Any pill can be a killer – five points on the fentanyl crisis in Vancouver

Last year, I gave a course with a former FBI agent on the fentanyl overdose crisis. Learning about the U.S. law enforcement response, I was struck by how global response efforts are not as aligned as they could be.

Here are five points every Vancouverite should know about the fentanyl crisis.

Your first pill could be your last

One, street drugs are so dangerous today that no one cares anymore if you become addicted  –  we care about whether you’re going to die. 

That’s right. 

It’s no longer about addiction. It’s about survival because your first illicit pill may be the last pill you ever take. 

Fentanyl is cut into heroin, crystal meth, cocaine, ecstasy, Oxycodone, Xanax, Adderall, Ritalin and Percocet. Because fentanyl is being cut into everything and pressed into counterfeit pills, it presents new dangers to teenagers and young adults.

Hot loads

Two, counterfeit drug makers and Mexican drug cartels make commercial-grade pills so they look and feel like a real Ritalin or Adderall pill. Mexican drug cartel workers are not chemists. The mixing of their pills is haphazard and that means any pill that your teenager is buying from friends at university may be a “hot load.” A hot load is a pill that is badly mixed and contains a lethal dose of fentanyl. During a recent home seizure, the DEA found that 13% of counterfeit pills seized had fatal doses of fentanyl.

Vancouver is ground zero

Three, in 2016, according to my research at the time, Vancouver was ground zero for fentanyl deaths in the world per capita, beating out New York City and Philadelphia. In January 2019, British Columbia had 2.9 deaths per day from illicit drug overdoses. We now have 5.3 deaths per day. Not only that, cases of extreme fentanyl potency deaths have increased from 8% to 13%, meaning that the concentrations of fentanyl in illicit drug overdose deaths almost doubled. More hot loads are making their way into our streets and university campuses. Five years on, we are still ground zero.

Where is it coming from?

Four, 85% of fentanyl is from Mexican drug cartels that buy precursors to manufacture it from China. Despite the incarceration of El Chapo, the Sinaloa cartel has the largest footprint in manufacturing and distributing fentanyl.

In terms of drug typology, fentanyl trafficking overlaps with the Sinaloa cartel’s heroin routes from Mexico and up to the Great Lakes and the U.S. Northeast. This is relevant for Vancouver because the Sinaloa cartel claimed Vancouver for its own a while ago.

This means two things – the Sinaloa cartel is supplying fentanyl to Vancouver, and Vancouver will always have worse fentanyl exposure than the rest of Canada unless the Sinaloa loses ground. With global drug trafficking, the most damage always occurs at drug settlement (entrance) points. We know from fentanyl overdose death rates that the most damage per capita is indeed occurring in Vancouver and in the U.S. Northeast and Great Lakes – all Sinaloa territory.


Five, every pill sold that is laced with fentanyl has a money launderer behind it, often working for a Mexican drug cartel. Those money launderers repatriate billions of dollars annually in proceeds of crime from Vancouver to Mexico. Because Vancouver is a global hub for wealthy Chinese and Iranian politically exposed persons close to the regimes of those countries, it became a breeding ground for illicit groups that provide money laundering as a service to move money from the Middle East or China, obfuscated by shell companies through culture-based money services businesses.

Those providers of money laundering as a service now serve more lethal cartel masters. Part of the money laundering repatriation services they provide involve mirror laundering using Bitcoin through Vancouver at unregulated online digital currency exchanges embedded in Canada and China.


The solutions are both simple and complex. Lots is being done on demand and harm reduction among many agencies. The Canadian Chiefs of Police and the Vancouver Police Department have taken leadership roles, calling for innovative health-based approaches to disrupt the cycle of death.

In terms of supply reduction, transnational criminal organizations can only be debilitated by cutting off their money. That requires a concerted effort by federal decision-makers to understand and address money laundering as a service in Vancouver and invest in technology innovation to identify and dismantle bad actors.

But more than anything, we must de-stigmatize those caught in the circle of illicit drugs and bring the same compassion to human suffering that we brought to bear for the HIV crisis because those who are drug dependent or addicted are not druggies – they are our children, our co-workers, our friends, our relatives, our neighbours.

Christine Duhaime is a financial crime expert with Fusion Intelligence.