The Lethbridge SCS has been closed for a year

Last 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.

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 while we still don’t have data for November and December yet, it’s turning out to be the only year when Lethbridge hasn’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 2020, which had 11. In the first month of the fourth quarter for 2021, we’re already up to 10.

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.

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 each of the 4 quarters since the UCP defunded the Lethbridge SCS. The highest was the North Zone.

	Q4 2020	Q1 2021	Q2 2021	Q3 2021
North	1958	1960	2270	2332
South	1627	1605	1904	1900
Central	1468	1443	1691	1860
Edmonton	1345	1367	1637	1674
Calgary	1328	1355	1382	1502

Those numbers are consistent with previous years.

As far as general hospitalizations go, the South Zone once again came in second place, this time behind the Central Zone though.

	Q4 2020	Q1 2021	Q2 2021	Q3 2021
Central	694	707	707	757
South	639	677	683	645
North	633	670	666	556
Edmonton	516	520	569	542
Calgary	472	459	477	463

Again, those numbers are consistent with previous years.

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

The Alberta substance use surveillance system tracks weekly EMS data going back to only 2018.

According to the surveillance system, between September 2020, after the Lethbridge SCS closed because of the UCP cancelling provincial funding, and August 2021, Lethbridge EMS responded to 358 opioid related events.

Here’s how this compares to the same 12-month period for the previous 2 years.

Not only did the number of EMS responses increase over the previous 12-month period, but that increase was greater than that of the previous period.

EMS responses increased by 14.1% between the 12-month period starting in September 2018 and the same period starting in September 2019. The following year—the one marked by the UCP defunding the Lethbridge SCS—EMS responses to opioid-related events jumped by 34.08%.

That’s nearly double the rate.

Lethbridge EMS responded to 136 responses in the third quarter of 2021. That’s the highest number of responses to opioid-related events in Lethbridge of any quarter since 2018.

On a related note, EMS responses for the fourth quarter of 2021 (86) are already at the highest level of any fourth quarter over the last 4 years. And we’re still missing two weeks of data.

And this next year is already looking worse. The first four months of the second year following the defunding of the SCS, Lethbridge EMS have responded to 121 opioid-related events.

Keep in mind, again, that we’re still missing data for the last two weeks of December. Even so, that’s the highest number of responses seen during the same period over the previous 4 years. The next highest was in 2018, when it was 95. That’s a 27.4% increase.

If this trend continues, 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 the first year since the UCP defunded the SCS run by ARCHES, SCS usage was 48,040 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.

Unsurprisingly, so has the number of unique visitors per month.

And while it shouldn’t be that shocking that if SCS visits drop, unique visitors will as well, 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 third 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 all 6 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.

Same goes for the number of visitors: more visitors, fewer deaths and EMS responses. And vice versa.

Even the frequency 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 other two 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.