More than 800 lives in British Columbia (BC) were lost to unregulated toxic drugs in the first four months of 2023. 

The latest report by the BC Coroner's Service shows that the opioid epidemic is disproportionately taking the lives of men (77%) between the ages of 30 to 59 (70%) in their homes (48%).

As a 40-something-year old man, I am deeply disturbed by these trends. These are men in my age group – cut down in the prime of their lives. Brothers, sons, boyfriends, husbands, partners and fathers are dying at home from illicit, toxic drugs.

The BC Coroner's Service has called this “a crisis of incomprehensible scale.” Unregulated drug toxicity continues to be the leading cause of unnatural death in BC. In fact, it is responsible for more deaths than homicides, suicides, motor vehicle incidents, drownings and fires combined.

Together, we need to do more. This includes comprehensive mental health and addictions care, new treatment beds and increasing access to harm-reduction programs, such as supervised consumption sites, safer supply and social supports.

The federal and provincial governments are piloting a decriminalization initiative in BC. Adults in the province are not to be subjected to criminal charges for the personal possession of 2.5 g of certain illicit drugs. On June 14, BC announced it was expanding access to opioid treatment medications, such as methadone and Suboxone, by providing universal coverage to help people with substance use disorders. 

These efforts are a great start in the fight against drugs. But a missing piece is addressing the illicit sources of these drugs. Decriminalization and removing financial barriers to treatment are important parts of an integrated approach but we must include access to a safer supply alongside these options. Several BC Coroner's Service reports reference the various panels and committees that have recommended urgently implementing a safe, regulated supply of substances for those at risk. 

As the Centre for Addiction and Mental Health expert Benedikt Fischer wrote in The Lancet: the pharmacological composition of the drugs in question has evolved from that of an ”opioid death” into a “poly-drug death” crisis, significantly increasing the overdose risk. This has also diminished the effectiveness of our existing interventions, such as naloxone. Fischer advocates providing safe, predictable and pharmaceutical-grade substances to help save lives.

As a pharmacist, I was on the front lines in the early years of this epidemic. I saw the impact addiction had on people’s daily lives. Illicit drugs tore away jobs, families and financial resources. It reduced their world to search for their next fix. Without a safe supply, they turned to wherever these drugs could be found. I agree with Fischer – only by providing safe, predictable and pharmaceutical-grade substances will we slow and eventually prevent the deaths of the thousands of lives we lose yearly to illicit and toxic drugs.

We must ask ourselves if stigma prevents us from taking the meaningful action that is required to save lives. In many of these recent deaths, fentanyl, cocaine or methamphetamines were found. 

Bonnie Henry, BC’s provincial health officer, recently addressed the challenge of shifting our thinking after a century of prohibition and criminalization of drug users. But the most important shift we need to make is recognizing that people who use drugs are people first. They are our family, friends, colleagues and neighbours.

This crisis is insidious, and we must take bolder action to stop the senseless deaths. We must confront personal and societal stigma around addiction and people who use substances. Without addressing the stigma that persists around addiction, we will continue to lose lives. Our society will continue to mourn the loss of the more than 11,000 people who can no longer raise a family, hold a job or strive for a better life. 

We need a holistic plan that addresses safe supply, harm reduction, addiction treatment and mental health support. It is time for every part of the healthcare, social and community services systems to be engaged in the solution, together. 

It is time to pull together as a country, put aside stigmas, address our own biases and invest in the programs and systems that will save lives.

Conflict of Interest

Michael Forbes is a registered pharmacist who operates a series of pharmacies in BC as part of the Forbes Group, a diversified health care, cannabis, and real estate company. He also serves as the CEO of Adastra Holdings Ltd., a leading cannabis extraction, distillation and product manufacturer. Its subsidiary, Adastra Labs Inc. – an agricultural-scale, Health Canada-licensed facility – holds a controlled substances licence, enabling them to possess, produce, sell and distribute cocaine exclusively for medical or research purposes to licensed dealers, including pharmacists, practitioners, hospitals, or those with a section 56(1) research exemption under the Controlled Drugs and Substances Act (S.C. 1996, c. 19).

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