The Toxic Drug Poisoning Crisis through the DPIE Framework in British Columbia

The toxic drug poisoning crisis, also known as the opioid crisis, is a major issue in British Columbia, as there are daily overdose fatalities. This study introduces a novel framework, DPIE, connecting deaths to population at risk, the incidence rate, and the effectiveness of intervention. We analyze the factors of opioid-related mortality between 2016 and 2024 across multiple municipalities in British Columbia. The analysis reveals that the increase in the incidence rate was the main cause of increases in the fatality rate, which has risen on average since 2019. Regionally, Northern Health recorded the highest death rate in 2024 at 124.5 per 100,000 people at risk. In contrast, Fraser Health had the lowest death rate (47.8 per 100,000) followed by Vancouver Coastal. City level analysis revealed even greater disparities: Victoria and Langley (City) had the highest fatality and death rates driven by the incidence rate. Surrey demonstrated many overdose cases but a very low mortality, indicating high intervention effectiveness. These findings suggest that overdose mortality is strongly influenced not just by the support service presence, but by accessibility and many other systemic factors. The framework offers a macro level evidence-based tool for evaluating and targeting overdose policy interventions. Coordinated action at municipal, provincial, and federal levels remains critical to apply the appropriate measures to improve the crisis