BC Coroners Data Shows Benzodiazepines Detected in Nearly 1,000 Deaths by 2023

This post reviews official government records released to the public under Canada's Access to Information (ATI) laws or provincial Freedom of Information (FOI) legislation. These laws allow members of the public to request internal government documents. This article summarizes what the records contain and what they show. While we strive for accuracy, this is an analysis and interpretation of the source material. For complete accuracy, readers should review the original documents, which are available in full below.

Full Document

The complete document is available for download below:

Between 2015 and 2024, British Columbia recorded 16,857 deaths from unregulated drug toxicity. But beneath that staggering total lies an equally troubling shift: benzodiazepines, a class of sedatives that includes drugs like Xanax and Valium, surged from being detected in just 24 deaths in 2015 to 988 deaths in 2023—a more than 40-fold increase. The data, obtained through a Freedom of Information request to the BC Coroners Service, reveals how the province's overdose crisis has evolved from primarily heroin-related deaths to a complex poly-drug emergency dominated by fentanyl and increasingly contaminated with other dangerous substances.

The numbers paint a picture of a crisis that peaked in 2023 with 2,578 deaths before declining to 2,253 in 2024—still more than four times the 2015 toll. Whilst fentanyl remains the primary driver, detected in 86 per cent of closed investigations with toxicology results in 2023, the proliferation of other substances in the drug supply has transformed the nature of the emergency.

The Fentanyl Transformation

The data captures the moment fentanyl transformed British Columbia's drug supply. In 2015, fentanyl and its analogues were detected in 150 deaths, representing roughly 30 per cent of completed investigations. By 2016, that number had more than quadrupled to 656 deaths. The following year saw 1,219 fentanyl-related deaths, and by 2018, fentanyl was present in 89 per cent of fatal overdoses with completed toxicology.

This wasn't a gradual shift—it was a wholesale replacement of the drug supply. The data shows that whilst other opioids (likely including heroin) were detected in 291 deaths in 2015, they had dropped to 159 by 2024. Fentanyl, far more potent than heroin, had become the default opioid in BC's unregulated market. Even as total deaths fluctuated year to year, fentanyl's dominance remained constant from 2017 onwards, consistently appearing in 85 to 90 per cent of fatal overdoses.

The 2024 data shows 746 fentanyl-related deaths, but this figure requires context: only 865 investigations had completed toxicology results by the time this data was compiled, compared to 2,253 total deaths that year. The coroners service operates in a live database environment, and toxicology results often take months to complete. Based on historical patterns, fentanyl will likely be present in the vast majority of 2024's completed investigations.

The Benzodiazepine Surge

Whilst fentanyl captured public attention, another trend developed more quietly but no less dangerously. Benzodiazepines—typically prescribed for anxiety but increasingly found in the illicit drug supply—appeared in just 24 deaths in 2015. That number barely moved for years: 50 in 2016, 57 in 2017, 48 in 2018, 49 in 2019.

The alarming rise in drug-related fatalities in British Columbia has raised concerns about the broader economic implications, as seen in the recent report on the decline in private vehicle sales amidst increasing provincial tax revenue, which may reflect changing consumer behaviours in light of the ongoing crisis. For further context, see our coverage on BC private vehicle sales and tax revenue.

Then something changed. In 2020, benzodiazepines were detected in 213 deaths. By 2021, that number had more than doubled to 521. It climbed to 603 in 2022, then exploded to 988 in 2023—the highest count for any substance except fentanyl. Even with incomplete 2024 data, 414 deaths already involved benzodiazepines.

The coroners service doesn't explain why benzodiazepines became so prevalent, but public health experts have noted that these substances are increasingly mixed into the drug supply, sometimes deliberately and sometimes through contamination. Benzodiazepines are particularly dangerous when combined with opioids because both depress breathing, creating a synergistic effect that naloxone (the overdose reversal medication) cannot fully counteract.

A Poly-Drug Crisis

The substance data reveals that most deaths involve multiple drugs. In 2023, fentanyl was detected in 1,951 deaths, but the total number of completed investigations that year was only 2,270—meaning some deaths involved fentanyl alone, but many involved combinations. Cocaine appeared in 955 cases, methamphetamine in 1,150, benzodiazepines in 988, and alcohol in 446.

Methamphetamine's rise is particularly notable. Detected in 152 deaths in 2015, it appeared in 1,150 deaths in 2023—a more than seven-fold increase. This aligns with public health reports documenting the widespread use of both stimulants and opioids, sometimes simultaneously. Cocaine has remained consistently present throughout the decade, hovering between 700 and 950 detections annually since 2017.

The data underscores a critical point: this is no longer a single-drug crisis. The unregulated market now routinely provides substances contaminated or deliberately combined with multiple psychoactive drugs, making each use unpredictable and potentially fatal.

Who's Dying

The age distribution has remained remarkably consistent throughout the decade. People aged 30 to 39 represent the largest group of deaths every single year from 2015 to 2024. In 2023, this age group accounted for 642 deaths, or roughly a quarter of the total. Those aged 40 to 49 weren't far behind with 573 deaths, whilst the 19 to 29 age group recorded 342 deaths.

The 50 to 59 age group has also seen substantial numbers, with 585 deaths in 2023. Together, people aged 30 to 59 represented approximately 70 per cent of all drug toxicity deaths in 2023. Deaths in people over 70 remain rare—just 48 deaths in the 70 to 79 age group in 2024, and only one recorded death in someone over 80 throughout the entire decade.

Notably, deaths in the youngest age group (under 18) have fluctuated but remain comparatively low: 20 deaths in 2024, down from a peak of 34 in 2022. Whilst any youth death is tragic, these numbers suggest the crisis disproportionately affects adults in their prime working years.

Where It's Happening

Geographically, the crisis touches every corner of British Columbia, but urban centres bear the heaviest burden. Vancouver Centre North—an area that includes the Downtown Eastside—recorded the highest numbers, with 398 deaths in 2023 alone. Surrey consistently shows the second-highest death toll, with 222 deaths in 2023. Burnaby, the Tri-Cities, Kamloops, and Prince George all record substantial numbers.

But the crisis isn't confined to cities. Vernon recorded 59 deaths in 2023. Campbell River had 55. Nanaimo saw 118. Even smaller communities like Penticton (27 deaths), Nelson (16 deaths), and Cranbrook (20 deaths) have been significantly affected. The data includes numerous entries marked "suppressed" for very small communities where reporting deaths could risk identifying individuals—a reminder that even BC's most remote areas aren't immune.

The Fraser Health region, which includes Surrey, Langley, Abbotsford, and surrounding communities, consistently records the highest regional death toll. Vancouver Coastal Health is second, driven largely by Vancouver's downtown core. Interior Health, Vancouver Island Health, and Northern Health all show substantial numbers that have generally increased over the decade.

Temporal Patterns

Monthly data shows relatively consistent death tolls throughout the year in recent years, though some variation exists. In earlier years of the crisis (2016-2017), deaths tended to spike in late autumn and winter months, particularly November and December. In 2016, December alone recorded 162 deaths compared to 51 in May. This pattern has largely disappeared in recent years, with deaths distributed more evenly across months—though still with some fluctuation.

The year 2019 stands out as an anomaly, with deaths dropping to 990 from 1,562 the previous year—a 37 per cent decline. The coroners service data doesn't explain this decrease, and deaths surged again in 2020, reaching 1,776. The COVID-19 pandemic coincided with increased deaths, though whether this reflects increased substance use, increased isolation making overdoses more likely to be fatal, supply chain disruptions affecting drug composition, or other factors cannot be determined from this data alone.

What the Numbers Can't Show

The coroners service data provides comprehensive statistics but leaves many questions unanswered. The documents don't explain why certain substances became more prevalent or what specific drug combinations proved most deadly. They don't indicate what percentage of deaths occurred alone versus with others present who might have called for help. They don't reveal whether the deceased had previously survived overdoses or whether they had accessed treatment services.

Crucially, the substance data only reflects completed investigations with toxicology results. For 2024, only 865 of 2,253 deaths (38 per cent) had completed toxicology at the time of this data release. This lag means the most recent year's substance patterns remain incomplete and could shift as more investigations close.

The geographic data is organised by Local Health Area, a system meaningful to health planners but potentially confusing to the general public trying to understand their own community's risk. Some very small communities have their data suppressed entirely to protect privacy, making it impossible to understand the crisis's full geographic scope.

The rising number of deaths linked to benzodiazepines is part of a broader crisis in British Columbia's drug landscape, which has prompted discussions about fiscal responsibility and public health funding, as seen in the recent coverage of the BC Budget 2026 tax increase.

A Crisis Without Resolution

A decade into British Columbia's overdose emergency, the data shows a crisis that has evolved but not abated. The total deaths from 2020 onwards have remained stubbornly above 1,700 annually, reaching as high as 2,578 in 2023. The 2024 figure of 2,253, whilst lower than 2023, still represents more than four times the 2015 death toll and suggests the crisis has reached a sustained plateau rather than trending towards resolution.

The transformation of the drug supply from primarily heroin in 2015 to fentanyl-dominated by 2017 happened with shocking speed. The more recent emergence of benzodiazepines as a major contaminant suggests the supply continues to evolve in ways that make using unregulated drugs increasingly unpredictable and dangerous. With multiple substances now routinely present in fatal overdoses, each use carries compounded risks that even experienced users may struggle to navigate.

The geographic spread demonstrates this isn't an isolated urban problem but a province-wide public health emergency affecting communities of all sizes. The age distribution shows the crisis is taking people in what should be their most productive years—people in their 30s, 40s, and 50s who might be parents, workers, and community members. Over the decade covered by this data, British Columbia lost nearly 17,000 people to drug toxicity—more than three times the population of Fernie, more than the population of Powell River.

The monthly data's evolution from seasonal spikes to year-round consistency might suggest the crisis has become normalised, a steady drumbeat of deaths that continues regardless of season or circumstance. Whether this represents a new equilibrium or a temporary plateau before further changes in the drug supply remains to be seen.

All data referenced are from the BC Coroners Service, request number OCC-2025-50134, obtained through Freedom of Information requests. The records contain statistics on unregulated drug toxicity deaths in British Columbia from January 1, 2015, to December 31, 2024, broken down by age, geography, month of death, and substances detected.