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Yukoners face dark side of high levels of substance use

Coroner says deaths from drug overdoses causing ‘massive pain’ in Yukon
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The Yukon Coroner’s Service is reporting 21 opioid-related deaths in 2021. (Gabrielle Plonka/Yukon News file)

Opioid-related deaths in Yukon have surpassed the sky-high rate set by British Columbia. The Yukon’s Chief Coroner, Heather Jones, says the numbers are “both heartbreaking and staggering.”

Twenty-one people have died since January 2021 with opioids and fentanyl in their system.

“Opioid deaths now represent over 20 per cent of all deaths investigated by Yukon Coroner’s Service from Jan. 1 to Nov. 26, 2021,” Jones said.

For the last year, Jones has kept Yukoners up to date with statistics that have been on the rise since 2016, when opioids and fentanyl first showed up in toxicology reports in her office.

In a Nov. 29 news release she notes that since the spring of 2016, 64 individuals in the Yukon have lost their lives due to drug overdoses, 54 of those had opioids in their system, and 46 of those had fentanyl in their system as well.

“Most are dying alone,” Jones said.

Jones noted that a large percentage of the opioid-related deaths also involved cocaine and various formats of fentanyl, and that for some cases, alcohol and benzodiazepines are also seen.

Another observation by the coroner is that the effectiveness of Naloxone to stave off fatal overdose situations appears to be waning. Jones does not know whether that is due to new combinations of other drug additives or increased toxicity. COVID-19 altered the established supply routes of illicit substances to the Yukon, which likely affected the consistency of supply, which is challenging for users.

The dramatic increase in opioid-related deaths is not only in Yukon and B.C. On Nov. 30, the Canadian Medical Association (CMA) released a report, A struggling system: Understanding the health care impacts of the pandemic, which stated that there had been a 70 per cent increase in opioid-related deaths from 2019 to 2020.

It included the grizzly statistic that, across Canada in 2020, nearly 17 opioid-related deaths occurred every day, but that this rate increased to nearly 20 deaths per day in the first three months of 2021.

Yukon’s high numbers

The Yukon has traditionally used substances at higher rates than southern Canadians, annually topping the Canadian comparators for highest rates of alcohol consumption and achieving the highest value of per capita sales of cannabis.

Jones noted there should also be a recognition of the more over-riding but less measurable statistic of alcohol-related deaths in the territory.

As the pandemic has pulled people into their houses and constricted social relations, use of alcohol has increased as well. The CMA report says that amongst those 54 and under, drinking at home has increased.

Yukoners, whose per capita consumption of alcohol as measured in the global standard of “litres of absolute alcohol per person over 15 years of age” remained constant at 13 in 2019-20, still tops all the other provinces and territories. Canada’s rate of 8.1 pales compared to Yukon’s 13. A recent OECD (Organisation for Economic Co-operation and Development) report in 2021, using the same calculations for litres of absolute alcohol, again showed that Yukon’s consumption levels exceed the highest levels reported from any country around the world, with only with Latvia reporting a sliver less.

Community level consequences

The CMA report states that pandemic-related stress — emotional strain, changes in routine, closure of services like detox and rehab centres — may have increased substance use. And this was felt acutely in Yukon’s small rural communities too, as mental health supports and services went online, or switched to telephone, and workers transferred locations. It all meant that clients experienced inconsistency and uncertainty of support. Long-term,reliable support networks are critical to mental health and recovery from addiction.

On Nov. 17, a petition was tabled in the legislative assembly stating that “Mayo has experienced several substance use disorder-related deaths, with many being this past year.” The petition asks for the Yukon government to declare a state of emergency “to deploy an immediate response and develop trauma and culturally informed, resources in the community to address substance use.”

In October, the mayor of Mayo, Trevor Ellis, indicated that the deaths were widespread across all strata of the community and that they were not confined to a specific group of people.

“It’s hitting just run-of-the-mill normal people — these drugs now are so addictive,” he said.

Jones, too, stated that “no part of our society is unaffected” by the surge in fatalities. While men in their 40’s predominate the statistics over the last five years, the age range spans from people in their 20’s to their 70’s.

Disconnection one cause of addiction

The fact that most people are dying alone and that men predominate the statistics does not surprise Dr. John Ogrodniczuk.

Ogrodniczuk is a professor of psychiatry and director of the UBC psychotherapy program with a particular focus on personality disorders and men’s mental health. He spoke with the News on Nov. 25 about substance use, the Yukon’s situation and the invisible problem of what are sometimes called “deaths of despair.”

Ogrodniczuk believes that these opioid deaths, and other deaths related to other mental health circumstances and different substances, are inexorably linked.

“Substance use, by and large, is a kind of a coping strategy,” he said. “People use it to numb pain, and to distance themselves from thoughts and feelings of pain.”

Ogrodniczuk goes on to describe how people can have “a hyper-critical inner voice, and sometimes the only way they can get that voice to shut up is by drinking, smoking and taking other substances.”

He says that this relief only works for a short period of time, because inevitably the pain comes back, coupled with additional remorse, and that becomes a wicked and dangerous cycle that is hard to escape.

Ogrodniczuk says there is no blueprint or psycho-socio predictor.

“There are so many variables that contribute to any one individual’s pain and personal challenge,” he said.

“For almost all humans, our fundamental need is a sense of connection with others. We want to feel that we matter to others. And for many of us, that is our sense of meaning and purpose — that we have these connections.”

Ogrodniczuk’s research and counselling practice is mainly with men. In his work he found, from a sample of over 50,000 men, that the top indicators on a stress test were: lack of purpose, loss of connection with others and loneliness.

He says that men are reluctant to show weakness or vulnerabilities for fear of not looking strong or competent. They buy into the attitude that they need to go it alone. But, he says, we are social beings whether we like it or not.

And we need to understand that recovery takes time, he said. Long-term supports are absolutely crucial, he explained.

“Short-term interventions and their effectiveness over the long-term is very limited,” Ogrodniczuk said.

“If it’s taken years for a person, for these different kinds of challenges to become ingrained in their lives, there’s no such thing as a quick fix, it’s going to take time,” says Ogrodniczuk.

Necessary steps

Those who work in the Yukon Coroner’s Service have seen the most-deadly consequences of mind-altering substances first-hand. Jones says, “the pain is massive,” collectively, and throughout the territory.

As a way to honour the voices heard through these deaths, she stresses to the importance of working together courageously for change — to make a difference soon.

Contact Lawrie Crawford at lawrie.crawford@yukon-news.com