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The Intersections of Marginalization: BC's Urban Indigenous Drug Users and the COVID-19 Pandemic

On April 14, 2016, BC’s provincial Medical Health Officer, Dr. Perry Kendall, declared a public health emergency under the Public Health Act in response to increasing overdose incidents and overdose deaths in the province. Since then, approximately 5,700 British Columbians have been lost to overdoses and hundreds of millions of provincial and federal funds have been allocated to and spent in expanding and improving addiction prevention, treatment, and recovery services. Following two deadly years where 3,041 British Columbians perished from drug overdoses, largely attributable to fentanyl contamination in 2019, the death rate fell below 2016 levels. This was achieved by establishing communities, support networks harm reduction initiatives and healthcare capacity for current and former drug users to prevent overdoses, assist in the immediate aftermath of overdoses and assist in addiction recovery. This trend may have continued through 2020 with overdose deaths in January and February lower relative to 2019 and additional resources being allocated for the aforementioned purposes.

In March 2020, BC had to and continues to, contend with the COVID-19 pandemic. By rapidly imposing and enforcing physical isolation requirements and healthcare capacity restrictions, many of the lifelines BC’s drug users relied upon were severed. The communities and support networks current and former drug users depended on were torn asunder, a choke was put on the harm reduction services that allowed safer drug consumption, British Columbians were discouraged from seeking healthcare in all but the most serious circumstances and governments disbursed unprecedented levels of financial assistance to individuals and businesses, in the name of economic survival. The results of these measures are clear insofar as the annual death rate among BC’s drug users is now at a level akin to the deadliest years of the overdose crisis. In these times, current drug users use alone, use more dangerous substances in riskier ways, have more financial resources to fuel their consumption and are discouraged from and/or restricted from accessing adequate healthcare.

The consequences of long-term systemic inaction on the parts of governments, health authorities and other entities were magnified by the pandemic. Long-standing restrictions on the types of substances available for OAT and IOAT, the health authorities failing to allocate adequate resources for such therapies, and the inflexibility of professional organizations within the healthcare professions have resulted in more dangerous drug supply. Enduring restrictions on visitors within SRO and other housing initiatives for BC’s most vulnerable have been strengthened because of the pandemic, resulting in riskier drug use conditions for drug users. The impacts of the provincial government’s deadly calculus have recently been brought to the fore with the monthly overdose death toll of the past two months being the highest in the past decade, greatly exceeding the provincial COVID-19 death toll for the entire pandemic period and leaving many drug users wondering whether they have been made the sacrificial lambs of the province’s COVID-19 response.

Between January and May 2020, overdose deaths among First Nations nearly doubled compared to the same period in 2019, and the proportion of First Nations overdose deaths relative to the total number of overdose deaths increased by 60% relative to the same period in 2019. In 2019 First Nations people died from overdoses at 3.8x the rate of other BC residents. Between January and May 2020, that rate had increased to 5.6x. It is evident that drug overdoses disproportionately impact Indigenous peoples and the concurrent COVID-19 pandemic has only exasperated the many barriers to treatment faced by Indigenous drug users. A barrier unique to Indigenous peoples within the urban centers, like Vancouver’s Downtown Eastside is the lack of cultural safety and humility in the support networks harm reduction initiatives and healthcare services available.

It is evident from the manner the provincial government weighed its response to the COVID-19 and the overdose crisis that the lives of BC’s drug users, and Indigenous drug users specifically, were perceived as less valuable, despite their established and ongoing contributions to BC and Canadian society. It is also clear that simply allocating resources to expand and strengthen existing models of prevention treatment and recovery is ineffective when those models lack inherent resiliency. Garth Mullins, a journalist, activist and former drug user based in Vancouver said in an interview with the Say Know Drug Education Project in January 2019, “We still have policies made by people who don’t understand.” Impact Resolutions recognizes the critical importance of creating and implementing tailored solutions that increase the resilience of existing systems. Through a multicultural and multidisciplinary approach, we use qualitative and quantitative research to identify and close gaps while adapting to changing conditions.


Cameron Swinton, Impact Resolution’s finance and risk specialist and blog author, takes great pride in applying quantitative and qualitative data analysis to facilitate initiatives undertaken by Indigenous communities and municipalities that are designed to humanize pressing socioeconomic problems. He has the skills and applied experience pairing technical analytical methods with organizational requirements and contextualizing their use across organizational and cultural silos to create and implement mutually beneficial solutions. Cameron’s approach in centered on the belief that professionalism and humility are necessary to establishing the strong relationships required to adequately address pressing socioeconomic concerns and cultivate a shared vision.



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