Beyond the Overdose: A Brain Injury Lens on Addiction and Drug Policy in BC

As British Columbia steps away from decriminalization, headlines are again dominated by enforcement, public safety, and crisis response. Yet in the same moment, another crisis continues to unfold; survivors of overdose are living with anoxic / hypoxic brain injuries that shape behaviour, recovery, and independence.

This is not a future concern. It is a present and growing disability across British Columbia and Canada.

When the toxic drug crisis is discussed in British Columbia, the focus is rightly on lives lost and the urgent efforts to save them. Each death represents a person, a family, and a community forever changed. At the same time, for every life lost, many more people survive overdoses and are often living with invisible neurological damage, an under-recognized consequence that also demands urgent attention¹.

At the CGB Centre (CGB) and the BC Brain Injury Association (BCBIA), our work includes leadership on the BC Consensus on Brain Injury, Mental Health and Addiction. Our objective is to extend the conversation beyond crisis response toward the neurological, human, and systems impacts of overdose-related brain injury.

You can view the full BC Consensus Statement here:
BC Consensus Statement on Brain Injury, Mental Health, and Addiction

Our Role: Informing Policy Through a Brain-Injury Lens

CGB / BCBIA serves as a provincial convenor and policy informant. Our intent with the BC Consensus Statement is to ensure that responses to overdose and addiction reflect the realities of neurological injury across BC — recognizing that impacts and service capacity differ across urban, rural, northern, and remote communities.

Our role is to:

• Promote awareness of overdose-related brain injury
• Translate neuroscience and lived experience into policy guidance
• Identify service gaps and system strain
• Support brain-injury-informed practice across sectors

We do this without partisan advocacy on drug laws, focusing instead on how systems respond to people whose brains have been injured through overdose and addiction.

Overdose Isn’t Just About Death — It Can Cause Lasting Brain Injury

National research shows¹: 

• Every fatal overdose may be accompanied, on the low side, by 15 non-fatal overdoses
• Each loss of consciousness during an overdose is a potential brain injury
• Conservative estimates suggest 600,000+ overdose-related brain injuries in Canada

Many non-fatal overdoses result in hypoxic or anoxic brain injury; damage caused when the brain is deprived of oxygen². Survival is lifesaving, but neurological injury is common and often overlooked.

Potential impacts of hypoxic brain injury include²:

• Memory and attention difficulties
• Executive functioning challenges
• Emotional regulation problems
• Behavioural changes
• Impaired self-awareness

Survivors of overdose often enter addiction, mental health, housing, or justice systems that do not recognize acquired brain injury, leading to misinterpretation as “non-compliance,” “resistance,” or “lack of motivation,” rather than neurological impairment.

Toxic Drug Crisis in BC — The Numbers Speak

The scope of the crisis in BC underscores why brain injury must be part of the response:

• 2,511 deaths in 2023 — nearly 7 per day³
• 14,000+ deaths since 2016³
• Paramedics responded to 40,000+ overdose and poisoning calls in 2024 — about 111 per day⁴
• Toxic drug poisoning is strongly linked to encephalopathy diagnoses, signaling serious neurological injury⁵

For every overdose death, many more people survive — often with hidden brain injuries that affect daily functioning, recovery, and long-term stability.

A Hidden, Growing Disability Across BC

Overdose-Acquired Brain Injury (OABI) is:

• Frequently undiagnosed
• Often unsupported by current services
• A growing barrier to recovery and independence

Current system gaps include⁵:

• Limited post-overdose screening and diagnosis
• Insufficient neurorehabilitation and cognitive-informed treatment
• Lack of supported decision-making and appropriate housing options

When OABI goes unrecognized, people miss critical supports and systems unintentionally create further harm.

How CGB / BCBIA and the BC Consensus Shape Response

Through the BC Consensus on Brain Injury, Mental Health and Addiction, we work to ensure provincial and community responses reflect neurological realities. Our work includes:

• Listening to lived experience and regional realities
• Mapping service gaps and system pressures
• Translating neuroscience into practical policy guidance
• Supporting providers in brain-injury-informed care
• Preventing a parallel crisis of unsupported neurological disability

The CGB / BCBIA acts as a non-partisan policy informant, shaping how BC responds to overdose-related brain injury across health, disability, and community systems.

Where to Go for Drug Policy Advocacy

Organizations leading drug policy and rights-based advocacy include:

• Canadian Drug Policy Coalition (CDPC)
• Pivot Legal Society (BC)
• Vancouver Area Network of Drug Users (VANDU)
• Canadian Students for Sensible Drug Policy (CSSDP)
• Canadian Centre on Substance Use and Addiction (CCSA)

When invited, CGB / BCBIA offers collaboration with organizations to provide a focus on the brain injury, disability, and systems impacts of overdose and addiction.

Looking Forward

Overdose prevention saves lives.
Brain-injury-informed systems protect them.

Recognizing overdose-acquired brain injury, and designing services, accordingly, is essential for recovery, stability, and dignity. CGB / BCBIA and the BC Consensus on Brain Injury, Mental Health and Addiction are committed to ensuring survivors are not navigating systems that were never built for injured brains.