When Dr. Bonnie Henry took the job of provincial health officer at the end of January, the overdose crisis in B.C. had been raging for a while. A public health emergency had been declared well over a year earlier, and the death toll was already staggering.

Now, illicit drug deaths continue to devastate the families and communities of the victims, strike fear into the hearts of drug users and keep officials like Henry on their toes, looking for solutions, improvements, and the type of victories that help overcome crisis-fatigue and maintain optimism.

'Frustrating and challenging'

March, the last month with available data, was among the worst on record, with 161 illicit drug deaths in B.C.

"It's tragic, and it's sometimes frustrating and challenging," said Henry. "I think we have to remember that we have made quite a lot of progress in areas that people haven't really thought of before."

Some of the changes are obvious if you spend time in Vancouver's Downtown Eastside neighbourhood, where there are several overdose prevention sites.

According to Henry, the province now has 45 such sites, which she calls "services" to highlight the various roles they play beyond allowing people to consume drugs under supervision.

The B.C. Coroners Service reports that 1,448 people were killed by illicit drugs in 2017, but not a single death occurred at a overdose prevention site.

"We probably saved hundreds of lives through the establishment of the overdose prevention services," said Henry. "It's terrible, the deaths we're seeing still, now, but the thought that it could have been much worse is really frightening."

Henry also points to the availability of Naloxone, the drug used to reverse an opioid overdose. The kits are found in every overdose prevention site, but they can also be seen elsewhere, dangling from people's backpacks and belts.

"We've got Naloxone everywhere ... if we think about when this started, it was still a prescription medication."

Henry said that Naloxone has revived thousands of people who overdosed.

Andy Watson became the spokesperson for the B.C. Coroners Service a year ago. Since then, most of the work he's done involves the crisis.

"Illicit drug overdose deaths account for more deaths than the other accidental, homicide and suicide deaths combined," said Watson, saying it's becoming the 'new normal.'

"It's completely overwhelming to look at our statistics and see just how much impact this is having on the province."

The coroners service got a $7 million boost to its budget last September. The money goes toward a special drug death investigation team — nearly 20 people strong — and the type of deep dives into the data that helps identify trends to inform the decisions of policy makers.

Reducing stigma

Watson and Henry point to the stigma around illicit drug use as a major contributor to the death rate.

About nine out of 10 deaths last year happened indoors, mostly in private residences. The victims are often alone, leading Henry and Watson to conclude that anti-drug stigma keeps people from talking about their drug use and using with people who could help save them if something goes wrong.

"I've been quite vocal about taking the next step around trying to reduce stigma by decriminalizing people who use drugs," said Henry. "I think there's no rationale for putting people in jail who have a chronic, relapsing health condition."

Henry said progress has been made to reduce stigma, but still, the grind of the endless crisis can wear on someone in her position.

"I do sometimes despair. I worry that there's more things we need to be doing, and that things aren't happening fast enough and that people may not understand the urgency," she said.

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