Medical Health Officer Report to Town of Qualicum Beach Council April 25, 2016

Transcription

1 Medical Health Officer Report to Town of Qualicum Beach Council April 25, 2016 Substance Use and Misuse

2 Substance use: Mortality and Morbidity Relatively, drugs receive more attention than more common substances.

3 Rates per 100,000 population 1000 Standardized Rate of Alcohol and Tobacco Hospitalizations by LHA, Island and BC The changing picture alcohol increasing while tobacco decreasing for hospitalization rate. Oceanside tobacco hospitalizations relatively high Qualicum Alcohol Hospitalizations 69 - Qualicum Tobacco Hospitalizations Vancouver Island Alcohol Hospitalizations Vancouver Island Tobacco Hospitalizations BC Alcohol Hospitalizations BC Tobacco Hospitalizations

4 Alcohol Use

5 Alcohol Related Mortality 60 Standardized Rate of Alcohol Deaths,

6 Liters of Absolute Alcohol Alcohol consumption per capita is generally increasing 12 Annual per Capita Alcohol Consumption to Per capita consumption is slightly lower in Oceanside. Recent increase is noted Qualicum Vancouver Island

7 Liters of Absolute Alcohol Annual per capita Alcohol Consumption, Island Health - 5 Year Average from 2010 to Consumption driven by location of purchase

8 Number of BC Deaths Number of Vancouver Island Deaths 500 Illicit Drug Overdose Deaths in BC and Vancouver Island, Drug overdose resurgence since December 2015 and January 2016 highest monthly number of deaths on record * 10 0 BC Vancouver Island

9 The Changing Street Environment Fentanyl has become more available in last 3 years. Effect comparable to heroin - may be longer lasting. Most product imported - not medical diversion. Higher concentration allows for smaller weights to be smuggled. Cheaper. Newer molecular analogues of fentanyl appearing on island, in province and nationally. Added issue: Poly pharmacy with many street supplies including narcotics and stimulants.

10 Longer Term Needs Effective prevention of drug use and addiction. School/university programming Early intervention activities Access to peer support/counselling Major policy shifts. Address negative impacts of underground economy Access for users to test drug product Safer consumption sites. Increased access to detox and treatment programs. Treatment effectiveness low and best setting unclear Current 12 detox beds for whole of Central Island 2-3 wk wait (Nanaimo) 500 beds initiative Rehab expensive Health professionals with more addiction training. Increased access to opiate substitution (methadone).

11 Marijuana Not a special case. Special only in regulatory environment changing. Many issues that local governments may wish to consider.

12 Issues Few proven health benefits, some health risks. Risk:benefit akin to alcohol. Dispensaries can be regulated to some extent by local government, but are not authorized by Health Canada that may change. Product currently not monitored for quality. Authorized growers/dispensors need only advise local governments, but are not required to obtain approval.

13 So What. Local governments can impact accessibility and can contribute to worsening or alleviating substance use issues. Local governments need to be aware of and involved in decisions related to marijuana including setting policy direction. Substance use impacts have long been problematic, and require community wide solutions.

14 Housing as a Community Solution Good evidence of value Local governments have significant influence, RDN has been a leader. RDN affordable housing approach Need for diverse options Detox, transition housing, collective supported environments Zoning and NIMBY issues

15 Advocacy Options Advocate for effective solutions Build hope Treatment and detox options Financial supports for clients Municipal Alcohol Policy

16 Additional Resources Centre for Addictions Research BC Canada s Public Health Officer 2015 report Canadian Centre on Substance Abuse

17 Paul Hasselback MD MSc FRCPC Medical Health Officer Central Vancouver Island

18 Outline Alcohol consumption increasing. Illicit drugs in midst of a tragedy. Marijuana the Changing environment. Prescription drug use on the horizon. Treatment options limited. Role for local government.

19 Rates per 100,000 Population Standardized Rate of Alcohol and Tobacco Deaths by LHA, Island and BC, Tobacco Alcohol Qualicum Alcohol Deaths 69 - Qualicum Tobacco Deaths Vancouver Island Alcohol Deaths Vancouver Island Tobacco Deaths BC Alcohol Deaths BC Tobacco Deaths

20 Rates per 100,000 Population Standardized Rate of Drug Hospitalizations and Deaths by LHA, Island and BC, Hospitalizations Deaths Qualicum Drug Hospitalization 69 - Qualicum Drug Deaths Vancouver Island Drug Hospitalization Vancouver Island Drug Deaths BC Drug Hospitalization BC Drug Deaths

21 Liters of Absolute Alcohol 18 Annual per Capita Alcohol Consumption,

22 Substance Use Trend

23 Prescription Drug Overdoses Increasing. Aging of persons with chronic pain. Misuse More controls in place