Beyond city limits: Strategies for preventing overdose deaths in rural British Columbia

Four years into the provincial overdose crisis, rural B.C. municipalities increasingly report overdose rates that meet, and often exceed, that of urban centres. In rural communities, where populations are dispersed and healthcare services limited, the overdose prevention strategies that have succeeded in urban centres may not apply. This report examines the geographical variations of British Columbia’s overdose crisis through an analysis of overdose rates across urban and rural municipalities. Socioeconomic factors are assessed for a subset of rural communities that, year-over-year, report the highest overdose rates in the province. This section of the report is supplemented by interviews with public health, addiction, harm reduction, and drug policy experts on the challenges to delivering overdose prevention services in rural settings. Findings from the research component of this report are used to develop a framework of analysis and recommendations for intervention. Due to the demographic complexities and urgent nature of the overdose crisis, this report recommends a short and long term strategy for increasing access to addiction treatment in rural settings. First, by streamlining the requirements for becoming a methadone prescriber, and second, through targeted opioid substitution programs designed for rural settings.