More than a third of people using drugs in Vancouver, Canada reported a decline in the quality of drugs during the COVID-19 pandemic, according to a new study published in the journal Substance and alcohol dependence. The decrease in drug quality was associated with an increased risk of experiencing a non-fatal overdose. The research results support calls for a safer, regulated supply for people who use drugs to prevent further deaths from an increasingly toxic and unpredictable supply.
Data for the study came from three ongoing cohorts of people using drugs in Vancouver: those from the At-Risk Youth Study, the Vancouver Injection Drug Users Study, and the AIDS Care Cohort to evaluate exposure to survival services. Researchers from Simon Fraser University, the British Columbia Center for Substance Use, the University of British Columbia, Curtin University and the Burnet Institute Behaviors and Health Risks Program in Melbourne, Australia, conducted the study – along with co-authors who included people with living and experience with living drug use.
Secure supply required
Researchers note that while harm-reduction measures such as monitored consumption points and naloxone distribution programs are crucial to saving lives, they do not fully address the increased risks and challenges posed by an increasingly toxic drug supply.
Their findings underscore the need to implement low-barrier and accessible models for a regulated and more secure supply of medicines to prevent further deaths.
“Our research findings reinforce what society of people using drugs has said since the pandemic was declared – the supply of drugs is increasingly toxic, dangerous and unpredictable, and people need safer options if we are to help keep them. alive, “says senior author of the study Kora DeBeck, an SFU associate professor at SFU’s School of Public Policy. DeBeck leads the At-Risk Youth Study and researches drug-related injury prevention.
Evidence of decrease in drug quality during the pandemic
Researchers surveyed 738 people using drugs, by phone or video conference, between July and November 2020. They found that 272 people or 36.9 percent of respondents reported a decrease in drug quality.
Those who reported a decrease in drug quality were also significantly more likely to report that they had experienced a recent non-fatal overdose, frequent drug use, and stimulant use.
People who regularly use stimulants were significantly more likely to report a decrease in the quality of drugs – a worrying finding, as data from BC Coroners Service found that cocaine was present in 46.2 percent of deaths from 2019 to 2021. Researchers suggest a safer supply is needed for those using stimulants as well as opioids.
“The perception is that it is the toxic drug supply of opioids that kills people, but contaminated stimulants also kill a large number of stimulant users,” says Kali Sedgemore, co-author of the study and a youth injury reduction and peer navigator / supervisor with Molson Overdose Prevention Site and Mobile Unit in Vancouver. “Many young people rely on stimulants as a survival tactic to stay safe, alert and protect themselves on the streets. Injury mitigation and other services will help support these realities for young people.”
Contamination of BC’s unregulated drug supply with benzodiazepines is another concern and increases the risk of overdose. Researchers say benzodiazepines occur more frequently during drug control in the community.
“If anyone is still wondering why overdoses continue at higher rates than ever before, just look at the drug supply,” says Dean Wilson, co-author of the study and head of peer engagement with BC Center on Substance Use. “The supply only became more unpredictable in 2016. What happened? People died. In 2020, supply became worse and more dangerous. What happened? More people died. The drug supply kills people. Regulate drugs and get people access to a safer supply where they know , what they use. “
Part of a global problem
The decline in drug quality during the pandemic is a global problem. Research conducted by the International Network of People Who Use Drugs showed that 50 to 70 percent of respondents globally reported that the quality of drugs fell during the pandemic.
The decline in quality is thought to have been influenced by border closures and travel bans; measures to control the spread of COVID-19, which also restricted the drug supply chain. These measures left an opening for an increased flow of fentanyl and other drugs that are more easily traded by mail, according to the United Nations Office on Drugs and Crime. Lack of methamphetamine production and trade and heroin deficiency during the pandemic may also have altered or replaced with synthetic opioids such as fentanyl.