Earlier this week, 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 first quarter 2023 data for deaths, hospitalizations, and supervised consumption site usage.
I wrote an article on first quarter EMS responses back in April.
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 first quarter of 2023, 36 people had been reported to have died from “drug poisoning”. Here’s how the first quarter’s death numbers compare to those of previous years.
During the previous first 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, first quarter deaths have dropped a bit slower, sliding from 38 in 2022 to 36 in 2023. As you can see from the graph, this is the second largest number of deaths of any first quarter since at least 2016.
Even though the numbers have dropped for the most recent first quarter, they are still higher than they were while the NDP were in power and higher than they were under the UCP’s first 3 years in power. In fact, last year saw more than twice as many deaths as the third highest year, which was in 2021.
As well, while it might seem positive positive that the number of first quarter deaths have dropped, even though they’re still quite high, the numbers for the second quarter of 2023 aren’t looking as positive.
| 2016 | 0 |
| 2017 | 3 |
| 2018 | 10 |
| 2019 | 4 |
| 2020 | 15 |
| 2021 | 13 |
| 2022 | 9 |
| 2023 | 20 |
Here we see that the second quarter numbers are already at their highest level for any second quarter ever recorded. Here’s the catch though: we have data for only April. We still don’t have data for May or June yet. So, we already have the highest number of drug deaths of any second quarter on record, despite missing two thirds of the data.
I don’t anticipate that by the time we get data for May and June that things will look any better.
Now, let’s break the quarter numbers by month.
The first quarter of 2023 saw a reduction in the number of drug deaths because the months in that quarter saw lower numbers of drug deaths.
Well, sort of. January 2023 was down from the previous year by 2 drug deaths. February’s 14 deaths were lower than the previous February, however, it’s still the most that any other previous February has seen. March, however, was up by 6 reported drug deaths.
Plus, March 2023 not only hit a record high of 14 for any other March since 2016, but that new high was also the second highest number of deaths of any month since 2016, tied with the month before.
And speaking of March, take a look at the rate of drug-related deaths per 100,000 person years for March 2023 among the cities Alberta’s reporting tool includes:
| Lethbridge | 163.8 |
| Red Deer | 63.5 |
| Edmonton | 69.6 |
| Medicine Hat | 50.9 |
| Calgary | 48.7 |
| Grande Prairie | 46.0 |
| Fort McMurray | 29.0 |
During the first 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 February and March.
| Jan | Feb | Mar | Q1 | |
|---|---|---|---|---|
| Lethbridge | 93.6 | 163.8 | 163.8 | 140.4 |
| Edmonton | 33.1 | 63.0 | 69.6 | 55.2 |
| Medicine Hat | 50.9 | 50.9 | 50.9 | 50.9 |
| Grade Prairie | 30.7 | 61.4 | 46.0 | 46.0 |
| Fort McMurray | 57.9 | 43.4 | 29.0 | 43.4 |
| Calgary | 38.0 | 38.0 | 48.7 | 41.6 |
| Red Deer | 31.3 | 31.3 | 31.3 | 31.3 |
Even then, January death rate in Alberta was still the largest in the province, by far.
Now let’s look at the number of deaths in 2023 in relation to total annual deaths over the previous 7 years. Keep in mind that 2023 includes data up to April only.
Last year had the highest number of drug deaths since 2016, continuing a worrying trend of record deaths in both 2020 and 2021. And that trend doesn’t look as though it’s going to reverse any time soon. We’re only 4 months into 2023, and Lethbridge has already seen the third highest number of deaths over the last 8 years.
If deaths continue at this rate, we could see as many as 168 deaths by the end of the year. That means we’re currently on track to see more than double the record set last year.
We’ve averaged 14.0 drug-related deaths a month so far in 2023. Last year, the average was 6.6, which itself was higher than the average of 5.6 in 2021 and 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.
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 last 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.
And even though we still have 4 more months before we have complete data for the period between September 2022 and August 2023, our monthly average for that period is already at 10.13, on track to set a new record, unless deaths start to decline.
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 10 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 | Q1 2023 | |
|---|---|---|---|---|---|---|---|---|---|---|
| North | 1958 | 2011 | 2335 | 2403 | 2051 | 1907 | 2226 | 2240 | 2064 | 2118 |
| South | 1627 | 1597 | 1886 | 1897 | 1747 | 1610 | 1556 | 1651 | 1616 | 1779 |
| Edmonton | 1345 | 1371 | 1649 | 1679 | 1580 | 1459 | 1489 | 1431 | 1402 | 1520 |
| Central | 1468 | 1473 | 1728 | 1896 | 1561 | 1457 | 1660 | 1650 | 1485 | 1499 |
| Calgary | 1328 | 1367 | 1399 | 1524 | 1426 | 1256 | 1144 | 1169 | 1112 | 1237 |
Those numbers are consistent with previous years.
As far as general hospitalizations go, the South Zone came in second place, behind the Central 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 | Q1 2023 | |
|---|---|---|---|---|---|---|---|---|---|---|
| Central | 694 | 725 | 739 | 812 | 697 | 718 | 726 | 646 | 510 | 565 |
| South | 639 | 674 | 687 | 652 | 542 | 484 | 484 | 387 | 440 | 539 |
| Edmonton | 516 | 527 | 589 | 576 | 557 | 512 | 507 | 437 | 456 | 478 |
| North | 633 | 691 | 701 | 629 | 521 | 518 | 547 | 537 | 512 | 464 |
| Calgary | 472 | 465 | 486 | 487 | 502 | 431 | 413 | 348 | 374 | 414 |
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 first quarter of 2023, as I reported in April, the number of calls Lethbridge EMS responded continued the increase from those seen last June; although there was a dip in March.
| 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | |
|---|---|---|---|---|---|---|
| Jan | 14 | 25 | 10 | 14 | 40 | 44 |
| Feb | 39 | 17 | 8 | 23 | 41 | 49 |
| Mar | 19 | 13 | 14 | 43 | 17 | 33 |
| 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 first quarter of 2023 was the highest first quarter on record, as well as the second highest quarter overall since the start of 2018, with EMS responding to 126 drug-related events.
| 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | |
|---|---|---|---|---|---|---|
| Q1 | 72 | 55 | 32 | 80 | 98 | 126 |
| 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 9,227 visits. Here’s how that compares to the first quarter in previous years.
The number of SCS visits increased during the first quarter of 2022 but it dropped in the first quarter of this 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 third lowest level (technically), but also higher over the last two years.
However, while the number of visitors rose in the first quarter of 2022, the number of visits per visitor actually decreased, but it was still at its second lowest level of any first quarter since 2018.
So, while the number of visitors increased in the first quarter of 2023, compared to the previous first quarter, the average number of visits each person makes to the SCS van has decreased. Even though more people are visiting it than a year ago, those who are using it do so less frequently.
Even so, the fourth quarter of 2022 saw the third lowest visit per visitor rate (26.1) of any quarter since the UCP defunded the SCS. The lowest was in the the third quarter of 2020, the first quarter after the original SCS closed down, when the visit per visitor rate was only 19.5.
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.
