In 2017, health authorities called together the media to make a public warning — fentanyl was in Newfoundland and Labrador, and was suspected in a string of overdoses within a two-week period.

Last year, 23 people died of opioid overdoses and 57 people were hospitalized, according to figures provided from Dr. Simon Avis, the province's chief medical examiner, to police.

"There's a significant increase in overdoses," Royal Newfoundland Constabulary Sgt. Steve Knight said in a wide-ranging panel discussion on the St. John's Morning Show Tuesday.

He added the overdoses were related to a number of opioids, including OxyContin, morphine, fentanyl, carfentanil, and hydromorphone.

In 2015, there were 20 overdose deaths province-wide.

Hard to pinpoint all overdoses

CBC News asked for the 2017 numbers broken down by region and by drug through access to information requests, but was told the data has not yet been completed.

However, the official number of people who overdosed and survived is likely skewed.

Dawn Smallwood's son Nathan died from a fentanyl overdose on March 28, 2015, at the age of 23. Dawn Smallwood attended a rally outside of Confederation Building on Aug. 31. (Mark Quinn/CBC)

"They're using the naloxone kit and forget the next bit, which is to call 911," said Newfoundland and Labrador's Health Minister John Haggie, who is also a surgeon.

"We don't know how many those are."

Tree Walsh has a better sense of the truth behind the statistics, having worked as an advocate for years.

She did a line of coke, man, she didn't think she was going to die. - Tree Walsh

Walsh distributes clean needles and naloxone kits — which can reverse an opioid overdose — as part of the Safe Works Access Program (SWAP).

"It sounds like it's happening quite frequently," she said. "People are reluctant to talk about the situation."

Walsh said she is hearing from drug users that the two vials of the antidote that comes in a typical naloxone kit aren't always enough to match the strength of the drugs on the street, and users have to give multiple doses in order to reverse the overdose.

Cocaine, heroin 'bigger drugs' in N.L.

From a policing standpoint, Knight said officers are noticing many prescription medications that are being abused on the street as well as other drugs that weren't as common years ago.

"Cocaine is probably one of the bigger drugs in our province right now, and we are starting to see an increase in heroin use," he said.

Those drugs are being cut with illicit fentanyl that's coming from the west coast of the country, he said.

Nicole (Niki) Chapman, 39, died April 26, 2017, of an overdose. At the time, it was believed to be fentanyl-related. (Facebook)

"When drugs are mixed with this fentanyl it's lethal and people don't know what they're taking," Knight said, who works for the the Combined Forces Special Enforcement Unit.

Walsh, through her work with SWAP, is also hearing stories of street drugs being mixed with fentanyl as a way to improve dealer's profit margins.

She recounted hearing from friends about a woman who died over Christmas.

"She did a line of coke, man, she didn't think she was going to die."

Not quite a crisis

Despite the increase in overdose deaths, Walsh stopped short of calling it a crisis but rather a personal crisis for those who are living it.

Haggie, meanwhile, points to the government's efforts to educate doctors on prescribing opioids.

"There's enough prescription opioids prescribed to give every man, woman and child a twice week course of opioids each year," Haggie said.

"Addictions start with a pad as far as we're concerned."

Volunteers with the Safe Works Access Program assemble take-home naloxone kits Tuesday. (Sherry Vivian/CBC)

A new program launched last November aims to flag health professionals if a person has visited multiple doctors in an attempt to get drugs.

But Walsh is hearing from pain patients who began injecting their prescription when the drugs no longer meet the need, and fear what will happen if they're cut off from their prescription.

"They're terrified. They're afraid that their doctor will be put under scrutiny for prescribing too much opioids," she said.

She said one man who uses SWAP fears he will have to go to the street for his drugs if that happens.

Introducing Suboxone

In 2016, Haggie and his department introduced an alternative to methadone treatment.

Suboxone is less prone to cause an overdose because of its chemical composition, and can be taken in a tablet form, instead of as a liquid like methadone.

"They don't have to line up at the drug store at 8 a.m. in the morning to get their dose," Haggie said, comparing it to methadone.

Numbers obtained by CBC News show far more individuals are on methadone than its reported safer alternative, Suboxone.

Between May 26, 2017 and Dec. 31, 2017, the health department said 1,954 people had prescriptions for methadone. It came at a cost of $2,990,931.66 to the Newfoundland and Labrador Prescription Drug Program (NLPDP).

Within that time frame, 376 people had prescriptions for Suboxone. Those prescriptions cost $153,626.87 to the NLPDP.