Drug overdoses killed hundreds of people in British Columbia in 2016, and no group died more often than men.
Men accounted for more than 80 percent of OD deaths across the province, or 605 of the 755 recorded deaths between January and November of 2016. Nearly 60 percent of them were between the ages of 19 and 39.
The super-potent opioid fentanyl has been detected in 299 male OD cases so far, compared with 75 cases involving women.
Though the gender gap appears to be a striking one, it's far from a new trend. Over the last decade, the proportion of men dying of overdose has hovered around 75 percent—rising from 72.2 to 80.1 percent since 2011, according to coroner data.
Why do so many more men die of drug overdose than women? As anyone who has ventured onto a Reddit comment forum can probably guess, it's difficult to raise this question without eliciting a fair volume of rage and anti-feminist conspiracy. What you don't tend to hear are answers based on scientific research and first-hand experience. VICE reached out to a few experts to get a fuller picture of what's going on.
One of the reasons for the disparity, say researchers in the field, is that men on average take more hard drugs than women. The most recent Canadian survey on alcohol, tobacco and drug use found that about one percent of women reported taking "hard" drugs (including coke, crack, ecstasy, meth, acid, or heroin) within the past year, compared with three percent of men.
According to a University of British Columbia nursing professor who studies youth, gender and drug use, the way men and women use drugs may also be a contributing factor.
"Some research has shown that women tend to use with others, and are less likely to be alone when they're injecting drugs or using other medications," UBC's Elizabeth Saewyc told VICE. When other people are around, there's a better chance that someone will be able to respond quickly and get them some help, she said.
With the rise of deadly synthetic opioids like fentanyl and carfentanil, which have increasingly been found in BC street drugs, the risk of dying while using alone has risen significantly. On top of using alone, opioid-dependent men may be less cautious, according to Saewyc: "It may be that they're taking larger doses without recognizing the potential risks there."
Frontline activist Sarah Blyth, who helped establish a cluster of volunteer-run overdose prevention tents in Vancouver's Downtown Eastside, told VICE that theory is backed up by her experience on the ground. "Men are more likely to use alone," she said. "Using alone is the thing that's actually killing people."
Blyth added that men are also over-represented in Vancouver's homeless population. "It's not surprising to people in the Downtown Eastside," she said. "There are more men than women living here." The latest homeless count in Vancouver found that about 76 percent of the city's street homeless were men.
Although the percentages may match up, Saewyc warned against jumping to conclusions about street homelessness and overdose rates. "You have to be careful about definitions of street homelessness, and who gets counted where," she said. "If women are able to temporarily access couch surfing, or go home with a sexual partner, they may not be counted… I would be cautious, as we don't have an underlying denominator."
Though risk taking, drug use and homelessness are cross-cutting issues, Saewyc says more research is needed. "It's clearly a huge health issue, and one that we definitely need to get a better handle on," she said.
VICE reached out to the BC Coroner for comment, but did not receive a reply by press time.
Follow Sarah Berman on Twitter.