Yukon has joined B.C. in declaring a substance use emergency. What does that mean?

Perry Kendall, British Columbia’s former provincial health officer, watched as the number of illicit drug deaths continued to rise, unabated, in the province in the spring of 2016. 

Three people died on average everyday in B.C. from illicit drugs at the time — an indication, Kendall said, that what his office was doing to try to curb the number of deaths wasn’t working.

He decided to call a public health emergency, on April 14, 2016.

“Despite the fact that we were doing a lot of preventative work, the numbers just kept going up,” Kendall told CBC.

The Yukon government followed suit, almost six years later, calling a substance use health emergency last month following a dramatic increase of deaths that mirrored what Kendall had seen in B.C.

Eight people in Yukon died from illicit drug use between Jan. 3 and 24, according to the most recent news release from the territory’s chief coroner. Toxicology results are still pending for one other case, but preliminary evidence suggests illicit drugs were a factor.

Declaration brought attention, rural services to B.C. 

Kendall said B.C.’s emergency declaration brought local and national attention to what was happening in that province, allowing for more federal support to trickle down to more health-care services.

It also justified new spending or policy changes by the provincial government to address the crisis.

“I think [an emergency declaration] gives you more political power because it says we recognize it is an emergency and we want to mobilize the resources we can,” he said.

The other immediate change, Kendall said, was more flexibility with how the province collected data on where and when people would overdose. That helped officials redirect services to parts of the province that were most in need, he continued.

“We were able to develop ‘heat maps,'” Kendall said. “You get weekly data … of where they responded to an overdose call, what time of day it was.

“Without the data, you really can’t plan and you can’t … determine whether [people are] accessing these services.”

Before the declaration, Kendall said, British Columbians outside of Vancouver didn’t have much access to supervised consumption sites and other services to manage addictions.

That started to change after the emergency declaration, when more federally sanctioned opioid prevention sites popped up across the province that December. One study found that these sites slightly increased the number of B.C. users who sought out a supervised consumption site or another addiction treatment over time.

Other changes, such as making a safe supply of methadone available and online training programs, “gradual[ly] ramp[ed] up” in the months and years afterwards, according to Kendall.

Still, Kendall said, the province has a long way to go when it comes to fighting its ongoing opioid crisis. Tackling the supply chain is an essential element, he says.

Expand safe supply to B.C. model, former medical officer says

Yukon MP Brendan Hanley watched what happened in B.C. closely, in his former role as Yukon’s chief medical officer.

Yukon saw its first fentanyl-related drug death in 2016, too, but Hanley said officials didn’t need to declare a state of emergency at the time.

“I think what we’re seeing now is so much more of an augmentation, an acceleration of the crisis and despite all of our measures, we’re still continuing to see an alarming … number of deaths,” Hanley recently told CBC.

Hanley said he looked to B.C. at the time to figure out how to widely distribute naloxone kits in the Yukon and to offer safe supply options like methadone and suboxone.

The territory also introduced a public awareness campaign in 2016, including a public alert, on the dangers of fentanyl. By 2018, the territory put in place an opioid response plan, a way of “putting down on a page” what the territory wanted to do to mitigate the number of deaths, according to Hanley. The plan was not renewed when it ended in 2020.

When asked whether those measures made a difference, Hanley said he’s “convinced” they have.

Still, there are some ways the Yukon government should again follow B.C.’s example, like improving access to the territory’s safe supply program, Hanley continued.

‘We don’t know if it would’ve been worse’

Kendall acknowledges that, despite B.C.’s emergency declaration, the number of deaths continues to go up — reaching 39.4 deaths per 100,000 people in 2021. He attributes that mostly to increased substance use during the COVID-19 pandemic and difficulties getting in-person services.

“I think the situation was getting better,” he said. “Then COVID[-19] came along … and the world essentially changed.”

Dr. Catherine Elliott, Yukon’s acting chief medical officer, was asked last month about what the Yukon could learn from B.C.’s declaration. She acknowledged that the province’s numbers haven’t improved, but that “we don’t know if it would’ve been worse” if the declaration had never been made.

“Declaring a crisis doesn’t solve the problem — it’s doing things,” Elliott said, in French.

The Yukon government has already promised a long list of actions to address the substance use emergency, including the launch of a territory-wide public awareness campaign and expanding drug testing and safe supply to communities outside Whitehorse. The territorial government’s spring budget will include dedicated funding to these initiatives.

Next steps will be planned during the first phase of a virtual mental wellness summit with Yukon First Nations leaders in February.

CBC