Vancouver's police chief says the fentanyl crisis hit a brutal low point Thursday with the overdose deaths of as many as nine people in a single night.

Flanked by Mayor Gregor Robertson and other emergency officials at a Friday news conference, Chief Adam Palmer said serious help is needed to deal with a problem that is claiming lives at an alarming rate.

"Can you imagine nine people dying from any other cause in one day in our city," Palmer said. "We need a longer-term strategy to help people in crisis."

Paramedics attend to an overdose patient after three doses of Narcan fail to revive him. (CBC)

Citing statistics from his officers that suggest as many as 35 people died of fentanyl overdoses in November alone, Palmer said addicts need "treatment on demand."

159 dead so far this year

So far this year, illicit drug overdoses have claimed the lives of 159 people in Vancouver. Fentanyl has been found to be a factor in the majority of those deaths.

Even though toxicology tests have not been completed on the nine people who died last night, fentanyl is suspected in their deaths.

Thirteen hundred people on any given day are playing Russian roulette with fentanyl. - Gregor Robertson, Vancouver mayor

Palmer said health workers are having to send people as far away as Armstrong and Nanaimo because of a lack of available beds in the Lower Mainland.

A grim-faced Robertson echoed Palmer's plea. He said waiting eight to nine days for treatment is unacceptable in a city where an estimated 1,300 people are taking illicit opioids every day.

"Thirteen hundred people on any given day are playing Russian roulette with fentanyl," the mayor said.

"It's desperate times in Vancouver right now, and it's hard to see any silver lining when we don't seem to have hit rock bottom."

Unprecedented number of deaths

Fentanyl has been found to be involved in the majority of the 159 drug overdose drug deaths so far this year in Vancouver. (Canadian Press)

Palmer said the rising number of overdose deaths is unprecedented and that Vancouver could see close to 200 deaths by the end of the year. In comparison, the city had 11 homicides and 15 motor vehicle deaths in 2015.

He said city officials have been asking for treatment on demand for years and said that recent treatment resources announced by provincial Health Minister Terry Lake are not enough.

"When somebody comes forward, they need help. We need to help that person," he said.

Robertson said a comprehensive solution is needed involving all three levels of government to deal with the poverty, addiction and mental health issues that have all contributed to an ever-escalating crisis.

"We're not able to tread water anymore, we're losing too many people," Robertson said.

As many as 13 deaths across B.C.

The BC Coroners Service says of the nine deaths, two have not been confirmed as being drug-related but are suspected.

It said there were also four other overdose deaths in B.C. on Thursday: one in Burnaby, two in the Fraser Valley and one in northern B.C.

"We are not sure what has caused this very distressing spike in fatalities," said chief coroner Lisa Lapointe in a statement. "It will take detailed toxicology testing and further investigation to try to determine that."

The coroners service said it is continuing to work with the Joint Task Force on Overdose Response, established by the government in July, to try to reduce the death toll.

Between January to October 2016, 622 people in British Columbia died of overdoses.

November's figures will be made public on Monday.

Premier says more needed on all fronts

In an interview with The Canadian Press on Friday, Premier Christy Clark described the overdose crisis as a complex issue that requires more police and treatment options. But she stopped short of promising more money or programs.

"The thing that frustrates me has been people who say, 'Here's the one thing we need more of,"' she said.

"We're not going to simplify it down to just detox beds. We need more police. We need more RCMP on the ground. We need more Canada Border Services Agency drug interdictions. We need more treaties. We need more health care. We need more naloxone."

Dr. Mark Tyndall, executive medical director of the BC Centre for Disease Control, said frontline workers are seeing the same people overdosing repeatedly without any follow-up.

"I really understand where the frontline people are coming from, that it seems to be just banging your head against the wall and things just getting worse, and there's really nowhere to send people."

With files from The Canadian Press