As the opioid crisis wreaks havoc in Western Canada, Quebec is also grappling with an increase in drug overdoses. According to data from the National Institute of Public Health of Quebec (INSPQ), more than 500 people died of suspected poisoning with opioids or other substances from October 2021 to September 2022.
While 90% of the approximately 32,000 Canadian deaths associated with opioids have occurred in British Columbia, Alberta and Ontario, unprecedented rates have also been observed in the Quebec and Montreal regions since 2016.
“The first wave of street fentanyl was in Montreal in the summer of 2014. By chance, a batch of bad fentanyl ended up on the street, and there were several overdoses in those two weeks. […] But the crisis we are currently experiencing began at the start of the pandemic, ”says Christopher Kucyk, trainer and support agent for the PROFAN 2.0 program, which offers training on overdose prevention, in an interview.
According to data from the Bureau du coroner au Québec (BCQ), regions of the province experienced a total of 1,258 overdose-related deaths from January 2019 to July 2022. The majority of them were men between the ages of 40 and 59. years.
“It’s not the drugs that make people die, it’s the stigma. People hide to consume, they are alone and therefore there is no one to intervene with them”, maintains Mr. Kucyk.
During the first year of the pandemic, the BCQ recorded an increase of about 25% in deaths possibly or probably related to drug poisoning compared to the previous year.
Data from the Direction régionale de santé publique de Montréal (DRSP) reveal that emergency interventions in supervised injection services (SIS) are four times more frequent than in 2019-2020. The distribution of naloxone – a drug that temporarily reverses the effects of an opioid overdose – by community organizations has also increased by at least 63% in Montreal between the pre-pandemic year and the last year.
However, some drug addiction services have improved in recent years, such as supervised injection services (SIS). In Montreal, three fixed sites and a mobile unit allow injection drug users to proceed safely.
Despite everything, the current crisis requires an improvement in the services offered to the population, because they are still insufficient, believes Dominique Gagné-Giguère, speaker for the Montreal organization Méta d’Âme.
“Even though there was a statistical lull in 2021 for fatal overdoses, it was almost the worst year for accidental non-fatal overdoses. 2022 promises to be the second worst year for fatal overdoses in Quebec, he explains in an interview. The situation clearly calls for either an increase in funds or government initiatives that have concrete impacts, but that’s not what we see”.
A silent crisis
In Quebec, more than one person per day dies of a drug overdose. “And again, we are talking about the deaths listed,” underlines Christopher Kucyk, himself an injection drug user.
In 2021, more Quebecers died of an overdose than in a road accident. However, this problem remains relatively little addressed within the media space.
“It’s not stigmatizing to heat up a tank, but it’s very stigmatizing to inject or just use drugs,” laments Mr. Gagné-Giguère. The public is aware that there is a crisis, but it affects a vulnerable and stigmatized population so much that in the end, it does not occupy a very large space in the public discourse”.
While fentanyl has been associated with an increase in overdoses for some time, new psychoactive substances are increasingly circulating on the Quebec black market. This is the case of carfentanil, which is considered to be 4000 times more powerful than heroin and 100 times more powerful than fentanyl.
“What has been exacerbated by the pandemic is the cessation of imports of foreign substances. People turned to local stock made with dubious mixtures, and it was really more complicated to know what we were consuming”, explains Dominique Gagné-Giguère, adding that the analysis of substances was not yet a very established practice.
Significant awareness-raising work remains to be done to tackle this problem, underlines the speaker, in particular with the police. While more and more patrollers are circulating with a naloxone kit on them, many of them do not have the appropriate training to intervene with users in crisis.
“The overdose crisis, unfortunately, is far from over. As long as the authorities do not act in a way proportional to what we see in the streets, fentanyl is there for good, ”laments Christopher Kucyk.
This article has been produced with the financial support of the Meta Scholarships and The Canadian Press for the news.