Late last 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 fourth quarter 2022 data for deaths, hospitalizations, and supervised consumption site usage.
I wrote an article on fourth quarter EMS responses back in January.
What I do in this article is break down the stats for deaths, hospitalizations, EMS responses, and SCS usage during the fourth 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 fourth quarter of 2022, 22 people had been reported to have died from “drug poisoning”. Here’s how the fourth quarter’s death numbers compare to those of previous years.
During the previous fourth quarter, Lethbridge had the highest number of drug-related deaths it had seen since the province began tracking data in 2016.
This past year, however, fourth quarter deaths have dropped a bit slower, sliding from 27 in 2021 to 22 in 2022. As you can see from the graph, this is the second largest number of deaths of any fourth 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 two years in power. In fact, last year saw twice as many deaths as the third highest year, which was in 2020.
Now, let’s break the quarter numbers by month.
The fourth 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. October 2022 was down from the previous year by 7 drug deaths, which was still tied with October for second highest we have seen in any October since 2016. November’s 9 deaths were tied with the previous November, which is still the most any previous November has seen. December, however, was up by 2 reported drug deaths.
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 fourth quarter compared to a record-breaking first quarter, it was the second highest quarter of 2022.
During the fourth quarter, Lethbridge had the highest rate of drug deaths per 100,000 person years of the 7 cities tracked by the province’s system, driven primarily by huge increases in November and December.
| Oct | Nov | Dec | Q4 | |
|---|---|---|---|---|
| Lethbridge | 34.6 | 103.7 | 115.2 | 84.50 |
| Grade Prairie | 63.3 | 63.3 | 63.3 | 63.30 |
| Edmonton | 66.0 | 49.2 | 50.3 | 55.17 |
| Red Deer | 33.4 | 22.3 | 89.2 | 48.30 |
| Calgary | 35.8 | 31.6 | 40.8 | 36.07 |
| Medicine Hat | 17.4 | 52.1 | 34.8 | 34.77 |
| Fort McMurray | 0.0 | 29.9 | 0.0 | 9.97 |
Now let’s look at the number of deaths in 2022 in relation to total annual deaths over the previous 6 years.
Last year had the highest number of drug deaths of any of the last 7 years, continuing a worrying trend of record deaths in both 2020 and 2021.
We averaged 6.6 drug-related deaths a month in 2022. Last year, the average was 5.6, which itself was higher than the average of 4.0 in 2020.
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.
With third-quarter numbers from 2022, 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 4 deaths away from doubling the first year’s numbers.
This also means that we have surpassed 100 drug-related deaths—134 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 9 quarters since the UCP defunded the Lethbridge SCS. The highest was the North Zone.
| Q4 2020 | Q1 2021 | Q2 2021 | Q3 2021 | Q4 2021 | Q1 2022 | Q2 2022 | Q3 2022 | Q4 2022 | |
|---|---|---|---|---|---|---|---|---|---|
| North | 1958 | 2011 | 2335 | 2403 | 2051 | 1907 | 2226 | 2240 | 2064 |
| South | 1627 | 1597 | 1886 | 1897 | 1747 | 1610 | 1556 | 1651 | 1616 |
| Central | 1468 | 1473 | 1728 | 1896 | 1561 | 1457 | 1660 | 1650 | 1485 |
| Edmonton | 1345 | 1371 | 1649 | 1679 | 1580 | 1459 | 1489 | 1431 | 1402 |
| Calgary | 1328 | 1367 | 1399 | 1524 | 1426 | 1256 | 1144 | 1169 | 1112 |
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 | Q4 2022 | |
|---|---|---|---|---|---|---|---|---|---|
| Edmonton | 516 | 527 | 589 | 576 | 557 | 512 | 507 | 437 | 456 |
| North | 633 | 691 | 701 | 629 | 521 | 518 | 547 | 537 | 512 |
| Central | 694 | 725 | 739 | 812 | 697 | 718 | 726 | 646 | 510 |
| South | 639 | 674 | 687 | 652 | 542 | 484 | 484 | 387 | 440 |
| Calgary | 472 | 465 | 486 | 487 | 502 | 431 | 413 | 348 | 374 |
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 fourth quarter of 2022, as I reported in January, the number of calls Lethbridge EMS responded continued the increase from those 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 |
| Oct | 28 | 10 | 15 | 32 | 29 |
| Nov | 28 | 16 | 38 | 43 | 39 |
| Dec | 21 | 13 | 20 | 22 | 37 |
The fourth quarter of 2022 was the highest fourth quarter on record, however, the second highest quarter this year, and the fifth highest since the start of 2018, with EMS responding to 96 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 | 96 |
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 fourth quarter of 2022, the mobile SCS van saw 11,594 visits. Here’s how that compares to the fourth quarter in previous years.
The number of SCS visits increased during the fourth quarter of 2021 but it dropped in the fourth quarter of last year. Either way, each of the last 3 fourth 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 fourth lowest level (technically), but also higher over the last two years.
Except, while the number of visitors rose in the fourth quarter of 2022, the number of visits per visitor actually increased, but it was still at its second lowest level of any fourth quarter since 2018.
So, while both the number of visitors decreased in the fourth quarter of 2022, compared to the previous third quarter, the average number of visits each person makes to the SCS van has increased. Even though fewer people are visiting it than a year ago, those who are using it do so more frequently.
Even so, the fourth quarter of 2022 saw the second lowest visit per visitor rate (29.7) 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 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.
