B.C. First Nations die from toxic drugs at nearly seven times the rate of others

First Nations people in B.C. died from toxic drugs at nearly seven times the rate of others in 2024, underscoring the continued disproportionate impact of the drug crisis on Indigenous people.

First Nations people make up just 3.4 per cent of B.C.’s population but accounted for 19 per cent of drug deaths last year, according to data released Monday by the First Nations Health Authority, or FNHA.

And while the 427 First Nations people who died last year represent a 6.8-per-cent decrease in deaths from the year prior – part of a broader trend of decreasing overdose deaths seen across North America – the First Nations death rate is 6.7 times that of other B.C. residents.

FNHA chief medical officer Nel Wieman said this is the largest gap since B.C. declared a public-health emergency on April 14, 2016, in response to escalating overdose deaths.

“The numbers do not tell the full story of the lives lost or the impact to the families, friends, communities and nations in the aftermath of these deaths,” Dr. Wieman told a news conference on Monday, which marks the ninth anniversary of the province’s declaration.

“The individuals who died had significant relationships and experiences before their deaths that are worthy of respect and acknowledgment. They are missed on birthdays, anniversaries, in ceremonies, out on the land and in their communities, urban, rural and remote. They are missed every single day.”

First Nations women are even more severely affected by the toxic drug crisis, dying at 11.6 times the rate of other female B.C. residents in 2024, according to the FNHA. First Nations men died at 5.2 times the rate of other male B.C. residents. Dr. Wieman noted that the data is limited to biological sex at birth, which may misidentify two-spirit, transgender and other gender diverse people.

About half – 50.1 per cent – of First Nations people who died from drugs last year were under the age of 40, compared with about 39 per cent of other B.C. residents.

The toxic drug crisis has also become an issue in the federal election campaign. One week earlier, Conservative Leader Pierre Poilievre used a campaign stop in New Westminster to pledge a crackdown on harm reduction services, including on prescribed alternatives (“safer supply”) programs and overdose prevention sites, which he called “drug dens.”

While Dr. Wieman was careful to avoid politics in her remarks Monday, she was unambiguous in stating that evidence-based harm reduction initiatives save lives.

In 2024, the FNHA’s surveillance team collaborated with the BC Centre for Disease Control on an analysis to estimate how many First Nations drug deaths were avoided because of harm-reduction measures, she said. From January, 2018, to December, 2022, 1,374 First Nations people died from drug poisonings across B.C., but the mathematical model found that at least 1,024 potential additional deaths were prevented.

Of these estimated prevented deaths, at least 39 per cent were from the use of take-home naloxone, a medication used to reverse the effects of opioid overdose; at least 28 per cent were from medication-based treatments; and at least 20 per cent were from overdose prevention and supervised consumption services, the modelling found.

Dr. Wieman also expressed frustration at what she said was the hijacking of the narrative over B.C.’s pilot to decriminalize simple drug possession, noting that it was introduced, in part, to address the overrepresentation of First Nations people in the justice system as a result of systemic racism. It never made all drugs “legal,” as some have erroneously claimed.

“We need to collectively stand against the misinformation, disinformation and harmful rhetoric that is circulating in the public discourse,” Dr. Wieman said.

Celeta Cook, FNHA’s executive director of public-health response, added that harm reduction from a First Nations lens means more than just focusing on substance use.

“It really means getting to those root wounds that people turn to to cope, how they might draw on substances,” she said. “It’s undoing the harms of colonialism, which put First Nations people at higher risk.”

In 2016, then-provincial health officer Perry Kendall declared B.C.’s public-health emergency to allow medical health officers to collect more real-time data on where overdose events and deaths were taking place, in order to better pro-actively warn people who use drugs.

The powerful opioid, fentanyl, is a central feature of the toxic drug crisis. In 2012, it was detected in less than 5 per cent of illicit drug deaths in B.C.; in recent years, that figure has risen to 85 per cent. Other common additives – including animal tranquilizers, benzodiazepines and substances chemically similar to fentanyl – have further worsened the crisis and had implications on treatment.