Overdose deaths are falling. Will fentanyl crackdowns change that?

It's hard to believe opioid deaths are dropping when you're walking on Vancouver's Downtown Eastside, where B.C.'s drug crisis is most visible.

Open drug use is still common and on a dry day, you can count on seeing dozens of people unconscious on the sidewalk.

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

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

But the declines mark a small but distinct shift in the country's overdose epidemic, which was officially declared a health emergency in B.C. nine years ago last month. 

The downward trend is even more pronounced in the U.S., where drops in fatalities of up to 45 per cent have been seen in states like North Carolina, according to the Centers for Disease Control and Prevention (CDC), which aggregates state numbers. 

However, any progress could be undermined if either country sees a dramatic shift in drug supply or harm reduction measures, warns Nabarun Dasgupta, a senior scientist at the University of North Carolina's Opioid Data Lab, which has been closely monitoring the shift in the U.S. 

"The worst thing we could do right now is crack down too quickly on fentanyl," he said. 

But that's what Canada's federal government has vowed to do in border measures initally crafted to stave off tariff threats from the U.S. — even though Canada has questioned the rationale, given that less than one kilogram of fentanyl has been seized on the U.S.-Canada border since January. 

Stopping "production and trafficking of illegal fentanyl" is part of the scope of the $1.3-billion Canada Border Plan, which also promises to strengthen border security.

Inside our borders, the government is also making plans to more strictly control some of the secondary chemicals used in the illegal production of fentanyl, on top of the already controlled essential ingredients.

In a statement to CBC News, the RCMP's national office says it's already uncovered "many chemicals" that are used as cutting agents for synthetic opioids like fentanyl, including veterinary drugs — not fit for human consumption. 

China had also made moves to demonstrate a co-operation on fentanyl to avoid tariffs, releasing a White Paper in March to show the actions it's taken to "curb the illegal manufacturing, smuggling, and trafficking of fentanyl-related substances," including reining in precursor chemicals. 

Those who work in harm reduction and people who use drugs fear a repeat of what happened during the pandemic, when closed borders and disrupted supply chains became a factor in "increased toxicity," a key issue discussed in a Canada-U.S. joint white paper.