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Increased drug toxicity leads to record number of January deaths

Following a record-setting year in 2020, the BC Coroners Service reports 165 suspected illicit drug toxicity deaths in January 2021, the largest ever number of lives lost due to illicit drugs in the first month of a calendar year.

Of those deaths, 17 were in the Northern Health area, with seven those in Prince George

“These figures are heartbreaking, both in scale and for the number of families who are grieving the loss of a loved one,” said Lisa Lapointe, chief coroner, BC Coroners Service. “In the fifth year of this public health emergency, there is virtually no community in the province that hasn’t been touched by this devastating loss of life.”

An average of 5.3 lives were lost each day in January due to the toxic drug supply in B.C., a death rate of 38.1 per 100,000 residents. January is also the 10th consecutive month in which more than 100 deaths were attributed to suspected illicit drug toxicity.

Almost one in five of the suspected deaths (18%) in January noted extreme levels of fentanyl concentrations (greater than 50 micrograms/litre), the largest number recorded to date. Additionally, there were 14 deaths in which carfentanil, a more lethal analogue of fentanyl, was detected, an increase from the December total of nine and the largest monthly figure since May 2019.

The report also notes recent increases in the presence of unprescribed benzodiazepines and its analogues, including etizolam. Since July 2020, etizolam has been identified in 31 per cent of illicit drug toxicity deaths where expedited testing was performed. In January, benzodiazepines and its analogues were detected in nearly half (49%) of all samples tested. The addition of etizolam to fentanyl increases the likelihood of overdose due to the combined respiratory depressant effects. Etizolam is not licensed in Canada. For more information about etizolam, visit:

“We’re particularly concerned about the toxicity of the drugs detected in many of the deaths recorded in January,” Lapointe said. “The findings suggest that the already unstable drug supply in B.C. is becoming even deadlier, underscoring the urgent need for supervised consumption options, prescribing for safe supply, and accessible treatment and recovery services.”

Additional key preliminary findings are below. Data are subject to change:

  • The 165 suspected illicit drug toxicity deaths represent a 104 per cent increase over the number of deaths in January 2020 (81) and a seven per cent increase over the number of deaths in December 2020 (154).
  • The number of illicit drug toxicity deaths in January 2021 equates to about 5.3 deaths per day.
  • Between April 2020 and January 2021, 18 per cent of fentanyl-detected illicit drug toxicity deaths in Vancouver Coastal Health had extreme fentanyl concentrations (greater than 50 micrograms/litre), followed by 13 per cent in Fraser Health and 11 per cent in Interior Health.
  • Post-mortem toxicology results suggest there has been a greater number of cases with extreme fentanyl concentrations in April 2020 and January 2021 compared with previous months.
  • From April 2020 to January 2021, approximately 13 per cent of cases had extreme fentanyl concentrations, compared to eight per cent from January 2019 to March 2020.
  • Carfentanil was detected in 14 suspected illicit drug toxicity deaths in January 2021 and 64 deaths in 2020.
  • The detection rate of benzodiazepines has rapidly increased from 15 per cent of samples in July 2020 to 49 per cent of samples in January 2021.
  • No deaths have been reported at supervised consumption or drug overdose prevention sites.

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