Overdose deaths are falling. Will fentanyl crackdowns change that?

It's hard to judge opioid deaths are dropping erstwhile you're walking connected Vancouver's Downtown Eastside, wherever B.C.'s cause situation is astir visible.

Open cause usage is inactive communal and on a adust day, you tin number connected seeing dozens of radical unconscious connected the sidewalk.

But the numbers don't lie: overdose deaths successful 2024 decreased 12 per cent successful B.C. and crossed the country compared to the previous 12 months, according to January data from the state and March information from Health Canada. 

The epidemic has killed 50,928 Canadians since 2016 — that's each the seats in Rogers Stadium successful Toronto, and past some. According to Health Canada, 21 radical a day, connected average, die from toxic drugs successful this country.

But the declines mark a tiny but chiseled displacement successful the country's overdose epidemic, which was officially declared a wellness exigency successful B.C. 9 years agone past month. 

The downward inclination is adjacent much pronounced successful the U.S., wherever drops successful fatalities of up to 45 per cent person been seen successful states similar North Carolina, according to the Centers for Disease Control and Prevention (CDC), which aggregates authorities numbers. 

However, immoderate advancement could beryllium undermined if either state sees a melodramatic displacement successful cause proviso oregon harm simplification measures, warns Nabarun Dasgupta, a elder idiosyncratic astatine the University of North Carolina's Opioid Data Lab, which has been intimately monitoring the displacement successful the U.S. 

"The worst happening we could bash close present is ace down excessively rapidly connected fentanyl," helium said. 

But that's what Canada's national authorities has vowed to bash successful borderline measures initally crafted to stave disconnected tariff threats from the U.S. — adjacent though Canada has questioned the rationale, given that less than 1 kilogram of fentanyl has been seized connected the U.S.-Canada borderline since January. 

Stopping "production and trafficking of amerciable fentanyl" is portion of the scope of the $1.3-billion Canada Border Plan, which besides promises to fortify borderline security.

Staving disconnected tariffs

Inside our borders, the authorities is besides making plans to much strictly power immoderate of the secondary chemicals utilized successful the amerciable accumulation of fentanyl, on apical of the already controlled indispensable ingredients.

In a connection to CBC News, the RCMP's national bureau says it's already uncovered "many chemicals" that are utilized arsenic cutting agents for synthetic opioids similar fentanyl, including veterinary drugs — not acceptable for quality consumption. 

China had also made moves to show a co-operation connected fentanyl to debar tariffs, releasing a White Paper successful March to amusement the actions it's taken to "curb the amerciable manufacturing, smuggling, and trafficking of fentanyl-related substances," including reining successful precursor chemicals. 

Those who enactment successful harm simplification and radical who usage drugs fearfulness a repetition of what happened during the pandemic, erstwhile closed borders and disrupted proviso chains became a origin successful "increased toxicity," a cardinal contented discussed successful a Canada-U.S. associated achromatic paper.

The report, co-authored by U.S. and Canadian authorities, including Health Canada and the Public Health Agency of Canada, noted successful March 2022 that "changes successful the availability of substances whitethorn lend to cause shortages, accrued toxicity, stockpiling, and changes successful tolerance among radical who usage drugs, which whitethorn summation substance-related harms."

"It's happened dozens of times earlier with drugs," said Dasgupta at the Opioid Data Lab. 

"A caller much potent opioid volition travel into the market. The marketplace is wholly primed for that benignant of a shift."

What's next? 

The illicit cause proviso is ever evolving. 

From period to month, definite unregulated drugs similar fentanyl oregon methamphetamine volition look successful varying amounts successful samples tested by cause checkers astatine a section level, oregon done autopsies and toxicology tests.

The unpredictability of ingredients is what makes accessing this uncontrolled proviso truthful dangerous, says Sarah Blyth, enforcement manager of the Overdose Prevention Society (OPS). 

"If it gets hard to get fentanyl, determination volition beryllium different drugs that flood the market," she said. "What's the adjacent drug? Is it carfentanil? Then we're worse off." 

Carfentanil, similar fentanyl, is simply a synthetic opioid. People interest astir it leaching into the drug supply, due to the fact that it's astir 100 times much toxic than fentanyl. It looks similar array brackish and conscionable a fewer grains tin beryllium fatal. 

Frequent changes successful the amerciable cause proviso are of people felt deepest by the radical who consume them. 

It's important to retrieve cause users are each somebody's brother, sister, girl oregon son, says Nick Reagan, a 31-year-old from Calgary who has utilized opioids for 10 years to negociate his chronic symptom aft a car accident. 

He lives successful Vancouver's Downtown Eastside and worries astir his cause proviso being chopped disconnected done crackdowns oregon becoming much contaminated. 

"My beingness is astatine risk," helium told CBC News. 

It's not hard to imagine overdose deaths numbers getting worse successful B.C., fixed it was conscionable a fewer years agone that astir 7 radical a time were dying, compared to astir 5 a time arsenic of January 2025. At the time, then-chief coroner Lisa Lapointe pointed to the dangers of radical utilizing toxic drugs alone, arsenic good arsenic proviso chains disrupted by the COVID-19 pandemic creating a void for drug makers to nutrient much almighty substances. 

CBC News asked Health Canada astir its new Precursor Risk Management Unit, which is helping pb the crackdown, on whether argumentation makers had considered however an abrupt shortage of fentanyl could impact cause users. 

In a statement, the agency said the portion was pursuing precedent acceptable by akin national government initiatives successful the past, adding that "substance usage harms and the overdose situation are driven by analyzable and interrelated factors, and necessitate a scope of services and supports to code them."

The impacts of the further enforcement mightiness not beryllium instantly obvious. It takes clip to cod information connected an unregulated cause supply, and if the proviso does commencement to change, it'll instrumentality astatine slightest fewer weeks for a signifier to emerge, says Dasgupta. 

3 theories  

Dasgupta's squad successful North Carolina is inactive trying to nail down the reasons down the important alteration successful overdose deaths, which person been seen successful each U.S. states but Nevada and Alaska.

He has 3 main theories, which astatine archetypal appeared similar full anomalies.

The archetypal is an evident displacement toward a much varied drug proviso that's little based connected fentanyl and includes tons of ingredients, similar different synthetic opioids oregon amphetamines. Simply put, the cause proviso may be getting saturated with substances that are little unsafe than ample amounts of fentanyl.  

"People are telling america successful our tract studies that the dope isn't the aforesaid arsenic it utilized to be," Dasgupta said. 

Then there's the cause users themselves. People who regularly crunch the numbers connected overdose deaths cognize there's a definite cohort of radical that commonly makes up a bulk of fatalities. In Canada successful 2024, 73 per cent of overdoses deaths happened to men aged 30 to 39, according to Health Canada. 

In the U.S., astir 70 per cent of overdose deaths deed men successful their late-40s to mid-50s. Dasgupta suspects parts of that cohort may have stopped utilizing drugs oregon could beryllium dying of different causes.

'It adds up'

The past hypothesis for the diminution is much hopeful. 

Interventions could beryllium having a existent impact. Treatment options, including lifesaving opioid reversal drugs similar naxolone, which people regularly transportation with them, or programs to trim the stigma of cause usage oregon amended young radical connected the dangers, mightiness beryllium making a dent. 

It adds up, says Sarah Blyth, who says the Overdose Prevention Society saves people every time successful antithetic ways.

Still, she remains sceptical of a imperishable betterment successful the long-running cause crisis, arsenic she personally knows radical who person precocious died from the supply. Optimism successful this rolling situation is easy broken and radical are desperate to spot things improve.

"No 1 wants to spot anymore radical dying," Blyth said. "I privation to spot radical surviving the champion beingness that they can."