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When tucking into your holiday feast this weekend, spare a thought for those unable to enjoy such comforts.

First responders come to mind, especially in Metro Vancouver, which is in the grip of an epidemic of drug overdoses. According to the most recent statistics, 755 people have died so far in 2016, a 70-per-cent increase over this time last year.

If you are shocked by this news, you are excused. For some reason, this public-health calamity has failed to galvanize the country's attention, certainly not like the great SARS panic of 2003 did. It was top of the news – and the federal government's political agenda – for months.

SARS claimed the lives of 44 people in Canada. That many are dying of overdoses in a single week in British Columbia.

The province may have more than 900 overdose deaths by year's end, at the rate things are going. The 128 people who died in November was the highest monthly total all year, which is pretty discouraging given that the provincial health officer declared a public emergency over the crisis last spring.

Certainly, government authorities at all levels deserve some of the blame for this mess; the response has not been the swiftest. But the trail of human destruction caused by newer strains of opioids such as fentanyl also caught local health agencies off guard. A mad scramble is in progress to find ways to prevent more deaths.

If you consider that last week, 13 people in the province died of drug overdoses in a single day, including nine in Vancouver, you would say the response so far has been an unqualified disaster. If, on the other hand, you consider how high the death toll might have been without some of the measures introduced – broader access to resuscitation drugs such as naloxone, mobile medical units and more supervised-injection sites – you would charitably say the plan has done at least some good.

So far, however, efforts have been almost wholly reactive. At some point, the province and Ottawa will have to address underlying issues and seek longer-term solutions, which is even more complex and politically fraught.

Some are drawing a line between what we are witnessing in British Columbia with the province's decision a few years ago to make it harder to access prescription painkillers such as OxyContin. Users will go in search of alternatives, including to the street if necessary, which has its own perils. However, that does not explain why the problem is so acute in British Columbia; governments across the country, including Ontario, have also delisted these types of narcotics.

This scourge is taking the lives of the troubled and dispossessed of Vancouver's Downtown Eastside as you might expect, and also members of the middle and professional class. It does not have a common, recognizable face, which, in some ways, makes it more difficult to tackle.

Any examination of possible remedies always leads to a conversation in which few are comfortable partaking.

One part of it is acknowledging that treatment is simply not an option for many people. Some will be drug users for the rest of their lives, regardless of the amount of intervention. If you accept this, then the best way to keep them alive is to ensure they have access to drugs that do not kill them.

The other aspect of this discussion few want to broach concerns decriminalization. It is the solution almost every public-health expert in the field recommends, and yet it is the one most unpalatable to governments and the public at large.

The example most often cited by those in favour of this route is Portugal, which decriminalized, and regulated, all hard drugs such as heroin and cocaine 15 years ago. In the interim, it has had a significant decline in overdoses, use and disease. Still, some insist on a more hardline approach: Throw anyone linked to drugs in prison, the longer the better.

While that might make some feel better, the so-called war on drugs has been demonstrated not to work, no matter where it has been waged.

The fact is, an ugly stigma around illicit drugs remains. If you use them you are somehow less of a person, if you die from them, you deserve less of our sympathy. We are witnessing that cold truth playing out now. And it is not anything of which we should feel proud.

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