Drug overdose crisis: Socioeconomic characteristics of those dying of illicit drug overdoses in British Columbia, 2011 to 2016
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According to the Public Health Agency of Canada, on average, nearly 10 people died each day of an illicit drug overdose in Canada from January 2016 to March 2018.
While the drug overdose crisis has affected all provinces and territories, the crisis has been most acute in British Columbia, where most illicit drug overdose deaths have occurred.
Based on administrative data from the British Columbia Coroner's Service, the number of people in British Columbia who died from an illicit drug overdose more than doubled, from 293 in 2011 to 639 in 2016. While the crisis affects people from all walks of life, most illicit drug overdose deaths―nearly three-quarters (73%)―occurred among males (77%) and among those aged 25 to 54.
Analysis of this fatal overdose cohort indicate that those dying from preventable illicit drug overdoses in British Columbia are a diverse population. This group includes both people who had not been in contact with the hospital, employment, social income assistance or justice systems in the years prior to their fatal overdose, as well as those who had. This highlights the need for a diverse plan of action when attempting to identify potential points of intervention around preventable fatal overdoses.
This release is the result of a partnership between Statistics Canada and the British Columbia Coroners Service, the City of Surrey, Surrey Fire Service, Surrey RCMP Detachment, Fraser Health Authority, BC Stats, the BC Centre for Disease Control, British Columbia Ministry of Health and Public Safety Canada. The findings are based on administrative data provided by the British Columbia Coroners Service, which have been integrated with hospitalization, employment, social assistance and justice data to provide a comprehensive profile of people who died as a result of an illicit drug overdose. Findings are available for British Columbia in general and for the City of Surrey in particular.
These findings are the first in a series of articles providing in-depth analysis of the social and economic circumstances of people who died of confirmed illicit drug overdoses in British Columbia. For further analysis, see the accompanying Juristat Bulletin—Quick Fact "Illicit drug overdose deaths, 2011 to 2016, British Columbia and Surrey."
Use of hospital and emergency services
Overall, 26% of people who died of an illicit drug overdose in British Columbia (and 23% in Surrey) had experienced at least one acute care in-patient hospitalization in the 12 months prior to death.
Among these hospitalizations, 15% of people who fatally overdosed in British Columbia were hospitalized only once in the year prior to their death, while 6% were hospitalized more than twice. In Surrey, 13% were hospitalized only once in the year prior to fatal overdose, and 4% more than twice.
Substance-use disorders were the most common reasons for a person's hospitalization in the year prior to fatal overdose, accounting for 20% of hospitalizations. In addition, 17% of people in British Columbia and 22% in Surrey were admitted for opioid poisoning in the year prior to fatal overdose.
Other reasons for hospitalization included mental health conditions (excluding substance-use disorders) and injury and poisonings (excluding opioid poisonings).
The main reason for hospitalization in the 12 months prior to death, British Columbia and Surrey, 2011 to 2016
In addition to acute care hospitalizations, more than 40% of those who fatally overdosed visited the emergency department at least once in the year prior to death, while 15% did so four or more times.
Employment and income
In British Columbia, 26% of people who died from an illicit drug overdose were employed in each of the five years prior to death. This was the case for 28% of people who fatally overdosed in Surrey.
In contrast, 34% of people who died from an illicit drug overdose in British Columbia had no earnings over this same time period, compared with 28% in Surrey.
The remaining people had employment earnings in one to four years, indicating at least some workforce attachment over the reference period. The contrast in these statistics shows that this crisis impacts individuals from all walks of life—the employed and the unemployed alike.
The number of years employed in the five years prior to death, British Columbia and Surrey, 2011 to 2016
Among those who were employed before they fatally overdosed in British Columbia, about one-fifth worked in construction. An additional 13% worked in building maintenance, waste management and other support service industries.
People in British Columbia who were employed in the year prior to their fatal overdose earned, on average, $28,437 that year. By comparison, workers in British Columbia reported an average employment income of $42,000 in 2016.
Industry of last main job in the five years prior to death, British Columbia and Surrey, 2011 to 2016
A similar pattern was also observed for social assistance. In British Columbia, 40% of people who fatally overdosed did not receive any social assistance benefits (or provincial or territorial supplements) in all five years prior to death, compared with 31% who received assistance in each of the five years.
On average, recipients of social assistance benefits in the year prior to death received $8,259.
Contacts with police
For the purposes of this study, a contact with the police occurs when a person is accused of a criminal incident. It does not include instances where a person interacts with the police as a victim, witness or complainant.
The majority of people who died of an illicit drug overdose―around two-thirds in both British Columbia and Surrey―did not have contact with police in the two years prior to their death.
Frequency of contact with the police in British Columbia in the 24 months prior to death, British Columbia and Surrey, 2011 to 2016
Of those who did have contact with police in the 24 months prior to their fatal overdose, some did so multiple times. For example, 11% of people who fatally overdosed in British Columbia and Surrey had four or more contacts with the police in the 24 months preceding their death.
Most people who came into contact with police in the 24 months prior to their fatal overdose did so for a non-violent criminal incident, with shoplifting of items valued at $5,000 or under being the most common reason in both British Columbia (14%) and Surrey (17%).
By comparison, this offence accounted for 5% of all criminal incidents in the whole of the province from 2009 to 2016.
Offences against the administration of justice, namely failure to comply with an order and breach of probation, were also among the most common reasons for contact with police in the two years prior to fatal overdose.
Reasons for contact with the police in the 24 months prior to death, selected offences, British Columbia and Surrey, 2011 to 2016
Around three-quarters of those who fatally overdosed in British Columbia and Surrey who had had contact with police died within one year of that police interaction.
One-third of people who fatally overdosed in British Columbia (24% in Surrey) who had had contact with police died within three months of the contact.
This is the first in a series of articles that will provide in-depth analysis of the social and economic circumstances of confirmed illicit drug overdose deaths in British Columbia. Additional articles will not only provide more in-depth analysis on contacts within specific social and economic systems, but will also look at contacts across these systems.
This information is needed to better understand the triggers and the multiple pathways leading to the crisis, in order to inform policy decisions focused on prevention and root causes. Identifying the primary risk factors and those at greatest risk of preventable illicit drug-related deaths will help support the development of evidence-informed interventions, precision programming and policies aimed at preventing future overdoses and saving lives.
Note to readers
To address the drug overdose crisis, the British Columbia's Coroners Service, the City of Surrey, the Surrey Fire Service, the Surrey Royal Canadian Mounted Police Detachment, the Fraser Health Authority, BC Stats, the BC Centre for Disease Control, and the British Columbia Ministry of Health, and Public Safety Canada partnered with Statistics Canada to launch a pilot project to collect administrative information on the social, economic and health characteristics associated with a person's circumstances prior to the preventable illicit drug overdose death.
The analysis presented in this release is based on administrative data on illicit drug overdose deaths integrated with Statistics Canada's data on employment and social assistance, health and hospitalization, and contacts with the criminal justice system.
Statistics Canada ensures the privacy, confidentiality and security of all data sources throughout the data integration process.
More information on the drug overdose crisis is available in BC Coroners Service: Statistical Reports.
Resources are available to people with problematic substance use on the Health Canada website.
The Juristat Bulletin—Quick Facts "Illicit drug overdose deaths, 2011 to 2016, British Columbia and Surrey" ( 85-005-X) is now available.
Also available are the infographic "Opioid awareness in Canada" and the Health Reports article "Social and economic characteristics of those experiencing hospitalizations due to opioid poisonings."
For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; STATCAN.infostats-infostats.STATCAN@canada.ca) or Media Relations (613-951-4636; STATCAN.mediahotline-ligneinfomedias.STATCAN@canada.ca).
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