Thread by @ehyshka

The Alberta government has finally released complete data on 2021 drug poisoning deaths. The numbers are bleak. 1758 people dead last year. In November and December we had the highest monthly totals *ever recorded;* 176 people lost in each month. 🧵 #ableg

Edmonton was very hard hit in 2021. Looking at the numbers it is reasonable to ask whether the closure of the Boyle Street SCS--the city's busiest supervised consumption service--in April 2021 wasn't an important factor driving these deaths. #yeg

In Q1 2021, there were 12,834 visits to #yeg SCS sites. After Boyle Street's SCS was closed, there were 10,186 visits in Q2; 9,513 visits in Q3, and 10,500 visits in Q4.

The provincial gov't stopped publishing neighbourhood-level death data at the end of 2020. But if it were still available, I suspect we would see increases in drug poisoning deaths in #yeg's core neighbourhoods in 2021 as well.

The government's closure of Boyle Street was political--designed to silence a vocal minority who have opposed 'concentration' of SCS in the core. But the need has always been the greatest there. I worry about what that choice may have cost us in terms of human lives.

It is undeniable that the pandemic is a major factor driving the ⬆️ in deaths. The illegal drug supply (by all accounts) has become far more dangerous and volatile. People are in worse socioeconomic circumstances, and disruptions to healthcare has made help harder to find.

But while COVID-19 was unavoidable, other provincial policy choices have worsened its impact. Over the past 2 years, in the pursuit of a 'recovery-oriented system of care,' the Alberta government has rolled back life-saving harm reduction services.

In addition to the Boyle Street closure, they canceled planned new SCS for #yyc + Medicine Hat. They also closed ARCHES SCS in Lethbridge, resulting in a net loss of service capacity.

Last year the provincial gov't announced a similar plan for #yyc. They will be closing the Sheldon Chumir SCS + replacing it with 2 smaller services w/ more limited reach.

SCS that remain are getting harder to access. The gov't now requires providers to ask clients for their personal health numbers. This effectively eliminates anonymity at these services. We are the only province to do this, and available data show it will push people away.

The provincial government has also stopped enrolling new patients into highly effective injectable opioid agonist treatment, and are encouraging AHS to switch current patients to oral meds. This practice is not evidence-based, and has led to adverse outcomes in other settings.

More recently, the gov't has been preoccupied with attacking the concept of safe supply, which has the potential to support people to reduce or eliminate their reliance on toxic street drugs. This preoccupation is curious from an epidemiological perspective.

Looking at confirmed toxicology data for 2021, out of 972 opioid-related deaths, only 52 (5%) involved pharmaceutical opioids. And yet gov't MLAs have paraded 20 'experts' before a legislature committee to warn of the extreme dangers of pharmaceutical drugs.

With 1758 Albertans dead last year, and trends only worsening, isn't it worth accessing federal dollars on offer and piloting safe supply programs as an alternative approach?

Tomorrow, Minister Ellis has a press conference scheduled in Medicine Hat. Now that the COVID-19 response is winding down, I sincerely hope he will announce a new emergency public health response to Alberta's drug toxicity crisis.

People who use drugs deserve to live, and families deserve the safety and presence of their loved ones. We have to stop all this grief and turn this epidemic around.