Rural, Indigenous hardest hit by lack of drug treatment services

Written By Rob Shaw

Smaller communities up and down British Columbia aren’t getting their fair share of drug treatment options, safe supply services or equitable decriminalization, and it’s costing lives in the ongoing overdose crisis, according to a new report by an all-party legislature committee.

MLAs from the BC Greens, Liberals and NDP spent seven months studying the more than 10,000 deaths caused by toxic drugs, and while they concluded there’s not enough help for pretty much anyone suffering addiction in this province, it is particularly bad in rural and remote communities.

The report… hammered home the province’s many failings on the overdose crisis.

“What we heard is that some British Columbians are not able to access life-saving supports and services,” said Niki Sharma, the NDP MLA from Vancouver-Hastings who chaired the committee.

“Sometimes this is because there are gaps in services that mean they don’t exist in their community or don’t fit their needs. Other times it’s because there are barriers that exist, whether this is the arduous requirements for receiving medication, wait-lists for entering treatment programs or spaces that are not welcoming to people.”

Investment and accountability needed

BC should urgently expand all areas of its response to the public health crisis, and make significant investments into an addictions system that has metrics, accountability and an overall strategy for success, according to MLAs.

The goal, said Sharma, should be “ensuring equitable life-saving services in all parts of the province.” 

But the MLAs found that’s currently not the case.

“Overdose prevention sites and drug checking are critical… but many communities don’t have them.”

Sonia Furstenau

“We heard that overdose prevention sites and drug checking are critical to preventing deaths, but many communities don’t have them,” said committee member and BC Green leader Sonia Furstenau.

“Others who provided input spoke passionately about the window of opportunity — that moment when people courageously ask for help,” added Liberal MLA Shirley Bond, deputy chair of the committee.

Waitlists, lack of resources

“What did we learn? Waitlists. Lack of resources, made even more challenging if you live in a rural or remote area of this province. It meant that that window was missed. We must do so much better.”

It’s a particular problem within Indigenous communities, where people are dying at significantly higher rates and Indigenous women in particular have died at 9.8 times the frequency of other women in the province.

There needs to be Indigenous-specific approaches to harm reduction services, safe supply and prescribed opioid alternatives, the MLAs found.

“…the disproportionate impact… for northern B.C. could be due to the current fragmentation of social services.”

Standing Committee on Health 2022 report

“The First Nations Health Authority and others noted the lack of harm reduction services available to Indigenous people living in rural and remote areas of the province,” read the report.

That dovetails into B.C.’s North, which has the highest rate of toxic drug deaths in the province and “inconsistent access to harm reduction services and treatment across the region,” wrote the MLAs.

“The BC First Nations Justice Council suggested the disproportionate impact of the drug toxicity and overdose crisis for northern B.C. could be due to the current fragmentation of social services available to people who use drugs across the province, noting that it is difficult for social service agencies to recruit and retain professionals due to burnout and low pay.”

Urban abundance

Urban centres like Metro Vancouver and Greater Victoria have an abundance of safe consumption sites, drug checking facilities, outreach programs, treatment options and safe supply alternatives to serve their dense populations.

B.C.’s first supervised consumption site opened in Vancouver 19 years ago, and B.C. is into its sixth year of a declared public health emergency on toxic drugs. But Northern Health is only now reporting that “at least some level of harm reduction services (are) now provided in every community in the north,” read the report.

“We must do so much better.”

Shirley bond

Urban B.C. is also where police agencies are far less likely to arrest someone in the grips of an addictions, mental health and homelessness crisis for simple possession of small amounts of drugs — something that increases stigma and reduces a person’s willingness to look for help from government agencies. 

Drug threshold questioned

“Representatives… also shared their experiences that police in rural communities still confiscate drugs despite police in more urban communities implementing de facto decriminalization, and expressed concerns that the threshold of 2.5 grams might increase the frequency of police profiling and use of the low threshold to target known users,” read one section of the report, which discussed whether B.C.’s decriminalization exemption from Ottawa had hit the right mark.

“Several organizations outlined that threshold limits are especially problematic for rural communities, noting that, due to limited availability in rural regions, many people who use drugs regularly purchase and hold larger quantities.”

MLAs highlighted a rural component to almost every issue of addictions.

The MLAs highlighted a rural component to almost every issue of addictions.

“The Committee also heard about challenges impacting the response in rural, remote, and northern areas, including vast distances between communities, small service centres, harsh climates, poor transportation systems, lack of cellular service, limited access to pharmacies, and potentially limited social, education, and employment opportunities,” they wrote.

The report was a difficult read, in that it hammered home again the province’s many failings on the overdose crisis.

But it’s particularly difficult for rural and remote communities. They haven’t had equal access to services for years. And they’re still waiting for more help from the government.