A major report on Vancouver’s overdose epidemic states that five years into the crisis, there is no end in sight.

“Despite concerted efforts by government and community partners,” the report begins, “Vancouver continues to be severely impacted by the convergence of a long-standing mental health and addictions crisis and increasingly potent and toxic drug supply, creating a sustained overdose crisis that will claim about the same number of lives in Vancouver in 2018 as it did in 2017.”

The city’s rate of overdose deaths stands at 58 per 100,000 people. That’s high enough to rank Vancouver among the very worst-affected areas of the United States.

“Vancouver continues to be the most impacted city of the overdose crisis in Canada,” the report notes.

The document is scheduled to go to council on Thursday (December 20). It is the first major product of the Mayor’s Overdose Emergency Task Force, a body that Vancouver’s new mayor, Kennedy Stewart, established shortly after he was elected to office last October.

“With almost one person dying every day from overdosing in Vancouver, this reality is unacceptable,” Stewart said quoted in a media release.

While most of Vancouver’s fatal overdoses continue to occur in the Downtown Eastside, the ratio of overdose calls to fatal overdoses is significantly wider there than in most other areas of Vancouver, the report notes.

In the Downtown Eastside, there are 27 overdose calls for every one fatal overdose and, in neighbouring Grandview-Woodland, there are 38 overdose calls for each overdose death.

This suggests that the harm-reduction programs deployed there—supervised-consumption sites, for example, and outreach teams trained in overdose response—appear to doing their jobs.

Meanwhile, in Kitsilano, there are 18 calls for every one death. In Fairview, there are 11, in Mountain Pleasant, there are 13, and in South Cambie-Riley Park, there are 12.

In Kensington, a community that includes a concentration of survival sex workers along Kingsway, there are just four overdose calls for each overdose death. That’s prompted special attention from the city. “The gap in services and programs in this area has created barriers to accessing services and support for survival sex workers, many of whom are affected by the opioid overdose crisis,” the report reads.

It repeatedly recommends that harm-reduction programs that have proven effective in saving lives in the Downtown Eastside expand into other areas of the city.

For example, during the winter of 2016, supportive-housing providers such as Atira Women’s Resource Society, the Portland Hotel Society (PHS), and RainCity Housing integrated supervised-consumption spaces for drug users, essentially decriminalizing drugs inside their buildings. This has had the effect of reducing stigma and promoting safer practices for using drugs. City staff have now recommended that other nonprofit-housing providers and privately-owned buildings copy those examples.

The report also recommends the city work with provincial partners including the B.C. Centre on Disease Control to make clean prescription drugs available to people addicted to opioids who are risking their lives with fentanyl on the streets. Fentanyl, a dangerous synthetic opioid, is associated with more than 80 percent of fatal overdoses in B.C. this year.

In a telephone interview, Jordan Westfall, president of the Canadian Association of People Who Use Drugs (CAPUD), described the report as encouraging, but criticized the review for failing to devote much attention to how policing and the criminalization of addiction are exacerbating the crisis. (This characterization was acknowledged in the report itself. “There were several Task Force members voicing concerns that until illicit drug use is decriminalized, the fear of using illegal substances will continue to keep drug users isolated," it reads. "There was also concern expressed about alleged arrests of low level dealers and how this impacted people’s access to a more trusted drug supply through their dealer was raised.”)

“We are very disappointed the city still refuses to discuss the role that the VPD plays in worsening the overdose crisis,” Westfall said.

He also suggested the time for reports on the crisis has passed.

"We’ve been task-forced to death the last couple of years," Westfall said.

As of December 16, there were 353 fatal overdoses in the city of Vancouver during 2018. That compares to 367 during all of 2017. From 2001 to 2010, the average number of fatal overdoses in Vancouver each year was 57.

Across B.C., it’s projected the province will see roughly 1,500 fatal overdoses this year. That compares to an average of 204 fatal overdoses recorded from 2001 to 2010.

Karen Ward is a former Vancouver Area Network of Drug Users (VANDU) board member and more recently has served as a consultant on drug use for the B.C. Centre for Disease Control. She criticized the report for a lack of urgency.

“It does not acknowledge that the constant state of emergency in this neighbourhood [the Downtown Eastside] needs to end,” Ward told the Straight. “It implies that the status quo in this neighbourhood is fine, and it is not.”