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 fourth quarter data for hospitalizations and supervised consumption site usage.
What I do in this article is break down the stats for deaths, hospitalizations, and SCS usage over the last year, compare them to previous years, and see if there’s a correlation between SCS usage and the rate of deaths and EMS responses.
I already did an article on EMS responses (but not their link to SCS usage) back in January.
Deaths
During 2021, 50 people had been reported to have died from “drug poisoning”. Here’s how last year’s death numbers compare to those of previous years.
Last year, Lethbridge had the highest number of drug-related deaths it has seen since the province began tracking data in 2016. They were 30.2% higher than what they were the previous year, which itself previously had the highest number of deaths.
The number of drug-related deaths Lethbridge saw last year were also 228.5% higher than they were in 2019, the last full year that the supervised consumption site was open.
Here’s what those numbers look like when we break it down by month.
Lethbridge saw an average of 8.5 deaths per month in 2021, and it was the only year when Lethbridge hadn’t seen a month with zero deaths.
Every one of the previous 5 years saw at least one month with no reported deaths.
And speaking of fourth-quarter deaths, the highest number of deaths reported for the fourth quarter in Lethbridge occurred in 2021, which had 27. That’s 10 more than next highest, which was reached in both the second and third quarter of 2020.
The fourth quarter of 2021 saw an average of 9 deaths per month. No other fourth quarter ever saw an average higher than 4. In 2020, which had the second highest, its monthly fourth quarter average was only 3.67%.
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.
During the first year the SCS was closed, there were an average of 4.08 drug-related deaths per month. In the four months so far of the second year since it’s closure, that monthly average has more than doubled, to 8.5.
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 5 quarters since the UCP defunded the Lethbridge SCS. The highest was the North Zone.
| Q4 2020 | Q1 2021 | Q2 2021 | Q3 2021 | Q4 2021 | |
|---|---|---|---|---|---|
| North | 1958 | 1960 | 2270 | 2332 | 2042 |
| South | 1627 | 1605 | 1904 | 1900 | 1764 |
| Central | 1468 | 1443 | 1691 | 1860 | 1546 |
| Edmonton | 1345 | 1367 | 1637 | 1674 | 1773 |
| Calgary | 1328 | 1355 | 1382 | 1502 | 1412 |
Those numbers are consistent with previous years.
This is the first quarter, however, where they were in third place regarding emergency departments. That being said, they were higher than they were in the fourth quarter of 2020.
As far as general hospitalizations go, the South Zone again came in third place, behind the Central Zone and Edmonton Zone.
| Q4 2020 | Q1 2021 | Q2 2021 | Q3 2021 | Q4 2021 | |
|---|---|---|---|---|---|
| Central | 694 | 707 | 707 | 757 | 676 |
| South | 639 | 677 | 683 | 645 | 538 |
| North | 633 | 670 | 666 | 556 | 491 |
| Edmonton | 516 | 520 | 569 | 542 | 553 |
| Calgary | 472 | 459 | 477 | 463 | 475 |
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 2021, as I reported in January, EMS responded to a record number of calls, compared to the previous 3 years.
| Oct | Nov | Dec | |
|---|---|---|---|
| 2018 | 24 | 28 | 21 |
| 2019 | 10 | 16 | 13 |
| 2020 | 15 | 38 | 20 |
| 2021 | 32 | 43 | 22 |
Not only that, but the fourth quarter of 2021 saw the most EMS responses to opioid-related events than any other fourth quarter since 2018. In fact, it was the fourth highest number of any quarter during that period.
| 2018 | 2019 | 2020 | 2021 | |
|---|---|---|---|---|
| Q1 | 72 | 55 | 32 | 80 |
| Q2 | 114 | 48 | 84 | 69 |
| Q3 | 77 | 54 | 112 | 136 |
| Q4 | 77 | 39 | 73 | 97 |
The previous quarter—July through September of 2021—saw record-breaking numbers of EMS responses..
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 last 3 years.
| Sep 2018–Aug 2019 | 236 |
| Sep 2019–Aug 2020 | 269 |
| Sep 2020–Aug 2021 | 358 |
In the 12 months since the SCS was closed due to the UCP government cancelling funding, Lethbridge EMS responded to an average of 29.8 drug responses a month, up from 22.3 during the same 12-month period the previous year. They also increased from 5.1 reponses per week, on average, to 6.9 per week.
If this trend continues—and according to the story I wrote yesterday, it might be—EMS here will be even busier during the second year since the UCP defunded the Lethbridge SCS.
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 2021, the mobile SCS van saw 52,101 visits. Here’s how that compares to the same 12-month period in previous years.
Clearly, the number of SCS visits has dropped dramatically over the last year.
The number of unique visitors per month isn’t much better, being at it’s second lowest level (technically) and about where it was the first year the old SCS was open..
And while it shouldn’t be that shocking that if SCS visits drop, unique visitors will be low, too, these aren’t the only SCS metrics that have dropped in the last year.
The average number of visits each person makes to the SCS van has also dropped, compared to the SCS building that the UCP defunded. So, fewer people are visiting the SCS van, and those who do visit, they’re using it far less frequently.
And the fourth quarter of 2021 saw the lowest visit per visitor rate during the first year since the UCP defunded the SCS.
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 no 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.
Defunding the SCS and replacing it with only 14% of its capacity is directly connected to more deaths and a greater burden on emergency services.
