This is the first of six stories covering B.C.’s opioid crisis as the province marks 10 years since B.C. Public Health Officer Perry Kendall called a public state of emergency on April 14, 2016. Between 2015 and 2025, 1,323 people died at the hands of the toxic drug market in Greater Victoria, while B.C. still experiences as much as five drug-poisoning deaths every day.
In 2012, B.C. toxicologists flagged highly unusual incidents to the B.C. Coroners Service in the Lower Mainland, where three men with histories of problematic substance use were found dead with toxic amounts of fentanyl in their bodies.
Then-Chief Coroner Lisa Lapointe didn’t know it at the time, but these were the first three lives taken by a drug that would become the embodiment of a devastating new wave of the opioid crisis.
“Sometimes we would have deaths where people had obtained fentanyl patches and put them on, but that was very, very rare. It was always prescribed fentanyl patches,” said Lapointe. “Sometimes they would find it in garbage or whatever and use them, but these three deaths, it was concerning because we thought, ‘Where did they get the fentanyl?’ It wasn’t something that was being trafficked at the time.”
By 2014, there was a noticeable climb in deaths attributed to fentanyl; and in 2016, 997 B.C. residents died at the hands of unregulated drugs, with fentanyl being relevant to nearly 66 per cent of those deaths. Over the next decade, over 18,000 B.C. residents would die as a result of drug poisoning, 1,305 of whom were in the Capital Region.
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On April 14, 2026, B.C. will commemorate a decade since former provincial health officer Dr. Perry Kendall declared a public health emergency prompted by the surge in overdoses.
“Under that public health emergency, you have additional powers to order quarantine or for people to stay home, or be tested, etc. So it raises the state of knowledge and awareness, and it can politicize an event,” said Kendall in an interview in early March. “And the other thing [is that] you have the power to collect information from sources that normally wouldn’t have to give me the information unless they chose to.”
Kendall, a long-time advocate for informed drug policies who is credited with helping open North America’s first legal supervised consumption site in Vancouver, said the provincial government responded quickly, first distributing naloxone, trying to improve treatment access, promoting harm reduction, and eventually cutting through federal red tape to open multiple overdose prevention sites.
“In order to try and get ahead of it, we were working with public health, with policing, with people with lived experience, with local authorities, to expand knowledge out there, to promote harm reduction practices, to improve treatment access, and to distribute naloxone and the knowledge of how to use naloxone,” he said.
Over the next ten years, however, the province would stick with a temporary drug decriminalization experiments, uncertain safer supply legislation, loose legislation around treatment and tenuous funding for supportive and long-term housing while deaths climbed, peaking at 2590 deaths in 2023, 177 of which were in Greater Victoria.
“To some people, they’re just numbers, and they’re just policies. But when you’re in the coroner’s office, we were picking up seven bodies every day. Every day. Human beings. Now it’s five, every day,” said Lapointe. “It certainly wears on you. I know it’s worn on me, and it still does. You see their kids and their siblings and their parents, and you learn about their hobbies and their pets, and they were great musicians, and they’re real people.”
The road to a toxic supply
Opiates in Canada have their roots starting with Chinese workers bringing opium in the late 1800s. Opium eventually graduated to the more-potent heroin in the 1950s. In the late 90s, opium-based pharmaceuticals like OxyContin started flooding the country, leading more and more people into using heroin.
“The preceding two decades saw fentanyl overtake heroin as the primary opioid in the illicit supply. High potency and an entirely synthetic production positioned fentanyl as a higher value compound for producers, transporters, and sellers; one that did not depend on cultivation of opium poppies. What followed, and persists to this day, is a cycle of reactive compound scheduling and supply turnover,” noted a statement from Katy Booth, project coordinator for the University of Victoria’s Substance Drug Checking.
B.C. Coroners Service data notes in 2014 fentanyl and fentanyl analogues were a factor in 24.6 per cent of unregulated drugs deaths while “other opioids” – including heroin, codeine and morphine – played a part in over 58 per cent of deaths. Between 2017 and 2025, fentanyl was playing a hand in over 75 per cent of drug-related deaths year-after-year while other opioids dropped to under 30 per cent by 2020. According to Substance Drug Checking’s weekly and monthly reports, by 2020 fentanyl was dominant in opioid-expected samples. between 2021 and 2023, samples showed a sharp increase in adulterants, mainly benzodiazepines like bromazolam and veterinary sedatives like medetomidine and xylazine, marking a shift in user’s consumption habits from strong, but fairly consistent opioids, to a complex cocktail of barely-understood drugs, often called “Down.”
The presence of other substances in the opioids makes the already deadly opioid supply even more precarious as the sedatives diminish the effectiveness of naloxone during overdoses, and they can make safer alternative prescribing difficult as clinical guidelines try to adapt to new drug tolerances, Booth said.
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In the first three months of 2026, Island Health issued 10 overdose advisories across the region, one of which prompted a warning from the Victoria Police Department on Jan. 28 after the city saw 15 non-fatal overdoses within 24 hours.
They said as a result of medetomidine, naloxone did not have the usual effect and complicated emergency response in several of those cases.
Between 2015 and 2025, benzos went from being relevant in just under five per cent of drugs deaths to being involved in nearly half of all drug-related deaths.
“There’s something that activists call the iron law of prohibition. If you prohibit the manufacture and sale and distribution of a substance that people really want, like tobacco or alcohol, what you do is you create a black market, because you don’t stop the demand, and there are always people ready to meet the demand,” said Kendall.
High-profits, along with the risk of jail, incentivize black market to get creative – for example opting for lab-created, high potency drugs that can be made in-country or smuggled in smaller quantities, rather than smuggling bricks of heroin or opium, Kendall added.
Booth says the highest risk of today’s supply is unpredictability in composition and concentration, with the “single most protective factor against drug-related adverse events and fatality is access to a known and regulated supply.”
Despite the fluid dynamics of the illicit drug market and the complex toxicity of the drug supply, 2024 marked the first year there was a decline in unregulated drug deaths – dropping from 2,590 at the peak in 2023 to 1,826 in 2025, an almost 30 per cent drop in two years.