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'We don't want to be over-optimistic': Deadly fentanyl overdoses on the decline in Alberta

Fentanyl deaths are on the decline in Alberta, with numbers down over the last two recorded periods — but experts say it’s too early to tell if the province has seen the worst of the overdose crisis.

137 Albertans died from a fentanyl overdose during the first three months of 2019

Fentanyl is the leading cause of death in Alberta. (CBC)

Fentanyl deaths are on the decline in Alberta, with numbers down over the last two recorded periods — but experts say it's too early to tell if the province has seen the worst of the overdose crisis. 

A total of 137 people died from a fentanyl overdose during the first three months of this year, compared to 160 deaths during the same period in 2018.

While the province's latest opioid report shows the highest number of deadly fentanyl overdoses continues to occur in Calgary, the number of deaths per capita has also decreased. 

"We want to be optimistic about it but we don't want to be over-optimistic," said Steve Buick, spokesperson for Jason Luan, Alberta's associate minister of Mental Health and Addictions. 

"This is still just far too many deaths, this number has to come down a lot more." 

2018 saw a record number of deadly opioid overdoses in recent years. (Alberta Health)

Coming off a record number of fentanyl deaths in 2018, Alberta's health department released the numbers quietly, with no press release. 

Alberta Health Services declined CBC's request for comment. 

Buick said the report was released as all quarterly reports are, and the reason the government didn't make a big deal of it was because they didn't want to "overplay" the small decline.

He said the province expects the numbers recorded so far this year will increase since they are preliminary. 

Southern Alberta has the highest number of deaths from fentanyl per capita. (Alberta Health)

However, he said there is reason to be optimistic as the data show non-fentanyl related opioid overdose deaths dropped significantly in the final quarter of 2018 from the same period in 2017.

The number of non-fentanyl deaths decreased by 11 per cent during that period.

Those numbers refer to diverted prescription opioids, which means physicians are prescribing fewer opioids, Buick said.

While he said harm reduction services are a contributing factor to the decline in fentanyl-related deaths, Buick said "there are just too many moving parts" to say what impact they had. 

He points to awareness of the risks of the drug changing behaviours. 

Rebecca Haines-Saah, an assistant professor of community health sciences at the University of Calgary, says she was surprised the province wasn't advertising the latest report as a public health success. (Bryan Labby/CBC)

"This should be something that we're touting, but at the same time, [the government's reaction to the report] is not surprising to me because it's going against the current government's mandate to stall and review services," said Rebecca Haines-Saah, a drug policy researcher and an assistant professor of community health sciences at the University of Calgary. 

Earlier this month, Luan announced that funding for all new supervised injection sites would be frozen until the United Conservative Party conducts a review of the sites. 

Harm reduction services a success, professors say

The report clearly shows harm reduction services, including supervised consumption sites and naloxone kits, are working, Haines-Saah said.  

"People are aware of what's potentially unsafe in their drugs and they have the tools and the skills to somewhat reverse," she said, adding that harm reduction services aren't the only factor at play, but they are an important one. 

Both Haines-Saah and addictions medicine specialist Dr. Hakique Virani said they are concerned that the province's cap on harm reduction services is going to halt the progress shown in the report. 

"We need to go bold and hard with improving access to those and not stop until we start to see a continuous decreasing trend and that people are comfortable with accessing those services," said Virani, a clinical assistant professor at the University of Alberta, who specializes in public health and preventive medicine. 

Drug traffickers will experiment with different molecules in order to move drugs more easily and sell them at lower prices and the province can't control that, he said. 

Addictions medicine specialist Dr. Hakique Virani says the stigma attached to harm-reduction services has resulted in more people using the services and fewer opioid-related deaths. (Bryan Labby/CBC)

But what Alberta can do, Virani added, is control the harm reduction services and rehabilitation services available to its residents. 

"We need to offer more of it, in more places and in more geographic locations in those places so that people who need them can access them," he said. 

An average of two Albertans died from opioid-related poisoning every day in 2018.

"There is no excuse for that when we have evidence that shows us that harm reduction services save lives," Virani said. 

Buick said the province accepts harm reduction is important, but they need to "look at the evidence and see what's the best way forward." 

About the Author

Maggie Macintosh is a 2019 CBC Joan Donaldson Scholar. She has done multimedia reporting for the CBC in Toronto and Calgary.