Last updated: January 30, 2024

Drug-related overdoses and deaths are a serious concern. Be drug smart if you are taking or planning on taking drugs, or know someone who takes drugs. Be drug smart:

• Make a plan and make sure someone can call 9-1-1 at the first sign of distress
• Use sterile syringes and inject slowly with small amounts at first
• Use supervised injection services when possible
• Do not mix with alcohol or other substances
• Understand the symptoms of an overdose
• Know when to call 9-1-1 in an emergency
• Know when and how to give naloxone
• Monitor public health, police, and RCMP websites and social media for information on bad drugs that may be circulating and could put you at increased risk

Talking openly with your kids, teenagers, and adult children about drug use and the associated risks can help reduce the likelihood of harm and encourage healthy behaviours. See our Parenting Articles to learn more.

Questions You May Have

What is opioid overdose?

Opioids are a class of drug or medication which includes hydrocodone, heroin, oxycodone, fentanyl, and morphine. They are most often prescribed for pain relief. Opioid drug overdose happens when you take more opioids than your body can handle. You will lose control over your breathing, and may lose consciousness. With slowed breathing, less oxygen gets into your blood. This can lead to brain damage, cardiac arrest and death. If you think someone is overdosing, call 9-1-1 right away.

Is opioid overdose a concern in B.C.?

Yes. The toxic drug crisis has been and remains a public health emergency since April 2016. Toxic drugs are the leading cause of death for British Columbians aged 19 to 39, and the second leading cause of death overall. Drug toxicity deaths continue to increase and now accounts for about 6 deaths per day. The drug supply is increasingly toxic and affects people in urban, suburban and rural areas of the province.

Why should I be concerned about fentanyl?

Fentanyl is a lot more powerful than other opioids, which makes the risk of accidental overdose much higher. It is roughly 50 to 100 times more toxic than morphine. In recent years there have been reports that fentanyl produced in illicit laboratories is being sold on the streets. It is sometimes sold as Oxycontin®, heroin, or other substances. People may be taking fentanyl and putting themselves at risk without even knowing it.

In 2018, fentanyl and substances chemically similar to fentanyl were detected in 85% of illegal drug overdose deaths.

What are the signs of opioid overdose?

Signs that someone may be having an opioid overdose include:

• Not moving
  • The person is not moving and can’t be woken
• Slow breathing
  • The person is breathing very slowly or not breathing at all.
• Blue lips
  • The person’s fingernails or lips are turning blue or purple.
• Choking sounds
  • The person is making choking, gurgling or heavy snoring sounds.
• Cold, clammy skin
  • The person’s skin feels cold and clammy to the touch.
• Tiny pupils
  • The person’s pupils look tiny.

If you think someone is overdosing, call 9-1-1 right away.

Can opioid overdose be reversed?

Naloxone is a drug that can reverse opioid overdose. When injected into the arm or thigh muscle, it can quickly reverse the effects of opioid drugs. Naloxone can reverse slowed breathing within 3 to 5 minutes, but its effects will only last for 20 to 90 minutes. A second dose of naloxone may be needed if the first dose does not restore a normal breathing rate.

If the opioid is still present after the naloxone wears off the overdose may return, requiring another dose of naloxone. This is why it is important to seek medical help as soon as possible by calling 9-1-1, and be prepared with a second dose of naloxone if the overdose symptoms return.

Fentanyl overdoses are much harder to reverse than other opioids and might require significantly higher doses of naloxone.

Where can I get Naloxone?

Kits are available at no cost to:

• people at risk of an opioid overdose
• people likely to witness and respond to an overdose such as a family or friend of someone at risk

To locate a participating site near you, use our Site Finder search tool. Kits are not available to individuals directly through the BC Centre for Disease Control. To learn more about naloxone, see HealthLinkBC File #118 Naloxone: Treating Opioid Overdose.

Is the nasal spray version of naloxone available in BC?

If you are First Nations’ and living in BC, you may request Nasal Naloxone directly from your pharmacy – you do not require a prescription from a doctor or nurse practitioner. You will need your Status number and Personal Health Number. The First Nations Health Authority’s First Nations Health Benefits plan will cover the cost of injectable and nasal spray forms of naloxone.

What are W-18 and carfentanil?

While fentanyl has gotten much of the immediate public attention, other compounds like it—such as carfentanil or W-18—are also very toxic drugs that may be cut into and sold as heroin, fake “oxy” pills, or cocaine. These drugs are equally or more dangerous than fentanyl, and so extreme precautions need to be taken by people who use illegally possessed drugs. People should be aware that drugs they obtain other than from legitimate sources (i.e., a pharmacy or a hospital) may not be what the dealer says or believes they are.

Useful Websites

Stop Overdose BC

Stopoverdosebc.ca is the British Columbia’s web platform for overdose related content. Visit their website to learn more.

Here to Help

HeretoHelp provides information related to substance use and mental health. Their website includes personal stories, self-help resources, and information about getting help now.

Kelty Mental Health Resource Centre

The Kelty Mental Health Resource Centre is a provincial resource centre that provides substance use and mental health information, resources, and peer support to children, youth and their families from across BC. To learn more visit Kelty Mental Health Resource Centre – Substance Use.

Overdose Prevention and Response in B.C.

Drug-related overdoses and deaths have become a very serious concern in B.C. It can happen to someone you know. Learn more about signs of an overdose, what to do, how to prevent overdoses, decriminalization, and resources. To learn more see Overdose Prevention and Response in B.C.

Toward the Heart

Toward the Heart is a harm reduction program that is part of the BC Centre for Disease Control. Visit their website to learn about naloxone, fentanyl, supplies, and to find a harm reduction site.

• Toward the Heart
• Naloxone Saves Lives
• How to Use Naloxone (Narcan) (Video)
• Naloxone Wakes You Up (Video)
• Naloxone Saves Lives (Video)

Featured Services

Alcohol and Drug Information & Referral Service

Individual, family, and small group counselling is available to people of all ages who are directly or indirectly affected by alcohol and other drug use by calling the 24-hour BC Alcohol and Drug Information and Referral Service.

• Lower Mainland: 604-660-9382
• Toll-free anywhere in British Columbia: 1-800-663-1441

BC Mental Health & Substance Use Services

BC Mental Health & Substance Use Services (BCMHSUS), an agency of the Provincial Health Services Authority (PHSA), provides a range of substance use and mental health services for children, adolescents and adults across the province. To learn more see BC Mental Health & Substance Use Services.

Overdose Prevention and Supervised Consumption Sites

Overdose prevention and supervised consumption sites are safe locations where people can use illegal drugs under supervision by trained staff. Search ‘supervised consumption’ or ‘overdose prevention’ in the HealthLink BC Services and Resources Directory to find a site in your community or visit your health authority website for further information.

• First Nations Treatment Centres
  • Harm Reduction and the Toxic Drug Crisis
• Fraser Health
  • Overdose Prevention Site
  • Supervised Consumption Sites
• Interior Health, Overdose Prevention & Treatment
• Island Health, Overdose Prevention & Supervised Consumption Locations
• Northern Health, Overdose Prevention
• Vancouver Coastal Health
  • Overdose Prevention Sites
  • Supervised Consumption Service

The information provided in the Be Drug Smart health feature has been adapted BC Centre for Disease Control - BC DOAP Opioid Overdose Response Strategy (DOORS), Toward the Heart – Opioid Overdose in BC: Fentanyl on the Rise, accessed Jan 30 2023, Coroner Service – Illicit Drug Overdose Deaths in BC, September 27, 2018, accessed January 30 , 2023, (see Coroners Service - Statistical Reports), and Government of British Columbia – Overdose Awareness in BC – Frequently Asked Questions, accessed January 30, 2023.