Opinion: Ten years into B.C.’s toxic drug crisis, solutions are within reach

Initiatives like Road to Recovery show that integrated addiction care can work. But harm-reduction services, including overdose prevention sites and low-barrier rapid access addiction clinics, remain critical entry points that help people survive long enough to seek treatment, write Cheyenne Johnson and Dr. Seonaid Nolan. Photo: Providence Health Care Photo by Brian K. Smith MPA/SPA

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Ten years ago, B.C. declared a public health emergency in response to the rapidly escalating toxic drug poisoning crisis that still holds us in its grip. Each anniversary since has been marked by grief and loss, and is a painful reminder of the urgency of this continuing crisis.

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Since April 14, 2016, this emergency has taken the lives of more than 18,000 people in B.C. Behind each number is a person whose loss reverberates through families, friends, and communities.

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Deaths are only part of the story. Many people survive toxic drug poisonings but experience serious and often long-term health consequences. In 2025 alone, B.C.’s emergency services responded to nearly 40,000 drug poisonings.

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While toxic drug poisoning deaths in B.C. declined by 21 per cent in 2025 compared with 2024, this does not signal the end of the emergency.

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Toxic drug deaths remain far higher than before the public health emergency was declared: There were 474 in 2015, the year before the public health emergency was declared, compared with 2,318 deaths in 2024 and 1,833 in 2025. There is also no guarantee the downward trend in overdose deaths will continue as the illicit drug supply is increasingly poisoned with a number of new adulterants, in addition to fentanyl.

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Now is a critical moment to strengthen evidence-based addiction care so people seeking help can access care when they need it. Demand for treatment continues to grow, and timely access to safe, effective care remains a challenge.

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At Providence Health Care and Vancouver Coastal Health, an initiative called Road to Recovery has transformed how people access addiction services. The program replaces a fragmented system with a co-ordinated, person-centred model of care that is delivering far better outcomes for people in recovery.

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The process begins at Access Central, a phone line that acts as a single entry-point to care where people receive same-day assessments from trained addiction clinicians. Patients can quickly access medications to support their recovery through their pharmacy or see an addiction physician the same day at St. Paul’s Hospital’s rapid access addiction clinic, or through Vancouver Coastal Health’s Downtown Eastside connections clinic. Those at higher risk of withdrawal complications can access medical withdrawal management often within 24 hours.

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The model also addresses a long-standing gap in care by introducing transitional care beds that help patients move from hospital or withdrawal management into housing or longer-term treatment. Harm-reduction services, counselling, and peer support are available for people who are still considering treatment, while enhanced aftercare teams help connect patients with housing, employment supports, legal services, and counselling.

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Early results are promising. Wait times have dropped significantly through co-ordinated intake at Access Central, and treatment retention rates for patients with opioid use disorder are higher than the provincial average. St. Paul’s Hospital also operates Canada’s only acute-care overdose prevention site, providing life-saving support for hospitalized patients and a vital connection to life-saving care and pathway into treatment and recovery when they are ready.