihood that some clients will become desperate and leave the site to consume drugs elsewhere. With the SCS site already operating near its capacity, approvals are being sought from the province to add four more injection booths and another inhalation room.
In the first two months, there have been more than 1,300 referrals to wrap-around services provided at the SCS site, including addictions counselling, primary wound care, housing supports, and harm reduction reviews. In addition, there have been more than 1,500 referrals to external or internal services such as long-term treatment, opioid agonist therapy, naloxone kit training, detox, harm reduction education and supplies, as well as food, shower and laundry facilities.
Health representatives on the coalition continue to emphasize that the rates of opioid addiction are epidemic in nature and a major public health issue for Alberta and that addictions should be addressed like chronic illnesses, similar to diabetes, as individuals do not choose to be addicted. From a public health perspective, a combination of medication with opioid replacements and counselling support is the most effective way to treat opioid misuse.
Meanwhile, the opioid crisis continues to be a challenge for emergency responders in Lethbridge. Lethbridge Fire & EMS responded to 664 emergency overdose calls in 2017, an increase from 608 in 2016. So far in 2018, they had responded to 272 calls to 911 regarding overdoes, as of Apr. 25. In 2017, EMS administered naloxone 208 times to revive patients from overdoes, compared to 132 times in 2016.
Meanwhile, the Lethbridge Police Service continues to see high property crime and drug-related violent crime as well as public intoxication, aggressive and unpredictable behaviour stemming from the opioid crisis. Although it's too soon to determine the impacts of the SCS site from a policing perspective, Ascroft said that, anecdotally, police are seeing less public drug use. While police continue their battle against drug trafficking, Ascroft noted that arrests alone can't solve the problem of crime driven by addictions. He re-emphasized that associated crime and negative behaviour are likely to continue until the cycle of addiction is broken with support services that help people with addictions.
The local coalition was formed to collaborate on addressing the issue of opioid abuse in Lethbridge after the rapid increase in addictions to opioids such as fentanyl – a dangerous and highly-addictive form of opioid – resulted in sharp increases locally in overdose deaths, emergency room visits, and treatment of overdose victims by emergency medical responders. The coalition includes representatives from the health, police, justice, emergency medical, post-secondary, municipal, education and social service sectors.
Council members meet periodically as Community Issues Committee to hear presentations and gather information on matters but do not make decisions during such meetings.
More information on the Executive Leaders Coalition on Opioid Use is available at: www.lethbridge.ca/OpioidCoalition.
Gerald Gauthier, Communications Consultant
City of Lethbridge