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Introduction: British Columbia (BC) declared an overdose public health emergency in 2016. Since then, BC has consistently reported the highest overdose death rates of any province in Canada. In the context of the COVID-19 pandemic, overdose deaths in BC reached a record high in 2020. This analysis reports on changes in the profile of people who have died of overdose since BC's declaration of COVID-19 as a public health emergency on 17 March 2020., Methods: Using BC Coroners Service data, Chi-square tests and multivariable logistic regression were conducted to compare demographic, geographic and post-mortem toxicology data between people who died of overdose before (17 March-31 December 2019) and after (17 March-31 December 2020) BC's declaration of COVID-19 as a public health emergency., Results: Overdose deaths observed since 17 March 2020 (n = 1516) more than doubled those observed in the same period in 2019 (n = 744). In the adjusted logistic regression model, odds of death in the post compared to pre-COVID-19 period was significantly higher among males compared to females, among all older age groups compared to people aged 30-39, and was lower in public buildings compared to private residences., Discussion and Conclusions: Alongside a significant increase in overdose deaths since BC's declaration of COVID-19 as a public health emergency, the demographic profile of people who have died of overdose has changed. Ongoing overdose prevention efforts in BC must seek to reach people who remain most isolated, including older adults, who during dual public health emergencies are facing compounded risk of preventable mortality., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

Introduction: British Columbia (BC) declared a public health emergency in April 2016 in response to a rapid rise in overdose deaths. Further understanding of health care utilization is needed to inform prevention strategies for individuals who overdose from illegal drugs., Methods: The Provincial Overdose Cohort includes linked administrative data on health care utilization by individuals who experienced an illegal drug overdose event in BC between 1 January 2015 and 30 November 2016. Overdose cases were identified using data from ambulance services, coroners' investigations, poison control centre calls and hospital, emergency department and physician administrative records. In total, 10 455 overdose cases were identified and compared with 52 275 controls matched on age, sex and area of residence for a descriptive analysis of health care utilization., Results: Two-thirds (66%) of overdose cases were male and about half (49%) were 20-39 years old. Over half of the cases (54%) visited the emergency department and about one-quarter (26%) were admitted to hospital in the year before the overdose event, compared with 17% and 9% of controls, respectively. Nevertheless, nearly onefifth (19%) of cases were recorded leaving the emergency department without being seen or against medical advice. High proportions of both cases (75%) and controls (72%) visited community-based physicians. Substance use and mental health-related concerns were the most common diagnoses among people who went on to overdose., Conclusion: People who overdosed frequently accessed the health care system in the year before the overdose event. In light of the high rates of health care use, there may be opportunities to identify at-risk individuals before they overdose and connect them with targeted programs and evidence-based interventions. Further work using the BC Provincial Overdose Cohort will focus on identifying risk factors for overdose events and death by overdose., Competing Interests: The authors have no conflicts of interest to declare.

Illicit drug toxicity (i.e. overdose) is the leading cause of unnatural death in British Columbia, with 2021 recording a 26% increase since 2020, and more deaths than recorded in any prior year. This rise has been largely driven by the increased toxicity of the illicit drug supply. While harm reduction and treatment interventions have reduced deaths, these services alone are insufficient to stop the illicit drug toxicity crisis. Calls are mounting to provide access to a "safe supply" of drugs. One size does not fit all, and a diverse range of substances must be made widely available to separate British Columbians from the illicit drug supply. [ABSTRACT FROM AUTHOR]

Introduction: British Columbia (BC) declared a public health emergency in April 2016 in response to a rapid rise in overdose deaths. Further understanding of health care utilization is needed to inform prevention strategies for individuals who overdose from illegal drugs. Methods: The Provincial Overdose Cohort includes linked administrative data on health care utilization by individuals who experienced an illegal drug overdose event in BC between 1 January 2015 and 30 November 2016. Overdose cases were identified using data from ambulance services, coroners' investigations, poison control centre calls and hospital, emergency department and physician administrative records. In total, 10 455 overdose cases were identified and compared with 52 275 controls matched on age, sex and area of residence for a descriptive analysis of health care utilization. Results: Two-thirds (66%) of overdose cases were male and about half (49%) were 20-39 years old. Over half of the cases (54%) visited the emergency department and about one-quarter (26%) were admitted to hospital in the year before the overdose event, compared with 17% and 9% of controls, respectively. Nevertheless, nearly onefifth (19%) of cases were recorded leaving the emergency department without being seen or against medical advice. High proportions of both cases (75%) and controls (72%) visited community-based physicians. Substance use and mental health-related concerns were the most common diagnoses among people who went on to overdose. Conclusion: People who overdosed frequently accessed the health care system in the year before the overdose event. In light of the high rates of health care use, there may be opportunities to identify at-risk individuals before they overdose and connect them with targeted programs and evidence-based interventions. Further work using the BC Provincial Overdose Cohort will focus on identifying risk factors for overdose events and death by overdose. [ABSTRACT FROM AUTHOR]

Background: Illicit drug overdose deaths (IDD) relate to individual drug dose and context of use, including use with other drugs and alcohol. IDD peaked in British Columbia (BC) in 1998 with 417 deaths, and continues to be a public health problem. The objective of this study was to examine IDD in 2006 in BC by place of residence, injury and death, decedents' age and sex and substances identified. Methods: IDD data was obtained through the BC Coroners Office and entered into SPSS (version 14). Fisher's exact and Pearson's ?2 were used for categorical data; Mann-Whitney U-test for continuous variables. Rates were calculated using 2006 population estimates. Results: We identified 223 IDD in BC; 54 (24%) occurred in Vancouver. Vancouver decedents (compared to those occurring outside Vancouver) were older (mean age 43.9 vs. 39.2 years; p < 0.01) and more likely to be male (90.7% vs. 77.5%; p = 0.03). Provincially Aboriginal ethnicity was reported for 19 deaths; 13 (30.2%) of 43 females and 6 (3.3%) of 180 males (p = < 0.001). Cocaine was identified in 80.3%, opiates 59.6%, methadone 13.9%, methamphetamine/ amphetamine 6.3%, and alcohol in 22.9% of deaths. Poly-substance use was common, 2 substances were identified in 43.8% and 3 or more in 34.5% of deaths. Opiates were more frequently identified in Vancouver compared to outside Vancouver (74.1% vs. 55.0%) p = 0.015. Conclusion: Collaboration with the Coroner's office allowed us to analyze IDD in detail including place of death; cocaine, opiates and poly-substance use were commonly identified. Poly-substance use should be explored further to inform public health interventions. [ABSTRACT FROM AUTHOR]