Fentanyl-Detected Illicit Drug Overdose Deaths January 1, 2012 to October 31, 2017

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Fentanyl-Detected Illicit Drug Overdose Deaths January 1, 2012 to October 31, 2017 Inclusion Criteria: This report summarizes all deaths that occurred between January 1, 2012 and October 31, 2017 for which fentanyl or its analogues were detected, whether alone or in combination with other drugs, and the death resulted from illicit drug use [1]. In the majority of deaths, fentanyl or its analogues [2] were detected in combination with other drugs. Deaths were excluded if the fentanyl was known to be prescribed or the death was suspected to be due to intentional self-harm. This data has been compiled to better understand overall illicit drug overdose trends in British Columbia and to inform other agencies public safety strategies in a timely manner. [1] Please see the BC Coroners Service website for a summary of illicit drug overdose deaths: http://www2.gov.bc.ca/gov/content/safety/public-safety/death-investigation/statisticalreports. Note that fentanyl-detected data is subject to change as further analogue testing becomes available. Summary: There were 999 illicit drug overdose deaths with fentanyl detected from January through October 2017. This is a 136% increase over the number of fentanyl detected deaths (423) occurring during the same period in 2016. From January to October 2017, fentanyl was detected in approximately 83% of illicit drug overdose deaths. Carfentanil has been detected in 48 suspected illicit drug overdose deaths in June- October 2017. Note this is subject to change as further toxicology results are received. Approximately 28% of those dying from January to October 2017 were aged 30 to 39, with 92% between 19 and 59. Males accounted for 83% of all deaths during this period. Fraser Health Authority had the highest number (324) of illicit drug overdose deaths with fentanyl detected from January through October 2017, followed by Vancouver Coastal Health (289) and Vancouver Island Health Authority (174). [3],[4] The Health Service Delivery Areas with the most fentanyl-detected illicit drug overdose deaths from January through October 2017 were Vancouver HSDA (239), Fraser South HSDA (161), and Okanagan HSDA (109). When looking at individual townships over the same time period, the highest numbers of deaths were seen in Vancouver, Surrey, and Victoria. [3],[4] Ministry of Public Safety and Solicitor General Posting Date December 11, 2017 Office of the Chief Coroner Metrotower II, Suite 800 4720 Kingsway, Burnaby BC V5H 4N2 Phone: 604 660-7745 Fax: 604 660-7766 Page 1 of 6

Preliminary data for January through October 2017 suggest that the proportion of apparent illicit drug overdose deaths with fentanyl detected (alone or in combination with other drugs) is approximately 83%. Proportions from 2012 to 2017 are as follows: o 2012 = 4% o 2013 = 15% o 2014 = 25% o 2015 = 29% o 2016 = 68% o 2017 (Jan.-Oct.) = 83% 100% 80% 60% 40% 68% 83% 20% 0% 25% 29% 15% 4% 2012 2013 2014 2015 2016 2017 YTD fentanyl detected no fentanyl detected Page 2 of 6

Fentanyl-Detected Deaths by Month, 2012-2017 [3] Month 2012 2013 2014 2015 2016 2017 January 0 5 5 20 46 107 February 0 3 5 8 29 104 March 0 6 9 8 48 116 April 1 8 8 12 48 127 May 1 3 8 8 37 108 June 1 2 6 11 42 100 July 0 1 3 14 40 99 August 1 4 8 15 38 100 September 1 2 9 15 42 64 October 0 4 13 16 53 74 Subtotal 5 38 74 127 423 999 November 4 6 6 12 112 December 3 6 11 13 133 Total 12 50 91 152 668 999 Fentanyl-Detected Deaths by Sex, 2012-2017 [3] Sex 2012 2013 2014 2015 2016 2017 Total Female 2 9 21 26 126 172 356 Male 10 41 70 126 542 827 1,616 Fentanyl-Detected Deaths by Age Group, 2012-2017 [3] Age Group 2012 2013 2014 2015 2016 2017 Total 10-18 0 1 0 2 12 13 28 19-29 3 19 28 43 153 196 442 30-39 2 10 33 45 198 283 571 40-49 6 13 19 29 154 233 454 50-59 1 5 7 24 120 204 361 60+ 0 2 4 9 31 70 116 Page 3 of 6

Fentanyl-Detected Deaths by Health Authority of Injury, 2012-2017 [3],[5] HA 2012 2013 2014 2015 2016 2017 Total Interior 2 3 9 21 117 170 322 Fraser 7 16 29 57 209 324 642 Vancouver Coastal 1 10 26 40 183 289 549 Vancouver Island 1 14 17 22 123 174 351 Northern 1 7 10 12 36 42 108 Fentanyl-Detected Deaths by Health Service Delivery Area of Injury, 2012-2017 [3],[5] HSDA 2012 2013 2014 2015 2016 2017 Total East Kootenay 0 1 2 1 6 4 14 Kootenay Boundary 0 0 1 2 4 11 18 Okanagan 2 1 4 14 62 109 192 Thompson Cariboo Shuswap 0 1 2 4 45 46 98 Fraser East 1 3 1 10 37 74 126 Fraser North 1 6 15 28 71 89 210 Fraser South 5 7 13 19 101 161 306 Richmond 0 0 0 3 13 19 35 Vancouver 1 5 22 32 153 239 452 North Shore/Coast Garibaldi 0 5 4 5 17 31 62 South Vancouver Island 1 3 2 9 60 80 155 Central Vancouver Island 0 10 13 10 46 67 146 North Vancouver Island 0 1 2 3 17 27 50 Northwest 0 1 0 1 7 4 13 Northern Interior 1 3 4 7 14 27 56 Northeast 0 3 6 4 15 11 39 Page 4 of 6

Fentanyl-Detected Deaths by Month of Death and Health Authority of Injury, 2017 [3],[5] HA Interior Fraser Vancouver Vancouver Coastal Island Northern Total January 13 34 41 18 1 107 February 17 30 30 22 5 104 March 17 39 31 23 6 116 April 18 39 47 18 5 127 May 20 42 28 11 7 108 June 20 29 26 22 3 100 July 24 33 24 14 4 99 August 21 30 24 17 8 100 September 7 21 21 12 3 64 October 13 27 17 17 0 74 Total 170 324 289 174 42 999 Fentanyl-Detected Deaths by Top Townships of Injury, 2012-2017 [3],[5] Township 2012 2013 2014 2015 2016 2017 Total Vancouver 1 5 22 32 153 239 452 Surrey 3 4 8 11 74 117 217 Victoria 0 3 2 8 54 70 137 Kelowna 0 0 1 6 38 58 103 Nanaimo 0 8 12 9 27 36 92 Abbotsford 0 1 1 6 22 34 64 Burnaby 0 3 0 6 27 29 65 Kamloops 0 1 2 3 30 29 65 Langley 1 1 5 6 19 29 61 Maple Ridge 0 3 7 12 20 21 63 Other Township 7 21 31 53 204 337 653 *sorted by 2017 data Page 5 of 6

Notes: 1. The BCCS operates in a live database environment. Some data for more recent years are based on preliminary circumstances and are subject to change as investigations are concluded. Data are not directly comparable to published counts from previous years. 2. Toxicology testing includes acetylfentanyl as of November 2015. Standard testing for carfentanil, 3-methylfentanyl, furanylfentanyl, and W-18 began in June 1, 2017. Fentanyldetected data is derived from testing conducted by the BC Coroners Service. 3. Data for 2017 include cases from January 1 to October 31, 2017. 4. Data are based on location of injury. 5. Death township was used in seven cases where injury township was unknown. 6. More information about the health regions can be found at http://www2.gov.bc.ca/gov/content/data/geographic-data-services/land-use/administrativeboundaries/health-boundaries Page 6 of 6