Fentanyl
Fentanyl is a synthetic (man-made) opioid that is more toxic than most other opioids, and can be prescribed by a physician to help control severe pain. Fentanyl is also being produced in illegal labs and sold on the streets, often mixed with other drugs. Increasingly, fentanyl is being detected in overdose deaths in BC.
About Fentanyl
Why is fentanyl dangerous?
Fentanyl is around 20 to 40 times more toxic than heroin and 50 to 100 times more toxic than morphine, which makes the risk of accidental overdose higher. When fentanyl is combined with other opioids (like heroin, morphine, methadone or codeine), alcohol, benzodiazepines, or cocaine or methamphetamines, it can further increase the risk of accidental overdose. Combining substances (including alcohol), intentionally or unintentionally, increases overdose risk. It’s also important to be aware that drugs other than fentanyl can also be lethal, and that there is no quality control or regulated manufacturing process for illegal drugs.
Where is it coming from?
Illicit fentanyl is manufactured in clandestine overseas drug labs, both overseas and in Canada. It may be cut into powders or pressed into pills prior to being sold.
Where is it found?
Fentanyl is sometimes sold as fentanyl but other illegal drugs can also contain it, including heroin, cocaine, oxycodone, crack or meth. It may be in drugs that are in powder, liquid or pill form.
These drugs may contain toxic contaminants or have different levels of fentanyl in each batch. Even pills produced in the same batch may have little to lethal levels of fentanyl.
What can you do?
Be aware that drugs obtained from anywhere other than a pharmacy or a hospital may not be what you think they are, or what others believe them to be.
Learn how to recognize and respond to a drug overdose.
See our tips for safer substance use.
Alerts
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VCH - Drug Alert - Vancouver Downtown EastsideJuly 07, 2025 • Posted by Vancouver Coastal Health
***Drug Alert - Vancouver - July 7, 2025***
VCH has issued a drug alert.
Multiple samples (pink chunk, beige chunk, beige granules) sold as down in the Downtown Eastside of Vancouver tested positive for piperidone, a precursor chemical used to make fentanyl, and negative for fentanyl itself. Substance may cause dizziness, nausea and abdominal pain.
Check your drugs: https://www.vch.ca/en/service/drug-checking
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Interior Health - Drug Advisory - Interior Region July 07, 2025 • Posted by Interior Health
***Drug Advisory - Interior Region - July 7, 2025***
Interior Heath has issued a DRUG Advisory for the Interior Region for DOWN frequently containing Carfentanil. These samples frequently also contain benzodiazepines as well as tranquilizers. Carfentanil is considered up to 100X more potent than fentanyl. The combination of opioids with these substances amplify the effects of the drugs and significantly heighten the risk of fatal overdose.
- Smoking is not safer than injecting.
- High risk of overdose and fatal overdose.
- Repeated doses of Naloxone may be required.
Please ensure your clients are aware of safer drug use tips that can help prevent overdose as well as where they can access naloxone, drug checking and other overdose prevention services in your community.
Please display the attached posters in high visibility locations and remove August 4.
Service Provider Information:
Supervised Consumption and Overdose Prevention Services
Drug Checking services found at www.drugchecking.ca
IH Mental Health Services: 310-MHSU
Virtual Addiction Medicine Clinic (VAM)
Our Virtual Addiction Medicine (VAM) clinic offers a full range of opioid agonist treatment (OAT), including buprenorphine-naloxone (Suboxone®), methadone, and slow-release oral morphine (SROM / Kadian®).
How VAM works:
- Our team works with you to assess your individual needs, develop a treatment plan, and help you achieve your goals
- The VAM clinic is virtual, meaning your appointments will take place over the phone no matter where you are in the Interior Health region
- The VAM clinic does not provide long-term care. Once you are comfortable with how your treatment is going, we will help you find health services in your community
- If you need help managing prescribed safer supply or alternatives, supervised consumption, overdose prevention, supervised withdrawal from alcohol, or counselling, please contact your nearest Interior Health Mental Health and Substance Use centre at 310-MHSU (6478).
- Click here to request an appointment.
No matter what or how you use (smoking, snorting, injecting) take steps to prevent overdose
- Check your drugs before using! Whether using take home fentanyl test strips or accessing drug checking services in your area, drug checking can inform you about what is in your drugs. Drug Checking services found at www.drugchecking.ca
- Know the signs of an overdose and be prepared with naloxone. Find out where to get naloxone on the ‘Towards the Heart’ website, under ‘Find a site’.
When using substances:
- Use with others around
- Use one person at a time so someone can respond to overdose if needed
- When using your substance start with a small amount, and then go slow.
- Know the risks when mixing drugs
- Smoking is not safer than injecting, be cautious when smoking your drugs
- If using alone, consider using the Lifeguard app which can connect you with 911 emergency responders if you overdose. Download at the App Store or Google Play.
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Interior Health - Drug Alert - NelsonJuly 02, 2025 • Posted by Interior Health
***Drug Alert - Nelson - July 2nd, 2025***
Interior Heath has issued a DRUG ALERT for Nelson and surrounding area for Pink Chunks/Powder/Pebbles sold as DOWN containing Fluorofentanyl, Ketamine and Benzodiazepine (unspecified).- High risk of overdose and fatal overdose.
- Dizziness, dissociation and confusion.
- Nausea, amnesia, sleepiness, nodding out for a long time.
- Smoking is not safer than injecting.
Ketamine is a dissociative anesthetic. In higher doses, it can cause immobilization, loss of body control, dizziness and hallucinations. The combination of fluorofentanyl, ketamine and benzodiazepines can lead to significant sedation. Overdose symptoms may last beyond administration of naloxone.
Click here for a printable poster.
If you have a drug that looks like this, get it tested before using. Drug checking is available at ANKORS in Nelson. Call or text 236-972-7080 for more information.
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Interior Health - Drug Alert - CranbrookJune 30, 2025 • Posted by Interior Health
***Drug Alert - Cranbrook - June 30, 2025***
Interior Heath has issued a DRUG ALERT for Cranbook and surrounding area for Pink Chunks/Powder/Pebbles sold as DOWN containing Fluorofentanyl, Ketamine and Benzodiazepine (unspecified).
- High risk of overdose and fatal overdose.
- Dizziness, dissociation and confusion.
- Nausea, amnesia, sleepiness, nodding out for a long time.
- Smoking is not safer than injecting.
Ketamine is a dissociative anesthetic. In higher doses, it can cause immobilization, loss of body control, dizziness and hallucinations. The combination of fluorofentanyl, ketamine and benzodiazepines can lead to significant sedation. Overdose symptoms may last beyond administration of naloxone.
Click here for a printable poster
If you have a drug that looks like this, call or text 260-426-3383 to get it tested before using. Drug checking is available from 9 to 4 Mon-Fri (excluding holidays) at ANKORS in Cranbrook.
Please ensure your clients are aware of safer drug use tips that can help prevent overdose as well as where they can access naloxone, drug checking and other overdose prevention services in your community.
Service Provider Information:
IH Mental Health Services: 310-MHSU
eOPS Nurse: 250-417-7056
Drug Checking: ANKORS (250)-426-3383
Virtual Addiction Medicine Clinic (VAM)
Our Virtual Addiction Medicine (VAM) clinic offers a full range of opioid agonist treatment (OAT), including buprenorphine-naloxone (Suboxone®), methadone, and slow-release oral morphine (SROM / Kadian®).
How VAM works:
- Our team works with you to assess your individual needs, develop a treatment plan, and help you achieve your goals
- The VAM clinic is virtual, meaning your appointments will take place over the phone no matter where you are in the Interior Health region
- The VAM clinic does not provide long-term care. Once you are comfortable with how your treatment is going, we will help you find health services in your community
- If you need help managing prescribed safer supply or alternatives, supervised consumption, overdose prevention, supervised withdrawal from alcohol, or counselling, please contact your nearest Interior Health Mental Health and Substance Use centre at 310-MHSU (6478).
- Click here to request an appointment.
No matter what or how you use (smoking, snorting, injecting) take steps to prevent overdose
- Check your drugs before using! Whether using take home fentanyl test strips or accessing drug checking services in your area, drug checking can inform you about what is in your drugs. Drug Checking services found at www.drugchecking.ca
- Know the signs of an overdose and be prepared with naloxone. Find out where to get naloxone on the ‘Towards the Heart’ website, under ‘Find a site’.
- When using substances:
- Use with others around
- Use one person at a time so someone can respond to overdose if needed
- When using your substance start with a small amount, and then go slow.
- Know the risks when mixing drugs
- Smoking is not safer than injecting, be cautious when smoking your drugs
- If using alone, consider using the Lifeguard app which can connect you with 911 emergency responders if you overdose. Download at the App Store or Google Play.
Resources

Opioid Overdose Awareness
Our web page features risks, signs and how to respond.