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 March 28, 2021 to April 03, 2021

Illicit Drug Toxicity 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 BC Illegal OD BC Projection 600 2021

500

400 387

ODs 300

200

100

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

50% 2021 44.5% 40%

30% Overdose Indicator Trends 20% Reporting Week: March 28, 2021 to April 03, 2021 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 387 Paramedic-Attended Overdose Events this reporting week. Jul 01 Jul Apr 01 Oct 01 Apr 01 Jun 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Sep 01 Dec 01 May 01 May 01 May 2) The provincial severity indicator shown here is based on assessment during the 911 dispatch call. Severity was 44.5% 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 2021 available to February 28, 2021 and is shown by epidemiological week ending February 27, 2021. 50 4) The side-by-side mortality map compares mortality at the Health Services Delivery Area (HSDA) from February, 2021, to the previous 12 months. 40 38 a. The following HSDAs had mortality in February, 2021, greater than 30 deaths per 100,000: 30 IHA: Thompson Cariboo Shuswap; FHA: Fraser East, Fraser North, Fraser South; VCH: Vancouver; VIHA: North Vancouver Island, South Vancouver Island; NHA: Northeast, Northern Interior. 20 b. The following HSDAs had mortality in February, 2021, between 25-30 deaths per 100,000: IHA: East Kootenay; VIHA: Central Vancouver Island. 10

Coroner Reported Coroner Deaths c. The following HSDAs had mortality in February, 2021, less than 25 deaths per 100,000: IHA: Okanagan; VCH: North Shore - Coast Garibaldi; NHA: Northwest. 0 d. The following HSDAs had no deaths in February, 2021: IHA: Kootenay Boundary; VCH: Richmond. Jul 01 Jul Apr 01 Oct 01 Apr 01 Jun 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Sep 01 Dec 01 May 01 May 01 May Questions? Contact: [email protected] Weekly Overdose Placemat - Interior March 28, 2021 to April 03, 2021

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 Merritt 2021 Williams Lake 150 West Kelowna

Kelowna

Oliver 100 Vernon ODs Kamloops

Penticton 58 Compared to 6 Months Prior 50 Salmon Arm Increasing Severity Trail Decreasing Severity

Cranbrook BC Average

0 Nelson 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Apr 01 Jun 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Sep 01 Dec 01 Proportion of Total ODs May 01 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 Salmon Arm 2021 Merritt

Cranbrook 15 Oliver

Williams Lake

Nelson 10 Vernon

7 Kamloops Compared to 6 Months Prior

Coroner Reported Coroner Deaths Kelowna 5 Increasing Transport Penticton Decreasing Transport

West Kelowna BC Average

0 Trail 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Apr 01 Jun 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Sep 01 Dec 01 Proportion of Total ODs May 01 May 01 May Weekly Overdose Placemat - Fraser March 28, 2021 to April 03, 2021

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 White Rock 2021 Coquitlam Port Moody Burnaby 150 Hope 127 Port Coquitlam Surrey

ODs 100 New Westminster Delta Compared to 6 Chilliwack Months Prior 50 Abbotsford Increasing Severity Decreasing Severity Maple Ridge Langley BC Average

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

White Rock 25 2021 Port Moody New Westminster 20 Chilliwack Hope Delta 15 Maple Ridge 13 Mission 10 Coquitlam Compared to 6 Surrey Months Prior Coroner Reported Coroner Deaths Langley Increasing Transport 5 Decreasing Transport Abbotsford Burnaby BC Average

0 Port Coquitlam 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Apr 01 Jun 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Sep 01 Dec 01 Proportion of Total ODs May 01 May 01 May Weekly Overdose Placemat - Vancouver Coastal March 28, 2021 to April 03, 2021

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) VCH Illegal OD VCH Projection 2021 200 North Vancouver

West Vancouver 150 135 Richmond

ODs 100 Vancouver Compared to 6 Months Prior 50 Powell River Increasing Severity Decreasing Severity

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

2021 North Vancouver

20 West Vancouver

15 Richmond

12 Squamish 10

Vancouver Compared to 6

Coroner Reported Coroner Deaths Months Prior 5 Powell River Decreasing Transport

BC Average Sechelt 0 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Apr 01 Jun 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Sep 01 Dec 01 Proportion of Total ODs May 01 May 01 May Weekly Overdose Placemat - Island March 28, 2021 to April 03, 2021

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 Ladysmith 2021 View Royal Saanich Nanaimo 100 Parksville Campbell River

ODs Port Alberni Sooke 50 Langford Compared to 6 46 Months Prior Duncan Increasing Severity Victoria Decreasing Severity

Courtenay BC Average

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

Sooke 2021 View Royal

15 Langford Port Alberni Courtenay Nanaimo 10 Ladysmith Duncan

6 Saanich Compared to 6 Months Prior Coroner Reported Coroner Deaths 5 Campbell River Increasing Transport Parksville Decreasing Transport

Esquimalt BC Average

0 Victoria 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Apr 01 Jun 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Sep 01 Dec 01 Proportion of Total ODs May 01 May 01 May Weekly Overdose Placemat - Northern March 28, 2021 to April 03, 2021

100 Smithers 2021

Fort St John 80

Fort St James 60

ODs Dawson Creek

40 Prince George Compared to 6 Months Prior Increasing Severity 20 21 Quesnel Decreasing Severity

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

12 Fort St James 2021

10 Terrace

8 8 Fort St John

6 Quesnel

Prince George Compared to 6 4 Months Prior Coroner Reported Coroner Deaths Increasing Transport Smithers Decreasing Transport 2 BC Average Dawson Creek 0 0% 20% 40% 60% 80% 100% Jul 01 Jul Apr 01 Oct 01 Apr 01 Jun 01 Jun 01 Jan Feb 01 Feb Mar 01 Aug 01 Aug Nov 01 Nov Sep 01 Dec 01 Proportion of Total ODs May 01 May 01 May