A report from the BC Coroners Service says 126 children and youth younger than 19 died from toxic drugs between 2019 and 2023.
That makes unregulated drug toxicity the leading cause of unnatural death for the age group over those five years.
The report says fentanyl or related drugs were detected in 83 per cent of the deaths, either alone or in combination with other substances.
It says about two-thirds of those who died were receiving services offered through the Ministry of Children and Family Development, or had previously received them.
About 60 per cent of those who died were aged 17 or 18, while just over half of those who died were females, in contrast to the general population where about eight in every 10 people killed by toxic drugs is male.
Since B.C. declared a public-health emergency in April 2016, at least 14,400 people in the province have died from toxic drugs.