In a significant, albeit cautious development, Canada reported a 17 percent decrease in opioid-related deaths in 2024 compared to the previous year. This cut comes at a time when our country is dealing with a lingering public health crisis. The crisis In 2016, British Columbia became the first province to declare opioid-related overdose deaths a public health emergency. The Canadian Centre on Substance Use and Addiction (CCSA) documented 7,146 opioid-related deaths in 2023, averaging 22 deaths per day.
Though the overall picture is one of decline, the reality is much more complicated. Some provinces and territories, including Quebec and Newfoundland and Labrador, experienced increases in opioid-related deaths, highlighting the ongoing challenges in combating this crisis. This mixed outcome highlights the importance of sustained advocacy and funding to expand access to both harm reduction and treatment.
Shifting Trends in Drug Supply
Most of the recent decrease in opioid overdose deaths can likely be explained by a shift in drug trafficking organization (DTO) characteristics. Dan Werb noted that these organizations are adjusting their product recipes, which could lead to fluctuations in drug potency and availability. “While I’m really elated to see these reductions in drug overdose fatality, it’s quite disappointing to me that 10 to 15 years into this generation-defining health crisis, we’re relying on drug trafficking organizations to decide whether people live or die,” he stated.
Fentanyl and related opioids, such as carfentanyl, seem to be winning out in the present-day drug supply. The introduction of hazardous chemicals, like animal sedatives—namely xylazine and medetomidine—has introduced unprecedented dangers. Kelly White, the manager of harm reduction programs at a non-profit organization, sent out this alert. She countered that these substances can dangerously slow heart rates and potentially cause a variety of severe health issues.
Dr. Monty Ghosh worried that Canada had hit a ceiling on increasing opioid overdose deaths. Yet even as he argued for greater access to treatment, he lent voice to a frustrating reality—that people in recovery often go through cycles of relapse. One day people are just getting up to market facing supports and treatment accessible to them and they’re called upon to enter treatment immediately. Next day, they’re still using and have gone back out. In this context, harm reduction resources are necessary to save overdose and keep them safe.
Provincial Disparities and Ongoing Challenges
While there are fewer opioid-related deaths overall, this decrease is not being felt consistently across Canada. British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, New Brunswick, and Yukon all showed significant decreases in unconfirmed opioid deaths. Quebec, Newfoundland and Labrador, and the Northwest Territories went up from 2023 to 2024.
In areas such as Nova Scotia and Prince Edward Island, the news is no better. Samantha King discussed the importance of continued commitment for resource investments in order to respond to this crisis in an impactful manner. “It’s not time to drop the ball in terms of allocating resources into either harm reduction or treatment,” she asserted.
These mixed results province by province are a good reminder that there is nothing simple about solving the opioid crisis. Border controls, the entry of new drug cartels, and ongoing drug wars contribute to changing patterns of substance use across Canada. Together, these conditions form a perfect, ever-changing storm that affects our communities and residents.
Looking Forward
While Canada responds to these shifts, advocates say that supervised consumption sites are more important than ever. They too highlight the importance of addressing the social determinants of substance use. DJ Larkin, executive director of the Canadian Drug Policy Coalition, underscored the significance of these factors. They are essential to ensure that any decrease in opioid-related deaths is sustained.
