Overdose Response Indicators

The Overdose Emergency Response Centre (OERC), part of the Ministry of Mental Health and Addictions, works in close partnership with the BC Centre for Disease Control (BCCDC) to provide provincial coordination of surveillance, monitoring, and evaluation related to the overdose emergency. This provincial surveillance report provides current data on key overdose-related indicators.

The OERC facilitates planning at the provincial, regional and local levels, structured upon a set of eight core interventions that capitalize on evidence-informed strategies. Together, these strategies form an integrated, comprehensive response to the overdose crisis.

The indicators contained in this report measure progress on these interventions across the province, and can be viewed at the provincial or regional health authority level, broken down by age and sex where possible. This report is updated monthly using the most up to date data available on each indicator. The interpretive text is updated quarterly.

Last updated : July 2022

Overdose in BC during COVID-19

The overdose public health emergency, declared on April 14, 2016, has claimed the lives of almost 7,000 British Columbians. Since the declaration of the COVID-19 public health emergency on March 17, 2020, the rate of overdose events and illicit drug toxicity deaths have increased and surpassed historic highs. Click to open the full infographic.

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Overdose

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1. Paramedic Attended Overdose Events

About the Data:

BC paramedics attend a range of overdose/poisoning events every day. This indicator focuses on illegal drug overdose events. Overdose events are identified and based on paramedic impression codes as well as 9-1-1 dispatch codes. Most people who experienced an overdose and are attended by paramedics survive. In many cases, 9-1-1 may not have been called during fatal overdose events. This indicator aims to exclude overdoses primarily due to alcohol and/or prescription drugs.

Trends:

This indicator represents largely non-fatal overdose events, expressed as a monthly rate per 100,000 BC residents.
Trends in paramedic-attended overdose events are often attributed to changes in drug toxicity and prevention measures.
The provincial rate of paramedic-attended overdose events has increased 4-fold in less than three years, attributed to the introduction of fentanyl in the illegal drug supply.
Rates in females, while lower than those of males, remain unacceptably high.
Over 40% of all events are in males aged 19-39 and 25% in males aged 40-59.

Additional Information:

Refer to the Paramedic Attended Overdose Events data notes for more information about the indicators including definitions, data sources, and limitations.

Source:

BC Emergency Health Services.

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2. Illicit Drug Toxicity Deaths

About the Data:

Illicit drug toxicity deaths, as reported by the BC Coroners Service, include overdose deaths involving street drugs (controlled and illegal drugs: heroin, cocaine, MDMA, methamphetamine, illicit fentanyl, etc.), medications that were not prescribed to the deceased, combinations of street drugs and prescribed medications, and overdoses where the origin of drug is not known.

Trends:

There was a sharp increase in deaths in November 2016 to December 2016, which is thought to coincide with the introduction of fentanyl into the illegal drug supply.
As of June 2020, illicit drug toxicity deaths are at an all-time high. Deaths have been increasing since March 2020 following enforcements in response to the COVID-19 pandemic.
Death rates tend to be higher in males than females, although regional differences exist. Mortality due to accidental illicit drug overdose is highest in males aged 19-59.

Additional Information:

Refer to the Illicit Drug Toxicity Deaths data notes for more information about the indicators including definitions, data sources, and limitations.

Source:

BC Coroners Services.

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3. BC Naloxone Program Indicators

About the Data:

Take Home Naloxone (THN)

BC's Take Home Naloxone (THN) program began in late 2012 and provides free personal THN kits to people at risk of opioid overdose or likely to witness and respond to an overdose. Registered THN distribution sites include harm reduction sites, community service organizations, emergency departments, correctional facilities, and community pharmacies, among others. Sites order naloxone from the provincial program and return records of the number of kits distributed to clients.

Facility Overdose Response Box (FORB)

The Facility Overdose Response Box (FORB) program, launched in late 2016, provides boxes containing multiple doses of naloxone to eligible not-for-profit community-based organizations. These boxes are designed for staff to use to respond to on-site overdoses. Site locations include supportive and subsidized housing, drop-in centres, and shelters, among others. The program helps staff to be prepared to recognize and respond to an overdose.

Indicators:

Number of THN Sites: The number of new THN sites enrolled in the provincial program each month
New Facility Overdose Response Box (FORB) Sites: The number of new FORB sites enrolled in the provincial program each month
Number of Take Home Naloxone Kits Shipped to Sites: The number of THN kits shipped to THN sites each month
Number of Take Home Naloxone Kits Distributed to Clients: The number of THN kits distributed to clients each month reported by sites
Estimated Number of Overdoses Reversed using Take Home Naloxone Kit: The estimated number of overdoses reversed each month using provincially funded THN kits, dependent on distribution reporting by sites.

Trends:

THN and FORB Site enrollment increased in mid-2016 and throughout 2017 in response to the ongoing overdose crisis. The sharp increase seen in December 2017 to February 2018 was due to the enrollment of many community pharmacies across BC.
THN orders remained high and steady in 2019 and 2020 and reached a peak in July 2020 with over 29,000 kits shipped that month.
Since June 2017, approximately 3000-6000 THN kits per month are reported distributed
The estimated number of reported overdoses reversed using a THN kit in BC began increasing gradually in December 2015 with a sharp increase beginning in November 2016.
Overdose reversal reporting is variable but generally between 1000-2000/month since March 2017. Over 64,000 THN kits have been reported as used to reverse an overdose from program inception to date.

Additonal Information:

More information on both naloxone programs can be found at Toward the Heart.

Refer to the BC Naloxone Program Indicators data notes for more information about the indicators including definitions, data sources, and limitations.

Source:

BC Center for Disease Control; Regional Health Authorities and Take Home Naloxone Distribution Sites

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4. Opioid Agonist Treatment Indicators:

About the Data:

Opioid Agonist Treatment (OAT) consists of a range of drug treatments for adults and youth with varying presentations of opioid use disorder. BC's evidence-based OAT treatment guidelines support the availability of diverse treatment options. Increasing the availability of this treatment represents an important component of the health system response to the opioid overdose emergency.

Indicators:

Number of clients dispensed OAT in BC: The number of unique clients who were dispensed OAT at a BC community pharmacy.
Number of Clients dispensed OAT for the first time: A new OAT client is defined as a client dispensed OAT for the first time at a BC community pharmacy
Number of OAT prescribers: A BC clinician is defined as an OAT prescriber when at least one has filled a prescription for an OAT drug in a given month
A New OAT Prescriber: A BC clinician is defined as a new OAT prescriber when at least one client has filled a prescription for an OAT drug in a given month at a community pharmacy and the clinician has not prescribed that drug type in the past.

Trends:

Number of new clients began increasing in 2016, largely driven by an increase in the number of clients dispensed buprenorphine/naloxone (Suboxone).
The number of clients dispensed OAT in BC for the first time increased in 2016 due to the increase in clients dispensed suboxone for the first time.
Numbers of new clients on sustained release oral morphine has risen since 2017.
The number of OAT prescribers in BC has been rapidly increasing since mid-2016 as Health Authorities and the BC Centre on Substance Use engage physicians in training and preceptorship activities.
An increasing trend in the number of sustained release oral morphine prescribers is seen starting in mid-2017.
New OAT prescribers are most likely to prescribe buprenorphine/naloxone (Suboxone).

Additional Information:

Refer to the Opioid Agonist Treatment Indicators data notes for more information about the indicators including definitions, data sources, and limitations.

Source:

BC PharmaNet, administered by the BC Ministry of Health.

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5. Overdose Prevention Services Indicators:

About the Data:

Overdose Prevention Services (OPS) provide many services designed to respond to and prevent overdoses and overdose deaths. It includes overdose prevention and Supervised Consumption Sites (SCS). This monitoring indicator is based on data received from BC Regional Health Authorities operating the sites and is designed to monitor trends for OPS and SCS locations combined (OPS/SCS).

Indicators:

Visits to Overdose Prevention Service Sites and Supervise Consumption: Sites The number of client visits to OPS/SCS sites each month. Site visits related to observed consumption of substances have been increasing over time.
Overdoses Survived at Overdose Prevention Service Sites and Supervised Consumption Services Sites: The number of overdoses responded to by staff at OPS/SCS sites each month.

Trends:

Number of OPS/SCS sites has increased since December 2016.
Sites reporting on the monthly number of substance-related visits and overdose events are displayed here from January 2018. As of May 2022, there are 43 OPS/SCS locations around BC.

Additional Information:

Refer to the Overdose Prevention Services Indicators data notes for more information about the indicators including definitions, data sources, and limitations.

Source:

BC Regional Health Authorities.