Urgent Call for B.C. Doctors: Time to Address Substance Use in Chronic Disease Patients!

New research reveals a startling truth: individuals suffering from chronic illnesses are at a far higher risk of dying from stimulant drug poisoning than from opioid overdoses. This alarming finding was shared by the B.C. Centre for Disease Control (BCCDC) on December 6, emphasizing the crucial need for healthcare providers to engage in open discussions about substance use with their patients grappling with these enduring conditions.

The study, published in BioMed Central Medicine, drew on insights from experts, clinicians, and individuals with firsthand experience, shedding light on the evolving landscape of drug-related deaths in British Columbia. Dr. Jatinder Baldwin, B.C.'s chief coroner, highlighted a disturbing trend: “In 2023, stimulant drugs were involved in a staggering 76% of illicit drug poisoning deaths.”

Patients with specific chronic conditions, such as heart failure or ischemic heart disease, are particularly vulnerable. The research indicates these individuals are roughly twice as likely to succumb to stimulant toxicity compared to opioid toxicity. Stimulants include substances like methamphetamine, cocaine, and various amphetamines, often associated with increased energy and alertness.

Dr. Heather Palis, the lead author of the study, pointed out an astonishing statistic: over a third of those who died from drug toxicity had interacted with healthcare professionals regarding their chronic illnesses within a month of their untimely death. This underscores a golden opportunity for the healthcare system to implement vital support services for at-risk patients.

Furthermore, the study revealed that during the period from January 2015 to December 2019, the BC Coroners Service documented 3,788 fatalities from drug toxicity, prompting further scrutiny into the complex interactions between stimulant and opioid use.

Dr. Frank Scheuermeyer, an emergency room physician at St. Paul’s Hospital in Vancouver, remarked on the intersection of the stimulant crisis and cardiovascular health, asserting, “It is imperative that healthcare providers conduct thorough screenings for cardiovascular diseases among stimulant users.”

Astoundingly, during the study's timeframe, 60% of the individuals who died from drug poisoning had both opioids and stimulants involved, while 11% died solely from stimulant toxicity— a clear indication of the multifaceted nature of substance misuse.

Beth Haywood, an advocate from a provincial peer advisory group, highlighted the stigma surrounding substance use that often prevents individuals from seeking medical assistance. “Many drug users feel unsafe disclosing their substance use to healthcare providers,” she stated, emphasizing the vital role primary care can play in initiating these necessary conversations.

The call for further research into the connections between chronic disease and stimulant use is urgent and welcomed by the co-authors of the study. As of September 2024, the statistics are grim: over 15,602 lives have been lost to unregulated drug poisoning in B.C. since 2016, making illicit drug toxicity the leading cause of death among individuals aged 10 to 59 in the province.

Healthcare professionals have a critical role to play in addressing this crisis, and the time to act is now. Failure to engage in these conversations could lead to even more tragic losses. Let’s shed light on this pressing issue to foster healing and save lives!