Lethbridge passes 250 drug deaths since SCS defunded

The Government of Alberta recently 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 third quarter 2023 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 2023, 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 2023, 23 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 fifth lowest number of drug-related deaths it had seen in any third quarter since the province began tracking data in 2016, and the lowest since 2019.

This past year, however, third quarter deaths have skyrocketed, more than doubling from just 10 in 2022 to 23 in 2023. As you can see from the graph, this is the largest number of deaths of any third quarter since at least 2016.

And by a long shot.

The next highest was only 15, set in the third quarter of 2020, and that’s about a two-thirds of what we saw this year.

Now, let’s break the quarter numbers by month.

The third quarter of 2023 saw a jump in the number of drug deaths because two of the months in that quarter saw higher numbers of drug deaths.

Two of those three months, in fact, hit record numbers of drug deaths.

July’s new record of 10 bypassed the previous July record of 7, set back in 2018.

August’s 3 drug-related deaths was the third highest of any August since 2016, behind the record of 7 set in 2020, followed by 4 in each of the next 2 years.

Finally, September’s 10 deaths, like those of July, bypassed the previous September record of 7, which had been reached in 2021.

Not only that, take a look at the rate of drug-related deaths per 100,000 person years for September 2023 among the cities Alberta’s reporting tool includes:

Lethbridge	117.0
Edmonton	66.3
Medicine Hat	50.9
Red Deer	31.3
Calgary	28.9
Grande Prairie	15.3
Fort McMurray	0.0

During the third 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 increases in July and September.

	Jul	Aug	Sep	Q3
Lethbridge	117.0	35.1	117.0	89.7
Edmonton	68.5	80.6	66.3	71.8
Medicine Hat	101.9	50.9	50.9	67.9
Grande Prairie	76.7	30.7	15.3	40.9
Calgary	43.0	42.1	28.9	38.0
Red Deer	41.8	20.9	31.3	31.3
Fort McMurray	29.0	29.0	0.0	19.3

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 September 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 9 months into 2023, and Lethbridge has already set a new high for the number of annual drug deaths.

If deaths continue at this rate, we could see as many as 140 deaths by the end of the year. That means we’re currently on track to see nearly double the record set last year.

We’ve averaged 11.6 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) compares to previous and subsequent 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.

And now, in the third full year since the SCS was shut down, we see that drug-related deaths have increased even more, rising to 119 between September 2022 and August 2023. That’s a 35% increase over 2021–2022 and 159% increase over 2020–2021.

This also means that we have surpassed 200 drug-related deaths—253 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.

Another record high, just shy of 10 drug deaths per month between September 2022 and August 2023. The previous high was set last year, at 7.33, which itself superseded the previous high set the year before.

In fact, every year the UCP have been in power, Lethbridge has seen a new high in the average monthly death for the 12 month period between September and the following August.

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 12 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	Q2 2023	Q3 2023
North	1958	2011	2329	2396	2053	1919	2258	2279	2108	2123	2614	2578
South	1627	1597	1885	1897	1748	1608	1559	1656	1623	1781	2026	1909
Edmonton	1345	1371	1635	1666	1579	1456	1513	1474	1520	1532	1766	1812
Central	1468	1473	1726	1729	1561	1457	1665	1655	1522	1500	1766	1848
Calgary	1328	1367	1397	1489	1426	1247	1147	1192	1218	1237	1378	1372

Those numbers are consistent with previous years.

As far as general hospitalizations go, the South Zone came in second place, which makes 3 quarters in a row, 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	Q2 2023	Q3 2023
Central	694	725	733	805	697	805	739	716	598	640	697	561
South	639	674	682	647	543	552	490	445	507	567	661	507
Edmonton	516	527	589	575	557	583	511	485	502	527	551	498
North	633	691	687	625	521	582	558	574	555	490	531	503
Calgary	472	465	483	481	502	488	413	394	423	458	502	451

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 2023, as I reported in October, the number of calls Lethbridge EMS responded continued the increase from those seen last June; although there was a dip toward the end of the third quarter of this year.

Here’s a look at all the months on record.

	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	39
May	38	16	20	28	12	43
Jun	35	20	49	27	21	39
Jul	35	28	56	52	23	44
Aug	24	10	42	49	24	33
Sep	18	16	14	35	21	18
Oct	28	10	15	32	29
Nov	28	16	38	43	39
Dec	21	13	20	22	28

The third quarter of 2023 was the third highest third quarter on record, as well as the ninth highest quarter overall since the start of 2018, with EMS responding to 95 drug-related events.

	2018	2019	2020	2021	2022	2023
Q1	72	55	32	80	98	126
Q2	114	48	84	69	45	121
Q3	77	54	112	136	68	95
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 was 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
Sep 2022–Aug 2023	441

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.

And then during September 2022 and August 2023, that number increased to a new record, with Lethbridge EMS responding to 441 drug-related event, an average of 36.8 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 2023, the mobile SCS van saw 10,620 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 each of the last two years. Either way, each of the last 4 third quarters are dramatically lower than when the much larger facility was open.

Which is interesting, given how much drug deaths has increased. But more on that in just a bit.

The number of unique visitors per month, on the other hand, is at its highest level.

I find it interesting that the number of visitors has dramatically increased, but the number of actual visits has decreased.

Let’s take a look at average visits per visitor.

See what I mean?

So, while the number of visitors increased in the third quarter of 2023, the highest number in any third quarter, the average number of visits each person makes to the SCS van has decreased to its second lowest level. Even though more people are visiting it than a year ago, those who are using it do so less frequently.

On top of that, the third quarter of 2023 saw the third lowest visit per visitor rate (22.2) 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 three 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.