Fentanyl and heroin contained in seized illicit drugs and overdose-related deaths in British Columbia, Canada: An observational analysis

Drug Alcohol Depend. 2018 Apr 1;185:322-327. doi: 10.1016/j.drugalcdep.2017.12.032. Epub 2018 Feb 20.


Background: Due to the alarming rise in opioid-related overdose deaths, a public health emergency was declared in British Columbia (BC). In this study, we examined the relationship between illicit fentanyl and heroin found in seized drugs and illicit overdose deaths in BC.

Methods: An observational cross-sectional survey was conducted using BC data from Health Canada's Drug Analysis Service, which analyzes drug samples seized by law enforcement agencies, and non-intentional illicit overdoses from the BC Coroner's Service, from 2000 to 2016. Initial scatter plots and subsequent multivariate regression analysis were performed to describe the potential relationship between seized illicit fentanyl samples and overdose deaths and to determine if this differed from seized heroin and overdose deaths. Fentanyl samples were analyzed for other drug content.

Results: Fentanyl is increasingly being found combined with other opioid and non-opioid illicit drugs. Strong positive relationships were found between the number of seized fentanyl samples and total overdose deaths (R2 = 0.97) as well as between seized fentanyl and fentanyl-detected overdose deaths (R2 = 0.99). A positive association was found between the number of seized heroin samples and total overdose deaths (R2 = 0.78).

Conclusion: This research contributes to the expanding body of evidence implicating illicit fentanyl use (often combined with heroin or other substances) in overdose deaths in BC. Policy makers and healthcare providers are urged to implement drug treatment and harm reduction strategies for people at risk of overdose associated with current trends in illicit opioid use.

Keywords: Drug overdose; Fentanyl; Heroin; Law enforcement; Opioid-related disorders; Substance-related disorders.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / analysis*
  • Analgesics, Opioid / poisoning
  • British Columbia / epidemiology
  • Cross-Sectional Studies
  • Drug Overdose / diagnosis
  • Drug Overdose / mortality*
  • Female
  • Fentanyl / analysis*
  • Fentanyl / poisoning
  • Heroin / analysis*
  • Heroin / poisoning
  • Humans
  • Illicit Drugs / analysis*
  • Illicit Drugs / poisoning
  • Male
  • Opioid-Related Disorders / diagnosis
  • Opioid-Related Disorders / mortality
  • Public Health / trends


  • Analgesics, Opioid
  • Illicit Drugs
  • Heroin
  • Fentanyl