The impoverished downtown of Vancouver is ground zero for deadly fentanyl overdose crisis (Dr. Nadia Fairbairn)

Sirens scream non-stop through the urban heart of Vancouver, as responders race toward drug addicts overdosing - and dying in such numbers that the city’s morgues are full.

This wealthy Pacific coast city is the bleak epicentre of an opioid epidemic that has claimed thousands of lives in Canada, while next door in the United States, drug overdoses are now the leading cause of accidental death.

The emergency room at St Paul’s hospital has handled more than 6,000 overdose patients so far this year, said physician Nadia Fairbairn.

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