Ten Years. 18,000 Dead. A System Built to Fail.

As a newcomer to Kamloops, I thought this crisis stemmed from bad choices. Four years later, the evidence changed my mind.

Somewhere in Kamloops right now, in a motel room, a vehicle parked in a back alley, or a basement stairwell, someone is using drugs alone. If something goes wrong, no one will find them in time.

That invisibility is not an accident. It is the outcome of a system built, piece by piece, to push them into invisibility.

On 14 April 2016, British Columbia declared a public health emergency in response to toxic drug deaths. Ten years later, more than 18,000 people in this province have died. In January of this year alone, 150 more lives were lost, nearly five people every day. Interior B.C. holds only about 17 per cent of the province’s population, yet our region has accounted for roughly a quarter of all deaths. In the Thompson-Cariboo-Shuswap, our home region, the death rate reached about 60 per 100,000 people in 2021.

Those numbers have not meaningfully improved. What has improved, it seems, is our ability to look away.

It did not start with fentanyl

Most of us grew up with a tidy story about drugs: people tried them, liked them, and then could not stop. It is easy to believe, but it is also wrong.

The crisis unfolded in waves. In the 1990s and 2000s, Purdue Pharma, the maker of OxyContin, knew its painkiller carried a high risk of addiction. The company marketed it anyway, in what researchers would later describe as an unprecedented promotional campaign in the history of opioid medicine. In 2001 alone, Purdue spent around $200 million marketing OxyContin, many times more than competitors spent on comparable medications. Sales representatives were coached to tell doctors that the addiction risk was less than one per cent. That figure did not come from clinical trials. It came from a five-sentence letter in a medical journal, taken wildly out of context.

Patients trusted their doctors. Doctors trusted the information they were given. Neither group knew they were being misled.

When OxyContin was reformulated around 2010 to make it harder to misuse, people who had become dependent on it did not simply stop needing an opioid. Many switched to heroin, which was cheaper and widely available. By 2015, heroin-related deaths had surpassed prescription opioid deaths.

Each wave was not a coincidence. It was a consequence.

The paradox we rarely discuss

Here is a piece of conventional wisdom worth examining: if we crack down harder on drugs, we will have fewer problems. It feels like common sense, but the evidence tells a different story.

The harder we crack down on the drug supply, the more dangerous it becomes. Drug policy researchers have recognised this pattern for decades. They call it the “Iron Law of Prohibition.” When police target bulky drugs like heroin, suppliers adapt. They shift to substances that are smaller, easier to hide, and far more potent. Fentanyl largely replaced heroin because a lethal dose fits in an envelope. You cannot say the same about heroin.

With each enforcement wave, the supply has shifted towards higher potency and smaller size. Each dose has become more unpredictable and more likely to kill, while the number of people who need a drug has not gone down. We did not get a cleaner street. We got a more dangerous drug.

Four reasons this crisis will not fix itself

Over the past six months, I set out to understand this crisis as part of the Map the Systems competition at Thompson Rivers University and the University of Oxford. I wanted to know why, despite a decade of headlines and task forces, the figures in Interior B.C. still look the way they do.

I did not find a pile of separate problems. I found one system, built from four self-reinforcing cycles that feed into one another. All four run simultaneously. Together, they explain why nothing seems to change.

Cycle 1: Enforcement makes drugs more deadly. Crack down on supply, and suppliers make drugs smaller and stronger to make them easier to hide. Smaller and stronger means a misjudged dose can kill. More deaths create public pressure for tougher policing, which pushes suppliers to increase potency again. Nothing in this cycle reduces harm. Everything in it turns the dial up.

Cycle 2: Clearing encampments pushes people indoors, alone. When we see tents in parks or people using in public, many of us feel angry or afraid. We phone the city. Encampments are cleared. Drug use does not stop. It moves into vehicles, stairwells, motel rooms, and private basements. Out of sight. Hidden use means no one is there to call 911. The crisis quietly reappears somewhere darker, and we repeat the same moves. In Kamloops, the 100-metre exclusion zone around parks and playgrounds does not stop drug use. It simply moves it where we cannot see it, and where dying alone is far more likely.

Cycle 3: Losing housing means losing your life. We tell ourselves that “those people” are homeless because of drugs. The truth on the ground is messier. One job loss, one rent hike, or one conflict with a landlord can push any of us into a shelter, a motel, or a friend’s crowded couch. These unstable, stressful environments make drug use more dangerous, rushed, hidden, and solitary. In Interior B.C., many shelters close from April through September. As the weather warms and tourists arrive in Kamloops, people who had a bed through the winter are suddenly outside again, with nowhere safe to go.

Cycle 4: A crisis that hits Indigenous communities hardest. This is the cycle many of us are most uncomfortable naming, especially in a city with Kamloops’s history. But the numbers are unambiguous. In B.C., First Nations people are dying from toxic drugs at 5.4 times the rate of the rest of the population.

For First Nations women, the rate is 9.8 times higher. These differences are not explained by individual choices or culture. They are governance outcomes. Provincial and federal governments control budgets, laws, and most data, while Indigenous governments are asked to implement decisions made without them. Where Indigenous communities lead the design of services, trust rises and outcomes improve. Yet those efforts remain small, underfunded pilots, not the foundation we build on.

Four cycles. All running at once. All making things worse.

Radhika M. Tabrez is a Master of Arts candidate in Human Rights and Social Justice at Thompson Rivers University. She was a Finalist and Audience Choice Award winner at the 2026 Map the Systems competition. This is the first of two parts. Part Two, what we got wrong and what could actually work, appears in our next edition.