Opioid deaths in Canada fell 17% in 2024, but thousands are still dying

By Amina Zafar, CBC News, RCI

A naloxone kit, used to temporarily reverse or reduce the effects of an opioid overdose. In 2024, deaths from opioid use were down in Canada, though some provinces and territories still saw an increase. Photo: CBC / Aura Carreño Rosas

Opioids in drug supply called a generation-defining health crisis

Reported opioids deaths decreased nationally in Canada by 17 per cent last year, federal figures show, but the decreases aren’t happening uniformly across the country, according to a new report.

The Public Health Agency of Canada released the most recent data on opioid toxicity deaths showing in 2024, 20 people on average lost their lives per day. In 2023, the average was 22 deaths per day. The grim toll last year was 7,146 lives lost.

On Thursday, the Canadian Centre on Substance Use and Addiction (CCSA) said despite the apparent decrease, the overall number of people dying from opioids in the toxic drug supply remains very high.

It’s not known why death rates are declining in many places, though the CCSA did note there was a decrease in potent carfentanil among some samples checked, and a shift from consuming by injection to inhalation.

Samantha King, a research and policy analyst with CCSA in Ottawa, said while the decreases are encouraging, deaths still remain much higher than when British Columbia declared opioid-related overdose deaths a public health emergency in 2016.

It’s not time to drop the ball in terms of allocating resources into either harm reduction or treatment, King said in an interview.

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Mapping the changes

B.C., Alberta, Saskatchewan, Manitoba, Ontario, New Brunswick and Yukon reflected the overall decrease in unconfirmed opioid deaths.

But in Quebec, Newfoundland and Labrador and the Northwest Territories, opioid-related deaths increased from 2023 to 2024.

The situation is largely unchanged in Nova Scotia and P.E.I., King said.

Source: Public Health Agency of Canada Photo: CBC

At the mercy of drug supply

Toronto’s Street Health has run a small supervised consumption site since 2018.

We’re still seeing thousands of people die of preventable deaths across this country. And that’s not something that I feel comfortable pretending is normal, said Kelly White, the non-profit’s manager of harm reduction programs.

White said their clients are at the mercy of the street drug supply people, which has varied over time with corresponding spikes and reductions in overdose deaths.

Fentanyl and similar opioids, like the more potent carfentanil, may be less common now, White said. But they’re seeing more animal tranquilizers with opioids, known as tranq, in the supply.

Animal tranquilizers like xylazine and medetomidine may not cause the same respiratory depression as fentanyl, but people’s heart ranges can plunge extremely low, and they may develop serious, seeping wounds, White said.

We really are constantly playing catch up.

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Dr. Monty Ghosh, an addictions specialist, said he worries Canada may have reached a plateau on opioid overdose deaths.

The people who are most likely to die are already dead, which is a very horrible and morbid thought, said Ghosh, an assistant professor at both the University of Alberta and the University of Calgary.

A multi-pronged approach is needed, he said.

One day people are ready for treatment and treatment supports and they need to access treatment right away, Ghosh said. The next day they’re still using, they’ve relapsed, in which case harm reduction supports are required for them to make sure that they don’t overdose and die.

The drug supply shifts so often given border controls, new drug cartels entering the market and drug wars, Ghosh said.

Dan Werb, executive director of the Centre on Drug Policy Evaluation at St. Michael’s Hospital in Toronto, attributed the reduction in opioid overdose deaths to drug trafficking organizations changing their recipes.

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, Werb said.