Toxic drug deaths appear to be falling in B.C.—and no one is sure why

Paramedic Specialist David Hilder from B.C. Ambulance tries to speak to a drug overdose victim in downtown Vancouver, June 23, 2021. THE CANADIAN PRESS/Jonathan Hayward

Frontline workers, drug users and experts alike are unsure why the number of reported deaths from toxic drugs appears to be decreasing in British Columbia, since the same trend is also taking place in jurisdictions with very different policies.

Early this month, the BC Coroners Service announced that toxic drug deaths for 2024 were 13 per cent lower than they were the year before. The agency does not provide analysis or theories as to why that is, but did point out that other jurisdictions, including Alberta, Ontario, and the United States are seeing similar year-over-year patterns.

The BC Centre for Substance Use is currently studying the trend, as are other researchers.

“I would caution anybody listening to people who say that they have very firm conclusions about why we’re seeing this,” said Kora DeBeck, a research scientist with the BCCSU and professor in the School of Public Policy at Simon Fraser University. “It’s very small in scope and it’s too early to know what is really driving it at this point.”

In British Columbia, harm reduction strategies including prescribed narcotic substitutes, free and easy availability of the overdose antidote Naloxone, supervised consumption sites, increasing availability of treatment beds, peer support strategies and other programs have been implemented since a public health emergency was declared in 2016.

The United States has a patchwork of policies and responses across its jurisdictions, yet the U.S. Centre for Disease Control has recorded declining drug overdose deaths since the fall of 2023. In November, the Drug Enforcement Agency found that the 14.5 per cent decrease in overdose deaths from June 2023 to June 2024 came at the same time as the “DEA has seen a decrease in the potency of fentanyl pills.”

CTV News has discussed the pattern with frontline workers, advocates and policy analysts in British Columbia who are considering a range or combination of possible factors, including that the nature of the drug supply has changed, the possibility that many illicit drug users have already died, the danger of the unpredictable illicit supply has essentially scared off casual users, drug dealers are modifying their products to avoid killing their customers, the growing availability of Naloxone and the availability of supervised consumption sites.

Read more: B.C. toxic drug crisis: Fewer 911 calls as deaths continue

The Tyee was first to report that the BC Coroners Service only performs autopsies on a fraction of the people suspected to have died from toxic drugs.

The BCCSU is testing samples of illicit drugs on the street to try and better understand the drug supply and hasn’t come to any conclusions.

“This is not a time to pat ourselves on the back and take our foot off the gas and think, ‘We’ve done a really good job and things have really changed,’” said Debeck. “There’s lots of reasons why people use drugs, but we know that trauma, economic insecurity, housing, these are all very important factors in substance use and why people really struggle.”