A new report from Fraser Health breaks down the lessons for battling increasingly deadly illicit street drugs.
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A public health emergency was declared 10 years ago this month as B.C. was hit by an unrelenting wave of toxic drug poisonings and overdose deaths. Health authorities, police, housing agencies, governments, Indigenous and social welfare organizations and many others have struggled to stem the tide, and the death rate is slowly — much too slowly — beginning to ease.
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A report from Fraser Health’s chief medical officer released this week discusses the challenges, successes and failures, and lessons learned in facing the crisis. The report focuses primarily on the Fraser Health region and the more than 5,600 lives lost there since 2016, but its message is consistent with and relevant for all of B.C. — where upwards of 18,000 people have died by illicit drugs in the past decade.
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“We are committed to acting on what we’ve learned from data, emerging evidence and from those who have lived experiences in our communities,” says Dr. Ingrid Tyler. “While we have made some important progress, we must continue strengthening our response.”
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Here are six things we’ve learned a decade into one of the most devastating health crises in B.C. history:
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1. It’s not just about fentanyl
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Early in the drug crisis, fentanyl was synonymous with the emergency, but that’s evolving. Traffickers continue to introduce more toxic, powerful and unpredictable substances into the illicit supply. Monitoring of the supply shows there have been “continual shifts in unregulated substance composition, including the emergence of new additives and adulterants,” says Tyler.
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In the Fraser Health region, fentanyl was present in over two-thirds of opioid samples checked. But benzodiazepine-like drugs such as etizolam were in about 40 per cent of samples, “complicating toxic drug poisoning management and diminishing the effectiveness of naloxone.” A veterinary sedative, medetomidine, that doesn’t respond to naloxone was detected in 38 per cent of opioids checked in November 2025.
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2. It’s not just about the homeless
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The lasting image of the toxic drug crisis might be of a user slumped over on a sidewalk or in a back alley, lost to the stupefying effects of opioids. But that’s just one part of the problem. The crisis has disproportionately affected those experiencing homelessness, it’s true, and getting people into housing — what’s known as the housing-first-approach — is considered a key to getting them help.
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But private homes are where most overdose deaths happen, largely because the more public emergencies often lead to 911 calls and rescue by first responders. Men aged 30 to 59 are heavily affected, and the crisis has hit Indigenous and South Asian people hard. Also deeply affected are youth and young adults and those working in the trades and transport industries.
