A decade after British Columbia declared a public health emergency due to a devastating wave of toxic drug poisonings, a new report from Fraser Health highlights six key lessons learned. The crisis, which began in 2016, has claimed approximately 18,000 lives across the province, with over 5,600 deaths in the Fraser Health region alone. While the death rate is slowly declining, health officials emphasize the need for continued action based on data, evidence, and lived experiences.
1. The Threat Extends Beyond Fentanyl
Initially, fentanyl was the primary driver of the crisis, but the illicit drug supply has become increasingly unpredictable. Traffickers are introducing more toxic and powerful substances, including benzodiazepine-like drugs such as etizolam, which complicate treatment and reduce the effectiveness of naloxone. In November 2025, the veterinary sedative medetomidine was found in 38% of opioid samples tested in the Fraser Health region, posing new challenges for first responders.
2. The Crisis Affects More Than the Homeless
While homelessness is a significant risk factor, the majority of overdose deaths occur in private residences. Public overdoses often prompt 911 calls and rescue, but those using alone at home are less likely to receive timely help. The crisis disproportionately impacts men aged 30 to 59, Indigenous and South Asian communities, as well as youth and young adults. Workers in trades and transport industries are also heavily affected.
3. Housing Is a Critical Intervention
Adopting a housing-first approach has proven essential. Providing stable housing enables individuals to access health services and reduces their risk of fatal overdoses. However, housing alone is not enough; it must be paired with comprehensive support services, including mental health and addiction treatment.
4. Stigma Remains a Barrier
Stigma surrounding drug use continues to prevent many people from seeking help. Public education campaigns and community engagement are vital to reducing discrimination and encouraging those affected to access treatment and harm reduction services.
5. Data and Monitoring Are Essential
Real-time monitoring of the illicit drug supply has been crucial for identifying emerging threats and guiding public health responses. Continuous surveillance allows authorities to issue warnings and adapt treatment protocols quickly.
6. Collaboration Is Key
The crisis requires a coordinated response across health authorities, police, housing agencies, governments, Indigenous organizations, and community groups. No single entity can solve the problem alone. Partnerships and shared resources have led to incremental progress, but sustained effort is needed to turn the tide.
Dr. Ingrid Tyler, Fraser Health's chief medical officer, stated: "We are committed to acting on what we've learned from data, emerging evidence, and from those with lived experiences. While we have made some important progress, we must continue strengthening our response."
