Despite a slight decline in unregulated drug deaths in 2024, the opioid crisis continues to take a devastating toll on communities across British Columbia and Canada. While recent data shows an eight percent decrease in fatalities, with 1,749 deaths in the first nine months of 2024 compared to 1,896 in 2023, this reduction doesn’t yet signal a broader victory. With six people dying each day in B.C. alone, the situation remains dire, especially as fentanyl continues to dominate the toxic drug supply.
A Glimmer of Hope?
The slight decline in overdose deaths in 2024, while encouraging, reflects a combination of several key factors. Changes in the drug supply, particularly shifts in the availability of less toxic substances, and the increased access to harm reduction programs have played significant roles. Overdose prevention sites, mobile apps designed to prevent fatalities, and widespread public education campaigns are proving to be effective measures in reducing the likelihood of fatal overdoses. These preventive strategies, along with improved access to addiction treatment, mental healthcare, and pain management, are beginning to show positive results.
For years, experts and frontline workers have emphasized the need for a comprehensive response to the opioid crisis. The combination of harm reduction services—such as overdose prevention sites and drug-checking programs—coupled with broader structural changes like better access to healthcare and substance use treatment, has been critical in addressing the crisis. This multi-pronged approach has undoubtedly contributed to the slight decline in deaths. However, the situation remains precarious, as overdose rates are still alarmingly high.
In 2018, Canada saw an average of 12 opioid-related deaths per day, a number that has nearly doubled in recent years despite the decline in 2024. While the current reduction is promising, it is clear that the country is still grappling with a crisis that remains at a “rolling boil.” The focus must now be on maintaining and expanding these life-saving interventions to bring overdose deaths down further.
The Rising Threat to Women and Girls
One particularly disturbing development in 2024 is the sharp rise in deaths among women and girls. The B.C. Coroner’s Service reports that 26 percent of this year’s overdose deaths were female victims, marking a 60 percent increase from four years ago. This trend calls for urgent attention and deeper analysis, as the face of the opioid crisis shifts and more women are affected.
While men continue to make up the majority of fatalities—72 percent of the deaths in B.C. in 2024—the growing vulnerability of women and girls points to gaps in current prevention and treatment strategies. Gender-specific interventions may be required to address this alarming rise.
Fentanyl’s Continued Grip on British Columbia
Fentanyl remains the primary cause of opioid-related deaths, detected in 85 percent of fatalities in B.C. The proliferation of this potent synthetic opioid has reshaped the landscape of drug use, making overdoses far more likely. Despite small victories, such as the recent decrease in deaths, the unregulated supply of fentanyl continues to be the biggest hurdle to tackling the crisis effectively.
British Columbia saw 1,158 opioid-related deaths in the first half of 2024—a nine percent decrease compared to the same period in 2023. However, this reduction doesn’t erase the fact that 2023 was one of the deadliest years, with over 2,500 deaths. Even in 2024, approximately six people are dying each day in the province due to unregulated, toxic drugs, underscoring the persistent danger of the drug supply.
The Crisis Beyond British Columbia
When viewed on a national scale, the opioid crisis paints an even bleaker picture. In Canada as a whole, there were 1,906 opioid-related deaths in the first quarter of 2024—an average of 21 deaths per day. This alarming figure mirrors the high death rates seen in 2022, reflecting the deeply entrenched nature of the opioid crisis across the country.
The rising potency of fentanyl and its analogues, combined with the increasing presence of other substances like benzodiazepines, has complicated efforts to reduce deaths. In many cases, fentanyl is mixed with stimulants or alcohol, creating a deadly cocktail that’s harder to treat and more difficult to predict. Overdose reversal drugs like naloxone, while life-saving, are less effective in the face of such complex drug interactions.
Overwhelmed Emergency Services
The surge in opioid-related deaths has also placed enormous pressure on emergency medical services (EMS) across the country. In the first three months of 2024 alone, Canada saw 8,719 EMS responses to overdoses—an average of 96 calls per day, or one every 15 minutes. The complexity of these overdoses, often involving multiple drugs, has made emergency response more challenging, stretching resources thin in many communities.
While British Columbia’s EMS numbers for 2024 are not yet fully available, the demand for emergency services in the province has similarly skyrocketed over the years. This increase reflects the broader national trend of a health system struggling to cope with the wave of opioid overdoses.
Have We Made Progress?
Looking back over the past five years, it’s clear that the opioid crisis has evolved but not improved. In 2019, opioid-related deaths in Canada were already on the rise, and by 2020, the number of daily deaths had climbed to 17. By 2022, that figure had escalated to 21 deaths per day, a grim milestone that has persisted into 2024.
Between 2018 and 2024, Canada recorded over 40,000 opioid-related deaths. The consistent rise in fatalities has been driven by the increasing toxicity of the illegal drug supply, which is now more unpredictable than ever. The combination of fentanyl with benzodiazepines and other substances has made drug use in Canada a dangerous gamble, even for those with a history of addiction.
Fighting a Crisis That’s Far from Over
Regardless of the small victories seen in 2024, the opioid crisis remains a public health emergency in Canada, particularly in regions like British Columbia and Vancouver’s Downtown Eastside. With fentanyl still dominating the unregulated drug market, and an increasing number of women falling victim to overdose, it’s clear that there’s more work to be done. Public health officials have emphasized that addressing the opioid crisis requires continued investment in evidence-based interventions. Harm reduction strategies—such as overdose prevention sites and drug-checking services—play a crucial role in saving lives, but they must be paired with other long-term solutions.
Prevention efforts must target young people who may not fully understand the risks of fentanyl and other dangerous substances. Public education campaigns, both in schools and through social media, are critical in reaching at-risk populations before they encounter the toxic drug supply.
The national scope of the crisis demands a coordinated, multi-faceted response that addresses the root causes of addiction, provides comprehensive treatment options, and ensures that harm reduction services are accessible to all who need them. Only by combining prevention, treatment, and harm reduction can we hope to turn the tide on the opioid epidemic.
Lance has lived in the Downtown Eastside for years, staying closely connected to the neighbourhood and the people who call it home. He writes about the issues that matter—from housing and policy shifts to the everyday stories that shape the community—because DTES isn’t just where he lives, it’s a place he cares deeply about.
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