VANCOUVER - The chief medical health officer of Vancouver Coastal Health is calling for a regulated drug supply as an alternative to illegal and deadly substances in response to the overdose crisis.

Dr. Patricia Daly says expanding treatment for people battling addiction to opioids isn't enough to eliminate the risk of death, especially for drug users who have not connected with the health-care system.

Daly has made 21 recommendations in a report that focuses on services provided by the health authority that covers a region of over a million people on B.C.'s urban and rural coast.

The report says a toxic supply of illicit drugs has meant fentanyl, an opioid 50 times stronger than heroin, was detected in 87 per cent of overdose deaths in the Vancouver Coastal Health area in 2018, up from 25 per cent in 2015.

Daly says while residents of the Downtown Eastside have experienced the highest rate of fatal overdoses in Vancouver, smaller rural communities such as Powell River and the Sunshine Coast are also disproportionately affected by the epidemic.

Her report says decriminalizing possession of illicit drugs for personal use would help reduce social isolation for people who could get better access to health care but Prime Minister Justin Trudeau has said his government will not take that step.