Yukon has joined B.C. in declaring a substance use emergency. What does that mean?

Perry Kendall, British Columbia's former provincial health officer, watched as the number of illicit drug deaths continued to rise, unabated, in the province in the spring of 2016.

Three people died on averageeveryday in B.C. from illicit drugs at the time an indication, Kendall said, that what his office was doing to try to curb the number of deaths wasn't working.

He decidedto call a public health emergency, on April 14, 2016.

"Despite the fact that we were doing a lot of preventative work, the numbers just kept going up," Kendall told CBC.

The Yukon government followed suit, almost six years later, calling a substance usehealth emergency last month following a dramatic increase of deathsthat mirroredwhatKendall had seenin B.C.

Eight people in Yukon died from illicit drug use between Jan. 3 and 24, according to the most recent news release from the territory's chief coroner. Toxicology results are still pending for one other case, but preliminary evidence suggests illicit drugs werea factor.

Declaration brought attention, rural services to B.C.

Kendall said B.C.'semergency declaration brought local and national attention to what was happeningin that province, allowing for more federal support to trickle down to more health-care services.

It also justified new spending or policy changes by the provincial governmentto address the crisis.

"I think [an emergency declaration] gives you more political power because it says we recognize it is an emergency and we want to mobilize the resources we can," he said.

The other immediate change, Kendall said, was more flexibility with how the province collecteddata on where and when peoplewould overdose. That helped officialsredirect services to parts of the province thatwere most in need, he continued.

"We were able to develop 'heat maps,'" Kendall said. "You get weekly data of where they responded to an overdose call, what time of day it was.

"Without the data, you really can't plan and you can't determine whether [people are] accessing these services."

Before the declaration, Kendall said, British Columbians outside of Vancouver didn't have much access to supervised consumption sites and other services to manage addictions.

That started to change after the emergency declaration, when more federally sanctioned opioid prevention sites popped up across the province that December. One studyfound that these sites slightly increased the number of B.C. users who sought out a supervised consumption site or another addiction treatment over time.

Other changes, such asmaking a safe supply of methadone available and online training programs, "gradual[ly] ramp[ed] up" in the months and years afterwards, according to Kendall.

Still, Kendall said, the province has a long way to go when it comes to fighting its ongoingopioid crisis.Tackling the supply chain is an essential element, he says.

Expand safe supply to B.C. model, former medical officer says

Yukon MP Brendan Hanley watched what happened in B.C. closely, in his former role as Yukon's chief medical officer.

Yukon saw its first fentanyl-related drugdeathin 2016, too, but Hanley said officialsdidn't need to declare a state of emergency at the time.

"I think what we're seeing now is so much more of an augmentation, an acceleration of the crisis and despite all of our measures, we're still continuing to see an alarming ... number of deaths," Hanley recently told CBC.

Hanley said he looked to B.C.at the time to figure out how to widely distributenaloxone kits in the Yukonand to offer safe supply options like methadone and suboxone.

The territory also introduced a public awareness campaign in 2016, including a public alert,on the dangers of fentanyl. By 2018, the territory put in place anopioid response plan, a way of "putting down on a page" what the territory wanted to do to mitigate the number of deaths, according to Hanley.The plan was not renewed when it ended in 2020.

When asked whether those measures made a difference, Hanley said he's "convinced" they have.

Still, there are some ways the Yukon government should again follow B.C.'s example, like improving accessto the territory'ssafe supply program, Hanley continued.

'We don't know if it would've been worse'

Kendall acknowledges that, despite B.C.'semergency declaration, the number of deaths continues to go up reaching 39.4 deaths per 100,000 peoplein 2021. He attributes that mostly to increased substance use during the COVID-19 pandemic and difficulties getting in-person services.

"I think the situation was getting better," he said. "Then COVID[-19] came along and the world essentially changed."

Dr. Catherine Elliott, Yukon's acting chief medical officer, was asked last month about what the Yukon could learn from B.C.'s declaration.She acknowledged that the province's numbers haven't improved, but that "we don't know if it would've been worse" if the declaration had never been made.

"Declaring a crisis doesn't solve the problem it's doing things," Elliott said, in French.

The Yukon government has already promised a long list of actions to address the substance use emergency, including the launch of a territory-wide public awareness campaign and expanding drug testing and safe supply to communities outside Whitehorse. The territorial government's spring budget will include dedicated funding to these initiatives.

Next steps will be planned during the first phase of a virtual mental wellness summit with Yukon First Nations leaders in February.