Grant: Project Grant

Unregulated drug poisoning is now Canada's leading cause of years of life lost, with more than 5,000 deaths every year. British Columbia has been the hardest hit, facing a public health emergency since 2016. The drug supply is increasingly unpredictable, with fentanyl, new synthetic drugs, and dangerous mixtures that cause severe and unusual poisoning. Current monitoring systems-such as drug checking, coroner testing, and police seizures-can identify substances but do not explain how they affect people, leaving doctors and paramedics without the information they need to treat critically ill patients. This study will address that gap by linking advanced toxicology testing with clinical data from 3,000 people treated in six BC hospitals for suspected drug poisoning. Blood samples left over from routine care will be analyzed to measure both known and newly emerging drugs. At the same time, detailed information will be collected from medical records on symptoms, complications, and treatments provided. By combining toxicology results with clinical outcomes, this research will create the most complete picture to date of the drugs and drug combinations causing harm. The findings will give healthcare providers timely, evidence-based knowledge to improve patient care and guide resuscitation efforts. They will also strengthen public health surveillance by adding critical clinical context, support faster detection of new drug threats, and inform policy. Just as importantly, results will be shared with people who use drugs and community partners, helping them recognize new risks and reduce harm. Conducted in the province most severely affected by the crisis, this project will improve emergency care, empower communities, and establish a model for national monitoring of the toxic drug supply.