Fentanyl has been blamed for thousands of lives lost in B.C. alone, but there's an unintended consequence of public awareness of the issue.

The people who legitimately need the powerful painkiller may not be getting them when they need them most – including during the painful final stages of a terminal illness.

When a loved one walks through the doors of a hospice, it's an emotional and scary time for everyone involved.

"Palliative care helps you live as well as you can for as long as you can," Dr. Romayne Gallagher said.

Gallagher became a palliative care physician after seeing how her father was cared for when he died. She was in medical school at the time, and said she noticed the difference it made for her father to have his symptoms controlled.

End-of-life care can include dealing with the intense physical pain, nausea, shortness of breath and other complications that can come with terminal illness. But some families, and even patients themselves, are turning down painkilling opioids like fentanyl.

"It's not a hard sell to (eventually) convince a person in pain that they would like to get rid of this… and usually not for family members. But family members also tend to worry more about things like addiction and something going wrong," she said.

Doctors like Gallagher point to public confusion about fentanyl, based on what people hear about illicit use and street drugs. Recreational and casual drug users are falling victim to the powerful opioid, which is often added to expensive but diluted street drugs in order to give buyers the high they’re searching for.

Before fentanyl started making headlines, people might ask whether a medication was safe and their doctor would explain risks and benefits, Gallagher said.

"But when you're hearing constantly in the news about people dying on the street and it appears they're dying from the very same drugs your doctor wants to give you, it's not surprising people were and continue to be confused about these medications," she said.

"It's not hard to understand how they want to protect their loved one."

She said she sees it as part of her job to help clear things up for concerned families and patients.

The most recent report from the BC Coroners Service, published Thursday, showed 511 people had died of illicit drug overdose between Jan. 1 and April 30. The number is down slightly from the 553 that died in the same time period last year. 

Fentanyl was detected in 83 per cent of the deaths in the first few months of 2018, according to preliminary data.

"Canada ranks as the world's second biggest consumer of pharmaceutical opioids," federal NDP health critic Don Davis said in April.

Even prescription opioids are under the microscope, blamed for long-term additions and a turn toward illicit drug use. But figures from the coroners service show a stable rate of prescription opioid deaths, even in the years since street drugs became tainted.

"In a medical situation and under medical supervision, (fentanyl) is a safe drug which will help with your pain and shortness of breath and help you feel better," Gallagher said.

"We know if we treat symptoms and get people eating better, sleeping better, moving around, they live longer."

It's a simple message from the dedicated palliative care physician, one she hopes will reach overwhelmed and emotional families during a complex opioid crisis.

With a report from CTV Vancouver's Penny Daflos