British Columbia THE FENTANYL FIX

Why comparing B.C.'s overdose crisis to those in other countries is difficult

British Columbia's numbers seem high, but there's a reason people are reluctant to put them in global context

Justin McElroy - CBC News

February 04, 2017

One of the maps in the 2016 United Nations World Drug Report. As seen by the chart, many parts of the world do not measure fatal overdose figures, making worldwide comparisons difficult. (United Nations)

If British Columbia was a country, how would its overdose crisis compare to those around the world?

The truth is we can't say for sure. There are major differences in how drug overdoses are measured around the world — and even in Canada itself — making such year-by-year comparisons impossible.

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What we do know is that in 2016, 914 people in British Columbia died of a suspected overdose, because the B.C. Coroners Service recently adopted aggressive timelines in publicly reporting drug overdoses on a monthly basis.

"We've determined that the timeliness of getting the information out to inform people at risk is more important than waiting until the investigation has concluded, which could be six to eight months down the road," said B.C. Chief Coroner Lisa Lapointe.

But we don't know how British Columbia's 2016 figures compare to the rest of Canada, let alone the world.

Caveats with the UN Drug Report

The most comprehensive global measurement of fatal drug overdoses comes from the United Nations annual World Drug Report. The numbers in that report are compiled via questionnaires sent to governments. 

The 2016 edition included data from 105 countries. Of those, 85 provided figures for deaths where drugs were the primary cause. 

But even then, the figures come from years ranging from 2002 to 2014.  

"Currently, only a few countries measure prevalence of drug use among the general population on an annual basis. The remaining countries that regularly measure it — typically the more economically developed — do so usually every three to five years," the report cautioned. 

Discrepancies within Canada

You might think Canada would be among those countries — but you would be mistaken.

The last figures from Canada in the report come from 2007. As the Canadian Drug Policy Coalition noted in 2013, "with only a few provinces actively reporting overdose fatalities, it is difficult to gauge the extent of opioid related overdose deaths and injuries across Canada."

Manitoba, for example, has no mechanism in place to track overdoses, and many provinces take months, if not years, to finalize annual overdose figures. There's been a push for standardized reporting across Canada by researchers, but no policy changes have happened yet. 

"It's one of a the real challenges," said Lapointe. "My counterparts across the country recognize this as well. Everyone's looking to do what they can to get some of the data together more quickly, [while] acknowledging we don't have consistent definitions across the country." 

British Columbia is the only province to post figures for all of 2016.  

What can we say?

Back to the global comparisons. It would be nice to contrast B.C.'s overdose figures with those submitted for the 2016 UN Drug Report, understanding that many countries aren't included, and their overdose figures could have gone up between now and the year in which they were submitted.

But even that is impossible, says Lapointe, because different countries classify overdose deaths in different ways.

"The data and definitions are so inconsistent. Some jurisdictions include deaths as a result of prescribed medication, for example. They'll roll that into their numbers. We don't," she said.

"I don't think there's any consistency anywhere in the world."  

With files from The Canadian Press

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