Last weekend, frontline health workers in Trail, British Columbia reported alarming situations to Dr. Karin Goodison, a medical health officer with Interior Health. The health workers witnessed approximately 20 individuals unconscious each night, lying in the cold streets and suffering from memory loss due to overdoses. Dr. Goodison mentioned that the experienced workers characterized this environment as the most severe they have ever encountered.
Dr. Goodison expressed concern over the disturbing scenes witnessed by the dedicated frontline workers, noting how unusual these conditions are for them, given their extensive experience in the field. The overdose victims are suspected to have fallen ill due to the veterinary sedative medetomidine, a new substance emerging in the unregulated drug supply. In response to this situation, the British Columbia Centre for Disease Control (BCCDC) issued a rare provincewide drug alert.
BC Emergency Health Services reported that paramedics responded to a record 256 overdoses in British Columbia on January 21, although they did not have data on how many of those encounters resulted in fatalities. According to the BCCDC, medetomidine was being mixed with opioids such as fentanyl, leading to dangerously low heart rates, fluctuations in blood pressure, and extended sedation periods.
Dr. Goodison highlighted the odd behaviors exhibited by the overdose victims, which can be traumatic for witnesses and perilous for the individuals themselves. She pointed out that frontline workers currently lack medication to reverse the sedative's effects. Dr. Alexis Crabtree, the medical lead for harm reduction and substance use services at BCCDC, further noted their concern regarding the rising prevalence of medetomidine, especially after a noticeable increase in 911 calls related to overdoses.
The detection of medetomidine has increased sharply, as seen in the samples collected by the BC Centre on Substance Use. In November, it was found in 38 percent of tested opioid samples—a significant rise compared to the previous year when instances of it were rare. Dr. Crabtree remarked that this substance is becoming more common across various regions of the province, including an observed prevalence of 52.2 percent in Fraser Health.
Dr. Crabtree indicated that the issue with medetomidine is not exclusive to British Columbia, as it has already become prevalent in regions like Ontario and the United States. Frontline workers have reported symptoms among users including prolonged sedation, ongoing drowsiness, and low heart rates, raising alarms about the increasingly complex nature of the drug supply.
On Wednesday, Victoria Police issued warnings about overdoses related to medetomidine, having responded to 15 non-fatal overdose cases linked to the drug within a 24-hour period. Dr. Crabtree was hesitant to pinpoint reasons for the rise in medetomidine's use in the illicit drug market, but speculated that it might offer a longer experience than fentanyl and could potentially be more cost-effective for producers.
Regardless of the rationale behind its increased presence, Dr. Crabtree emphasized the risks that individuals who use substances now face due to the complicated drug supply landscape. Drug-related deaths had previously been on a steady decline in British Columbia since their peak in 2023, where 2,589 deaths were recorded, with a tragic high of 242 fatalities noted in December of the same year. As of October 2025, there were 150 reported deaths.
