Weekly Overdose Placemat Data Sources and Notes

Provincial Summary Page Figure 1 - (upper left-hand corner) Weekly Illegal Drug Overdose Events Attended by Paramedics Data Source: BC Emergency Health Services (BCEHS) This trend is based on the BCEHS Patient Care Record (PCR) completed by attending paramedics and excludes overdoses coded as primarily due to alcohol and prescription drugs. The algorithm is designed to monitor trends in street drug overdoses. Due to a time lag in the PCR data, this trend line is projected for recent weeks based on calls to the 9–1–1 system coded by the BCEHS dispatch operator as an ingestion poisoning event (card 23). Approximately 51% of ingestion poisoning calls are determined to be paramedic-attended illicit drug events as the data is received.

Figure 2 - (second ﬁgure on left) Severity Indicator The trend shown on the provincial page is based on the BCEHS dispatch data. The dispatch data is timely and shows recent trends. The severity indicator shown on the provincial page is based on the weekly percentage of 9–1–1 ingestion poisoning calls that were coded into the most severe category, at the time of ambulance dispatch, based on assessment by the dispatch operator according to a protocol.

Figure 3 - (bottom left ﬁgure) Coroner’s Data on Illicit Drug Overdoses, 12–month rolling weekly deaths The BC Coroner investigates all accidental and undetermined illicit drug overdose deaths in British Columbia. Location of deaths are reported by place of injury(where the person most likely consumed the relevant substance), place of death (if not place of injury i.e. a medical facility), place of residence. In the HA summaries in this report, Health Authority is assigned based on place of injury, and if that is missing, place of death, and, if missing, place of residence. Some deaths (about 6.5%), do not have suﬃcient location information to assign any area, so only appear in BC counts. Illicit drug overdoses reported by the Coroner include overdoses involving street drugs (heroin, cocaine, MDMA, methamphetamine, etc.), medications that were not prescribed to the deceased, combinations of the above, prescribed medications, and those overdoses where the origin of drug is not known. Both open and closed cases are included.

Health Authority Summary Pages Percentage of Illegal Drug Overdoses Rated Severe in Previous 6 Months by Community - (upper right hand ﬁgure) Please note that the severity indicator on the Health Authority summary pages is not based on the BCEHS dispatch severity but a separate severity indicator from the PCR. Paramedics assess severity at arrival based on the Glasgow Coma Scale (GCS), a rating in between 3 and 8 qualify as severe. The chart, on each Health Authority page, highlights the proportion of all severe illegal drug overdoses in the past 6 months. These are presented by community, where more than 10 illegal drug overdoses were recorded. Furthermore, the bars are colour coded based on the change in severity compared to the prior 6 month period. For example, in community X, 60% of the illegal drug overdoses in the past 6 months have been rated severe. This is an increase over the previous 6 month period (i.e. 6 months to 1 year ago), where only 44% of the illegal drug overdoses were severe. The 6 month windows are rolling and update each week.

Percentage of Illegal Drug Overdoses Transported to Hospital in Previous 6 Months by Community - (bottom right hand ﬁgure) On each HA–speciﬁc page, there is a chart showing the proportion of illegal drug overdoses that were transported to hospital over the most recent 6 months. These are presented by community, where more than 10 illegal drug overdoses were recorded. Furthermore, the bars are colour coded based on the change in transport rate compared to the prior 6 month period. For example, in the community of XX, 86% of illegal drug overdoses in the past 6 months were transported to hospital. This is an increase over the previous 6 months period (i.e. 6 months to 1 year ago), where only 59% of illegal drug overdoses were transported to hospital. The 6 month windows are rolling and update each week as BCEHS PCR data updates become available. Weekly Overdose Placemat - Provincial December 06, 2020 to December 12, 2020

Illicit Drug Overdose Deaths by Health Service Delivery Area Weekly Illegal Drug Overdose Events Attended by BCEHS, Severity Indicator, and Deaths Reported by Coroners in the Previous 12 Months Cheque Weeks Marked by Brown Triangles 600 2020 BC Illegal OD BC Projection

500

400

300 289 ODs

200

100

0 Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 May 01 May

50% 2020

40% 40.5%

30% Overdose Indicator Trends 20% Reporting Week: December 06, 2020 to December 12, 2020 Severity Indicator Severity 10% 1) Paramedic-Attended Overdose Events are based on paramedic data and exclude overdoses due to alcohol or prescription drugs (dark blue). To overcome the data time-lag, recent events are projected based on the historical proportion of 911 Ingestion 0% Poisoning calls later conﬁrmed as street drug overdoses (light blue). There were 289 Paramedic-Attended Overdose Events this reporting week. Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 May 01 May 2) The provincial severity indicator shown here is based on assessment during the 911 dispatch call. Severity was 40.5% this week. 3) Mortality data is from the BC Coroners service. Weekly provincial deaths due to illicit drug toxicity are shown here. The data is 60 2020 available to October 31, 2020 and is shown by epidemiological week ending October 31, 2020. 50 4) The side-by-side mortality map compares mortality at the Health Services Delivery Area (HSDA) from October, 2020, to the previous 12 months. 40 35 a. The following HSDAs had mortality in October, 2020, greater than 30 deaths per 100,000: 30 IHA: East Kootenay, Okanagan, Thompson Cariboo Shuswap; FHA: Fraser East, Fraser South; VCH: Vancouver; VIHA: Central Vancouver Island, North Vancouver Island, South Vancouver Island; NHA: Northeast, Northern Interior, 20 Northwest. b. The following HSDAs had mortality in October, 2020, between 25-30 deaths per 100,000: 10

Coroner Reported Coroner Deaths No HSDAs reported. c. The following HSDAs had mortality in October, 2020, less than 25 deaths per 100,000: 0 IHA: Kootenay Boundary; FHA: Fraser North; VCH: North Shore - Coast Garibaldi. d. The following HSDAs had no deaths in October, 2020: Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 May 01 May VCH: Richmond. Questions? Contact: [email protected] Weekly Overdose Placemat - Interior December 06, 2020 to December 12, 2020

Weekly Illegal Drug Overdoses Attended by BCEHS in the Previous 12 Months Percentage of Illegal Drug Overdoses Rated Severe in Previous 6 Months by Community Cheque Weeks Marked by Brown Triangles (Min. 10 ODs) IH Illegal OD IH Projection Oliver 2020 Lake Country

150 Salmon Arm Keremeos West Kelowna Cranbrook Creston 100 Kelowna ODs Vernon Enderby Kamloops Compared to 6 Months Prior 50 Merritt 41 Increasing Severity Penticton Decreasing Severity Summerland BC Average Williams Lake 0 Nelson 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May

Weekly Illegal Drug Overdose Deaths Reported by Coroners in the Previous 12 Months Percentage of Illegal Drug Overdoses Transported to Hospital in Previous 6 Months by Community Cheque Weeks Marked by Brown Triangles (Min. 10 ODs) 20 Merritt 2020 Salmon Arm Lake Country Williams Lake 15 Keremeos Vernon Cranbrook Oliver 10 Penticton Creston Kamloops Compared to 6 Kelowna Months Prior Coroner Reported Coroner Deaths 5 5 Nelson Increasing Transport Summerland Decreasing Transport West Kelowna BC Average Trail 0 Enderby 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May Weekly Overdose Placemat - Fraser December 06, 2020 to December 12, 2020

Weekly Illegal Drug Overdoses Attended by BCEHS in the Previous 12 Months Percentage of Illegal Drug Overdoses Rated Severe in Previous 6 Months by Community Cheque Weeks Marked by Brown Triangles (Min. 10 ODs) FH Illegal OD FH Projection 200 Port Moody 2020 Burnaby Agassiz Coquitlam 150 Mission Delta Port Coquitlam

ODs 100 Surrey White Rock 75 Chilliwack Compared to 6 Langley Months Prior 50 Increasing Severity Maple Ridge Decreasing Severity New Westminster Abbotsford BC Average 0 Hope 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May

Agassiz 25 2020 Hope Delta

20 Chilliwack Mission Surrey 15 Maple Ridge Abbotsford New Westminster 10 Port Coquitlam Compared to 6 8 Months Prior

Coroner Reported Coroner Deaths Langley Increasing Transport Burnaby 5 Decreasing Transport Coquitlam White Rock BC Average 0 Port Moody 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May Weekly Overdose Placemat - Vancouver Coastal December 06, 2020 to December 12, 2020

North Vancouver

150 Richmond

ODs Vancouver 100 104

West Vancouver Compared to 6 Months Prior 50 Increasing Severity Squamish Decreasing Severity

BC Average Powell River 0 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May

2020 Squamish

20 North Vancouver

15 Powell River

13 West Vancouver 10

Richmond Compared to 6 Months Prior Coroner Reported Coroner Deaths Increasing Transport 5 Sechelt Decreasing Transport

BC Average Vancouver 0 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May Weekly Overdose Placemat - Island December 06, 2020 to December 12, 2020

Weekly Illegal Drug Overdoses Attended by BCEHS in the Previous 12 Months Percentage of Illegal Drug Overdoses Rated Severe in Previous 6 Months by Community Cheque Weeks Marked by Brown Triangles (Min. 10 ODs) 150 Island Illegal OD Island Projection Central Saanich 2020 View Royal Qualicum Beach Ladysmith Saanich 100 Nanaimo Sooke Courtenay

ODs Port Alberni Langford Campbell River 50 50 Compared to 6 Victoria Months Prior Esquimalt Increasing Severity Colwood Decreasing Severity Duncan BC Average Parksville 0 Port Hardy 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May

Esquimalt 2020 View Royal Qualicum Beach 15 Central Saanich Port Alberni Parksville Campbell River 10 Courtenay Port Hardy Nanaimo 7 Ladysmith Compared to 6 Saanich Months Prior Coroner Reported Coroner Deaths 5 Duncan Increasing Transport Sooke Decreasing Transport Colwood BC Average Langford 0 Victoria 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May Weekly Overdose Placemat - Northern December 06, 2020 to December 12, 2020

100 Prince Rupert 2020 Vanderhoof 80 Smithers

60 Fort St John ODs Prince George 40 Compared to 6 Terrace Months Prior Increasing Severity 20 19 Dawson Creek Decreasing Severity

BC Average Quesnel 0 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May

10 2020 Vanderhoof

8 Smithers

Fort St John 6

Prince George

4 Compared to 6 Terrace Months Prior Coroner Reported Coroner Deaths Increasing Transport 2 2 Dawson Creek Decreasing Transport

BC Average Quesnel 0 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Jan 01 Jan 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Dec 01 Sep 01 Dec 01 Proportion of Total ODs May 01 May