It seems unlikely we can control the supply of fentanyl to any meaningful extent - at least not in the short term. It's extraordinarily potent, and it can be mailed in small packages that wouldn't attract any attention in the mail, and still have huge potential - to get the user high, or to kill them. "A few hundred micrograms – the weight of a single grain of salt – are enough to trigger heroin-like bliss. But the line between euphoria and fatal overdose is frighteningly thin: An amount the size of two grains of salt can kill a healthy adult." [
source].
Why Canada? From the Globe and Mail article (above) - "
No other country in the world consumes more prescription opioids on a per-capita basis, according to a recent United Nations report. The widespread use of prescription opioids is behind the rise of a new class of drug addicts, many of whom are turning to the black market to feed their habit."
Deaths from opioids are actually worse in the US than in Canada overall. More than 70,200 Americans died from drug overdoses in 2017, including illicit drugs and prescription opioids—a 2-fold increase in a decade. 47,600 of those deaths involved some form of opioid, and the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (other synthetic narcotics) with more than 28,400 overdose deaths. With a 2017 population of 325 million, that's 1 in 6,800 people dying of opioid use.
I haven't found a 2018 number for Canada yet, but In 2017 there were 3,987 deaths linked to the use of opioids, and the first half of 2018 saw over 2,000 deaths, so it's probably still going up. There were 36 million people in Canada in 2017, so around 1 in 9,000 died of opioid use in 2017. I'm guessing it's higher in BC, probably because our drug supply is the most contaminated.
That's partly why the health authorities and the police favour supplying safe sources of opioids to users. Ironically, (and shown by the death rates) the greater problem is with recreational users - not addicts in the DTES. There the likelihood is there's someone else around who knows what's happening, and where Naloxone can be found, and there's a good chance of saving their life. Using 'cocaine' in a West End apartment is probably higher risk. I don't know how you go down the road of ensuring a supply of unadulterated drugs available to users like that, although we've done it with cannabis, and the world doesn't seem to have come to an end.
Portugal legalized all drugs "
Since it decriminalised all drugs in 2001, Portugal has seen dramatic drops in overdoses, HIV infection and drug-related crime" Anything other than legalization and a safer supply of drugs will probably see continued high death rates. It seems apparent that for now politicians aren't going to risk alienating people who don't agree with that idea, so the death rate will probably stay at least at the level we've seen in the past two years.