Access to free naloxone in B.C. preventing 4 out of 5 potentially fatal overdoses, report finds

Thousands of people have died due to the toxic drug crisis in the decade since B.C. declared it a public health emergency. But a new study shows that many more could have died if not for the province's harm reduction efforts.

Researchers estimated that access to free, take-home naloxone services in the province prevented 76 to 80 per cent of potential deaths due to opioid poisoning, based on modelling and data from 2019 to 2024.

While this number might seem large, Mike Irvine, the study's lead author and a senior scientist at the B.C. Centre for Disease Control (BCCDC), said that it's indicative of the number of harm reduction resources teams across the province who are working to make naloxone more accessible.

"It's quite an incredible number to think about," he said. "What that situation would look like if these weren't available, is not worth thinking about."

However, 12,356 lives were lost to the toxic drug crisis in B.C. during the time period of this study according to the B.C. Coroners Service, which Irvine says shows how much more work there is to do in preventing these deaths.

While nasal and intramuscular naloxone is free across B.C. through the Take Home Naloxone program, not all residents of the province have the same level or variety of access to harm reduction resources, he said.

Irvine said researchers chose to look at harm reduction efforts between 2019 and 2024 because of the significant shifts during that time in the toxicity of the unregulated drug supply, alongside shifts in harm reduction access due to the pandemic.

He says one in 10 drug poisoning events result in death, but with harm reduction efforts like naloxone and using an overdose prevention site, that drops to one in 20.

In the time period studied, the report found overdose prevention and supervised consumption sites prevented about 340 potential deaths per 100,000 people who injected drugs.

Alexis Crabtree, a public health physician at the BCCDC who leads the Take Home Naloxone program, was glad to see recognition for the "unsung" efforts to make naloxone more accessible across the province.

"What we want to see is prevention of drug poisoning from even happening in the first place," she said.

"But as a safety measure, naloxone is a really important one — it differs from some other harm reduction measures in that it can be carried by anyone, even people who don't use substances."

However, she still sees barriers to bringing down the number of people dying due to toxic drug poisonings, beyond responding to potential overdoses.

"I think we, as a province, need to continue to work upstream of naloxone," said Crabtree.

"Work that's happening in the province to strengthen prevention of problematic substance use in the first place and work to strengthen our treatment and recovery systems is great."

She hopes to see access for treatment and recovery to continue growing, as well as greater education to help young people understand the risks of substance use. As Indigenous people are dying from the toxic drug crisis at a disproportionate rate, she feels cultural programs and land-based healing are also significant to help prevent further deaths.

Bernie Pauly, a scientist with the Canadian Institute for Substance Use Research, says B.C. also needs to make an effort to prevent the rising number of people dying while experiencing homelessness — which is largely due to toxic drugs.

"Lack of access to trauma support, counselling, lack of access to housing, those are all key," said Pauly.

"That whole situation is worsened by constant and repeated targeting and displacement that happens in some places like Victoria on a daily basis, because you're now displacing people away from sources of help."

The isolation, stress, and trauma caused by this, she says, will only lead to further deaths.