Earlier this month, the Government of Alberta updated the Alberta substance use surveillance system, an online tool they released in 2020 to track data regarding drug and alcohol use in the province.
The update includes second quarter 2022 data for deaths, hospitalizations, and supervised consumption site usage.
I wrote an article on third quarter EMS responses back in October.
What I do in this article is break down the stats for deaths, hospitalizations, EMS responses, and SCS usage during the second quarter of 2022, compare them to previous years, and see if there’s a correlation between SCS usage and the rate of deaths and EMS responses.
Deaths
During the third quarter of 2022, 10 people had been reported to have died from “drug poisoning”. Here’s how the third quarter’s death numbers compare to those of previous years.
During the previous third quarter, Lethbridge had the second highest number of drug-related deaths it had seen since the province began tracking data in 2016. They were 2 fewer than what they were in 2020, which itself is the current record.
This past year, however, third quarter deaths have dropped a bit slower, sliding from 12 in 2021 to 10 in 2022. The previous third quarter had dropped by 3 from the record set in 2020.
As you can see from the graph, this is the third largest number of deaths of any third quarter since at least 2016.
Even though the numbers have been dropping for the last two third quarters, they are still higher than they were while the NDP were in power and higher than they were under the UCP’s first year in power.
Now, let’s break the quarter numbers by month.
The third quarter of 2022 saw a reduction in the number of drug deaths because the months in that quarter saw lower numbers of drug deaths.
Well, sort of. August 2022 was tied with the previous year with 4 drug deaths, which is the second highest we have seen in any August since 2016. July’s 3 deaths were up from the 1 death seen the previous July, but still tied with 2019 for fourth highest. September, with 3 reported drug deaths (down from 7), is what really brought down the quarterly stat.
That follows a record first quarter.
The first three months of 2022 each saw the highest number of deaths than the same months in an previous year since at least 2016. Not only that but two of the months—January and February—saw numbers in the double digits, something only seen one time before, last November.
Plus, February not only hit a record high of 19 for any other February since 2016, but that new high was also the highest number of deaths of any month since 2016, not just Februarys.
And speaking of February, take a look at the rate of drug-related deaths per 100,000 person years for February 2022 among the cities Alberta’s reporting tool includes:
| Lethbridge | 225.0 |
| Red Deer | 63.5 |
| Edmonton | 61.7 |
| Calgary | 52.9 |
| Medicine Hat | 51.4 |
| Grande Prairie | 15.5 |
| Fort McMurray | 0.0 |
And while Lethbridge seeing a decline in total drug death in the third quarter compared to a record-breaking first quarter, we had the third highest rate of drug deaths per 100,000 person years of the 7 cities tracked by the province’s system.
| Jul | Aug | Sep | Q3 | |
|---|---|---|---|---|
| Edmonton | 52.8 | 38.2 | 53.9 | 48.30 |
| Medicine Hat | 51.4 | 34.2 | 34.2 | 39.93 |
| Lethbridge | 35.5 | 47.4 | 35.5 | 39.47 |
| Grande Prairie | 15.5 | 15.5 | 62.2 | 31.07 |
| Fort McMurray | 29.4 | 14.7 | 44.1 | 29.40 |
| Calgary | 24.4 | 31.9 | 21.9 | 26.07 |
| Red Deer | 10.6 | 21.2 | 10.6 | 14.13 |
Now let’s look at the number of deaths in the first three quarters of 2022 in relation to total annual deaths over the previous 6 years.
With only 2 months left in the year, and 2022 already has the second highest number of drug deaths of any of the last 7 years. And if it sees just 12 more deaths over the next 6 months, it will move into first place.
In fact, the Alberta government already released death numbers for October (3) and November (11), and we’re already tied with all of 2021. Even if we report just 1 death in December, 2022 will end with having the highest number of drug-related deaths on record.
We’ve averaged 6.1 drug-related deaths a month in 2022, and if they continue at this rate, Lethbridge could potentially see 73 deaths by the end of the year.
And remember, these are just deaths that have been certified by the medical examiner. It’s possible the number of deaths could’ve been even higher.
In September 2020, the Lethbridge supervised consumption site, which had been run by ARCHES, closed its doors following the UCP government’s refusal to renew funding.
During the first 12 months after the SCS had closed (September 2020 to August 2021), 46 people died from drug poisoning in Lethbridge.
Now that we have third-quarter numbers, we can compare two full years of post-SCS data. Here’s how that same period (September through August) in the second year following the closure compares to previous years.
That 2020–2021 period had the highest number of drug-related deaths compared to similar periods going back to 2016–2017. But we easily surpassed that record this year. We were just 5 deaths away from doubling the first year’s numbers.
This also means that we have surpassed 100 drug-related deaths—133 to be precise—since the SCS was shut down due to government defunding.
Finally, Lethbridge’s average monthly deaths for the September–August period has increased compared to similar 12-month periods of previous years, as seen below, almost doubling.
Hospitalizations
As far as hospitalizations go, the Alberta substance use surveillance system doesn’t delineate to the city level; it doesn’t get any more granular than the health zone level, so the data below is for the South Zone, which includes not only Lethbridge but also Medicine Hat, as well as pretty much all of Southern Alberta south of Calgary.
The South Zone consistently had the second highest emergency department visit rate related to substance use of all 5 health zones in nearly each of the 6 quarters since the UCP defunded the Lethbridge SCS. Although it dropped to third place for the previous quarter. The highest was the North Zone.
| Q4 2020 | Q1 2021 | Q2 2021 | Q3 2021 | Q4 2021 | Q1 2022 | Q2 2022 | Q3 2022 | |
|---|---|---|---|---|---|---|---|---|
| North | 1958 | 2011 | 2335 | 2403 | 2051 | 1907 | 2226 | 2240 |
| South | 1627 | 1597 | 1886 | 1897 | 1747 | 1610 | 1556 | 1651 |
| Central | 1468 | 1473 | 1728 | 1896 | 1561 | 1457 | 1660 | 1650 |
| Edmonton | 1345 | 1371 | 1649 | 1679 | 1580 | 1459 | 1489 | 1431 |
| Calgary | 1328 | 1367 | 1399 | 1524 | 1426 | 1256 | 1144 | 1169 |
Those numbers are consistent with previous years.
As far as general hospitalizations go, the South Zone came in fourth place, behind the Central Zone, North Zone, and Edmonton Zone. Usually, however, it sits in third place.
| Q4 2020 | Q1 2021 | Q2 2021 | Q3 2021 | Q4 2021 | Q1 2022 | Q2 2022 | Q3 2022 | |
|---|---|---|---|---|---|---|---|---|
| Central | 694 | 725 | 739 | 812 | 697 | 718 | 726 | 646 |
| South | 639 | 674 | 687 | 652 | 542 | 484 | 484 | 387 |
| North | 633 | 691 | 701 | 629 | 521 | 518 | 547 | 537 |
| Edmonton | 516 | 527 | 589 | 576 | 557 | 512 | 507 | 437 |
| Calgary | 472 | 465 | 486 | 487 | 502 | 431 | 413 | 348 |
Remember, these numbers include not just Lethbridge, so it’s difficult to say if the UCP defunding the SCS affected emergency department visits or hospitalizations specifically at the Chinook Regional Hospital.
EMS responses
During the third quarter of 2022, as I reported in October, the number of calls Lethbridge EMS responded continued the increase seen in June.
| 2018 | 2019 | 2020 | 2021 | 2022 | |
|---|---|---|---|---|---|
| Jan | 14 | 25 | 10 | 14 | 40 |
| Feb | 39 | 17 | 8 | 23 | 41 |
| Mar | 19 | 13 | 14 | 43 | 17 |
| Apr | 41 | 12 | 15 | 14 | 12 |
| May | 38 | 16 | 20 | 28 | 12 |
| Jun | 35 | 20 | 49 | 27 | 21 |
| Jul | 35 | 28 | 56 | 52 | 23 |
| Aug | 24 | 10 | 42 | 49 | 24 |
| Sep | 18 | 16 | 14 | 35 | 21 |
The third quarter of 2022 was the second lowest third quarter on record, however, it was significantly higher than the previous quarter, with EMS responding to over 20 more drug-related events.
| 2018 | 2019 | 2020 | 2021 | 2022 | |
|---|---|---|---|---|---|
| Q1 | 72 | 55 | 32 | 80 | 98 |
| Q2 | 114 | 48 | 84 | 69 | 45 |
| Q3 | 77 | 54 | 112 | 136 | 68 |
| Q4 | 77 | 39 | 73 | 97 |
As well, during the 12 months since the SCS closed down in August 2020, Lethbridge saw 358 opioid-related events that EMS have responded to. This is the highest number of such events during the same period over the previous 3 years.
| Sep 2018–Aug 2019 | 236 |
| Sep 2019–Aug 2020 | 269 |
| Sep 2020–Aug 2021 | 358 |
| Sep 2021–Aug 2022 | 322 |
Between September 2021 and August 2022, EMS responded to 322 events, passing the 2018–2019 year and 2019–2020 year. That averages out to about 26.8 per month.
SCS usage
And finally, we come to SCS usage.
Technically speaking, Lethbridge isn’t completely absent of any supervised consumption facilities. The UCP chose to replace the 21-seat (13 injection, 8 inhalation) supervised consumption site with a remodeled RV that has 3 seats. And that’s just for injection. It has no inhalation capacity, unlike the defunded SCS location.
During the third quarter of 2022, the mobile SCS van saw 12,935 visits. Here’s how that compares to the third quarter in previous years.
The number of SCS visits increased during the third quarter of 2021 but it dropped in the third quarter of last year. Either way, each of the last 3 third quarters are dramatically lower than when the much larger facility was open.
The number of unique visitors per month isn’t much better, being at its third lowest level (technically), but also rising over the last two years.
Except, while the number of visitors rose in the third quarter of 2022, the number of visits per visitor actually dropped to its second lowest level of any third quarter since 2018.
So, while both the number of visitors increased in the third quarter of 2022, compared to the previous third quarter, the average number of visits each person makes to the SCS van has dropped. Even though more people are visiting it than a year ago, they’re using it far less frequently.
And the third quarter of 2022 saw the second lowest visit per visitor rate (32.9) of any quarter since the UCP defunded the SCS. The lowest was in the the fourth quarter of 2021, when the visit per visitor rate was only 22.3.
How SCS usage affects everything else
Now that we have all that data on the table, what relationships can we draw? Well, we can look at the difference in deaths and EMS responses when SCS usage is high and when it’s low to see if there is any sort of connection between the three.
Here’s the number of deaths:
Here’s the number of EMS responses:
What we see in these charts is that the more supervised consumption services are used in Lethbridge, the fewer substance-related deaths and EMS responses.
The higher the number of visits to the Lethbridge supervised consumption site, the lower the number of deaths and EMS responses. And the reverse is also true: as visits dropped, deaths and EMS responses increased.
That wasn’t quite the same for the number of visitors: the relationship between the number of visitors seemed to have little effect on deaths or EMS.
However, the frequency at which the average visitor used the SCS had an inverse relationship with both death and EMS responses. The more often the average visitor used the SCS, the lower the number of deaths and EMS responses, and like the first usage stats, the reverse was also true.
These new numbers add nearly two more years of data to confirm the conclusion I made in 2020 that there is a relationship between SCS utilization and drug death numbers.
Defunding the SCS and replacing it with only 14% of its capacity is directly connected to more deaths in Lethbridge and a greater burden on Lethbridge’s emergency services.
