The City of Vancouver has long led the way on harm reduction. For more than a decade now, its two supervised-injection sites have made it the only jurisdiction in North America with facilities where addicts can inject drugs under the watchful care of nurses. But the suburbs that surround Vancouver have taken more cautious and conservative approaches to drugs, declining to host safe-consumption sites of their own.

That’s finally beginning to change. Fraser Health, the authority responsible for care in communities from Burnaby to Hope in the Fraser Valley, has revealed that it plans to open multiple sites where users can inject heroin, cocaine, methamphetamine, and other drugs.

That doesn’t mean a building like the Downtown Eastside’s Insite is going to open on the so-called Surrey Strip.

In a telephone interview, Dr. Victoria Lee, Fraser Health’s chief medical health officer, said the model they are pursing will more closely resemble Vancouver’s lesser known consumption site, the Dr. Peter Centre in the West End. There, a small row of tables where members inject drugs is incorporated into a much larger health facility that offers a range of services. (Vancouver Coastal Health has said it plans to use the same cost-effective and inconspicuous model for five new consumption sites it’s planning for the region’s largest city.)

Lee said Fraser Health’s plan has been underway since early 2016 but took on a new sense of urgency over the July 15 weekend. From Friday night to Monday morning, authorities recorded 43 overdoses in Surrey. That compares to a weekend average of about 24. None were fatal, but there were many close calls that required the administration of naloxone, a drug that reverses the effects of opioids such as heroin.

According to the B.C. Coroners Service, fatal overdose deaths in Surrey increased from 44 in 2014 to 71 in 2015, and there have been 44 during just the first six months of 2016. In Abbotsford, those numbers are seven, 24, and 16. In Maple Ridge, they are 14, 26, and 15. In Langley, they are 10, 10, and 13. In Burnaby, there were 11 fatal overdoses in 2014, 16 in 2015, and 11 during the first six months of 2016.

On April 14, the province declared a public-health emergency.

Lee said t’s too early to say which cities will host consumption sites but added, “At this time, we are working and engaging with the City of Surrey”.

Asked if Fraser Health might also establish sites in jurisdictions such as Burnaby and New Westminster, Lee replied: “We are engaging more broadly on the comprehensive strategy and talking about supervised-consumption services as an integral component of our comprehensive services.”

She said community consultation is ongoing. From there, the next step will be to request exemptions from federal drug laws that supervised-consumption sites require to operate legally.

Across all of B.C., if current trends prevail, there could be more than 740 fatal overdoses by the end of 2016, up from 494 the previous year and far above the previous all-time high of 400 recorded in 1998.

Fentanyl, a synthetic opioid more toxic than heroin, was found in 31 percent of 2015 deaths, up from 25 percent in 2014 and 15 percent in 2013.