The Opioid Crisis in Canada: A Community Emergency That Demands Compassionate Action

By Regan Roberts – Student Intern

On August 31^st, 2025, it is Overdose Awareness Day in Canada. As it is known to those who work either in the justice system, social services, or health care, the opioid crisis in Canada isn’t just a health emergency—it’s a social, political, and community-wide disaster that touches thousands of lives. From big cities to rural towns, Canadians are dying every day from drug toxicity, primarily driven by fentanyl and other synthetic opioids. According to Statistics Canada (2024), between January 2016 and March 2024, more than 47,000 people in Canada lost their lives to apparent opioid toxicity. That’s the equivalent of losing an entire small town in less than a decade.

This crisis goes beyond the numbers. It’s about real people—parents, siblings, coworkers, and neighbours—struggling with pain, trauma, and systemic barriers. It’s a story of a health system that wasn’t ready, a society that judged instead of helped, and policies prioritizing punishment over support. But it’s also a story of change—harm reduction, integrated care, and community-led solutions rising to meet this pressing challenge.

Understanding the Roots of the Crisis

The roots of the drug epidemic and opioid crisis are deep and complex. Yes, individual choices play a role, but so do broader systemic issues—poverty, trauma, lack of healthcare access, and the social stigma surrounding substance use. Many of the people caught in the opioid crisis were first introduced to opioids through legal prescriptions meant to manage pain. According to Dr. Nora Volkow and Dr. A. Thomas McLellan (2016), widespread over-prescription practices created a pathway for many individuals to develop dependencies that later escalated into substance use disorders.

It’s essential to recognize that addiction isn’t a moral failure. As researchers Fischer and Rehm (2009) point out, it’s a public health issue influenced by various social and economic factors. In other words, people don’t become addicted in a vacuum. Often, they’re coping with untreated trauma, chronic pain, mental health challenges, or the stress of poverty.

Additionally, the idea that opioid misuse only affects marginalized communities is a dangerous myth. While it’s true that vulnerable populations are disproportionately impacted, data from Ontario and across Canada show that middle-class individuals and professionals are also among the victims. This crisis cuts across race, gender, class, and age.

The Deadly Role of Fentanyl

If there’s one drug that’s driving the opioid crisis today, it’s fentanyl. This powerful synthetic opioid is up to 100 times stronger than morphine. And it’s often mixed—unbeknownst to users—into street drugs like heroin, cocaine, and counterfeit pills. According to a 2024 study by Adamo, Marshall, and Woodall, fentanyl was detected in 82% of opioid deaths in Canada between 2016 and 2023.

The rise of fentanyl has made the drug supply increasingly toxic. People who use drugs may think they’re taking one substance but end up ingesting a lethal dose of fentanyl. This unpredictable and unregulated supply has turned drug use into a deadly game of Russian roulette.

Deaths

• There was a total of 50,928 apparent opioid toxicity deaths reported between January 2016 and September 2024.

The following statistics account for the period from January to September of 2024

• Most (83%) of the accidental apparent opioid toxicity deaths in Canada occurred in British Columbia, Alberta, and Ontario.
• Most accidental apparent opioid toxicity deaths occurred among males (72%) and individuals aged 30 to 39 years (28%).
• Of all accidental apparent opioid toxicity deaths, 75% involved fentanyl. This percentage has increased by 32% since 2016, when national surveillance began, but appears to have stabilized in recent years.
• Of all accidental apparent opioid toxicity deaths, 81% involved opioids that were non-pharmaceutical.
• Of all accidental apparent opioid toxicity deaths, 68% also involved a stimulant.

Hospitalizations

• There was a total of 46,835 opioid-related poisoning hospitalizations reported between January 2016 and September 2024.
• 72% of opioid-related poisoning hospitalizations were accidental.
• Most accidental opioid-related poisoning hospitalizations occurred among males (63%) and individuals aged 60 years or more (26%).
• Of all accidental opioid-related poisoning hospitalizations, 35% involved fentanyl and its analogues. This percentage has increased by 84% since 2018, when national surveillance began, but appears to have stabilized in recent years.
• Of all accidental opioid-related poisoning hospitalizations, 16% also involved a stimulant.
• Of all accidental stimulant-related poisoning hospitalizations, 52% also involved an opioid.

Emergency Department Visits

• There were 193,823 reported opioid-related poisoning emergency department visits from 2016 to September 2024. Among these, 79% were accidental opioid-related emergency department visits.
• Most opioid-related poisoning emergency department visits occurred among males (67%) and among individuals aged 30 to 39 years (32%).
• Of opioid-related poisoning emergency department visits, 8% involved co-poisoning with a stimulant.
• Fentanyl and its analogues were involved in 47% of opioid-related poisoning emergency department visits. The percentage of all opioid-related poisoning emergency department visits that involved fentanyl and its analogues has increased by 135% since 2018, when national surveillance began, but appears to have stabilized in recent years.
• Of stimulant-related poisoning emergency department visits, 33% involved co-poisoning with opioids and 19% with fentanyl or fentanyl analogues.

Emergency Medical Services

• There was a total of 237,809 EMS responses to suspected opioid-related overdoses reported between January 2017 and September 2024.
• Most EMS responses to suspected opioid-related overdoses occurred among males (71%) and among individuals aged 30 to 39 years (34%).

The Shift Toward Harm Reduction

In the face of this escalating opioid crisis, Canada has gradually been shifting its approach from punitive drug laws to public health-based strategies, especially harm reduction.

Harm reduction is precisely what it sounds like: it’s about reducing the harms associated with drug use without necessarily requiring abstinence. This includes providing access to clean needles, supervised consumption sites, and life-saving interventions like naloxone, a medication that can reverse opioid overdoses.

As Nolan and colleagues (2022) note, harm reduction is about meeting people where they are. It recognizes that not everyone is ready—or able—to stop using substances, but that doesn’t mean they don’t deserve dignity, safety, and care.

Opponents of safe consumption sites argue that these facilities may inadvertently enable drug use by providing a sanctioned space for illicit substance consumption, even in a supervised setting, which can be perceived as government endorsement of illegal activity and contradict existing national drug laws.

Critics contend that such sites send a contradictory message about substance use, potentially normalizing or even encouraging harmful behaviours rather than deterring them. Public safety concerns are also common, with fears that safe injection sites could lead to increased crime, loitering, or improperly discarded needles in surrounding areas, particularly in neighbourhoods already facing social and economic hardships.

Furthermore, among those who support harm reduction in principle, there is often resistance to placing such sites near homes, schools, or businesses due to fears around safety and property values, reflecting the “Not in My Back Yard” (NIMBY) sentiment.

Additionally, some question whether public funds would be better spent on abstinence-based treatment or prevention programs aimed at eliminating drug use. While these concerns raise important issues, they frequently overlook a growing body of evidence showing that safe consumption sites effectively reduce overdose deaths, connect individuals to healthcare and treatment services, and do not contribute to increased neighbourhood crime.

Supervised Consumption Sites

Supervised sites, for example, have been proven to save lives. These facilities allow individuals to use substances in a controlled environment under medical supervision. Canadian and international evidence shows clearly that not only do these sites prevent overdose deaths, but they also connect people with healthcare, social services, housing, and serve as pathways to treatment services they might otherwise never access.

The Benefits of Supervised Consumption Sites and Services

When properly established, these sites and services:

• reduce the risk of accidental overdose, because people are not rushing or using alone
• connect people to social services like housing, employment assistance, and food banks
• provide or connect people to healthcare and treatment
• reduce public drug use and discarded drug equipment
• reduce the spread of infectious diseases, such as HIV
• reduce strain on emergency medical services so that they can focus on other emergencies
• provides space for people to connect with staff and peers, which can help a person moderate their drug use and decide to pursue treatment

As former Health Minister Jane Philpott said in 2016, “Ottawa is done trying to arrest its way out of the opioid crisis.” This marked a turning point in how Canada approached addiction, not as a crime, but as a health issue requiring empathy and evidence-based care.

Integrated Treatment Approaches

Harm reduction is crucial, but it’s not the whole picture. Long-term recovery requires integrated treatment—a model that addresses both addiction and the underlying issues that fuel it, such as mental illness, trauma, and poverty.

Addiction rarely exists in isolation. As Priester et al. (2016) explain, people with co-occurring mental health and substance use disorders face higher rates of relapse, stigma, and barriers to care. That’s why a truly effective response must combine addiction treatment with mental health services, housing support, peer support, and trauma-informed care.

Owens et al. (2018) point out that formerly incarcerated individuals with substance use disorders face some of the highest barriers to care, including discrimination, lack of insurance, and few accessible programs. These systemic failures keep people trapped in cycles of crisis.

Integrated care means breaking down these barriers. It means offering wraparound services that treat the whole person, not just the addiction.

The Role of Policy and Community Action

None of these solutions can succeed without policy reform. Canada’s drug laws have historically criminalized people who use drugs, pushing them to the margins and cutting them off from help. Today, we know that evidence-based policies—focused on prevention, harm reduction, and treatment—are far more effective than punitive measures.

In 2023, Health Canada reinforced this shift through the Canadian Drugs and Substances Strategy, prioritizing public health over punishment. Still, much more needs to be done.

Local governments, healthcare providers, and law enforcement need to work together. As Calgary’s police chief expressed in a 2016 interview, even those in traditionally tough-on-crime roles are recognizing that arresting people doesn’t solve addiction.

But policy change doesn’t just happen from the top down. Community engagement is essential. That means listening to people with lived experience, including drug users, harm reduction workers, and families affected by overdose. These voices bring insight, urgency, and solutions often overlooked in formal policy circles.

By involving the community, we can ensure that interventions are culturally appropriate, geographically tailored, and grounded in real-world experience.

Focusing on Local Needs

Canada is a big, diverse country, and what works in Vancouver may not be right for rural Ontario or northern Manitoba. That’s why context-specific strategies are so important. As Adamo et al. (2024) highlight, fentanyl-related deaths in Ontario follow distinct patterns that call for regional approaches to the opioid crisis.

Similarly, Health Canada (2023) emphasizes the need for national coordination and local flexibility. A one-size-fits-all model won’t work. Instead, solutions must be built with local input, responsive to community needs, and backed by solid data.

A Call to Action

The drug toxicity crisis is far from over. But we have the tools, the knowledge, and the compassion to save lives—if we act together.

We must shift away from blame and toward support. We must demand more from our healthcare systems and governments while showing up for our communities in practical, human-centred ways. Whether carrying naloxone, volunteering at a local harm reduction center, or challenging stigma when we hear it, every action counts.

As someone who has worked in community services and harm reduction, I’ve seen firsthand the resilience of people who use drugs, the grief of families who’ve lost loved ones, and the hope that comes when someone gets the support they need.

As Priester et al. (2016) remind us, “Individuals with co-occurring mental health challenges often experience higher rates of substance use, stressing the need for integrated service care models.” This kind of care turns the tide, from chaos to recovery, healing loss.

It’s time to recognize the opioid crisis not just as a tragedy, but as a call to build a better, more compassionate society where no one is disposable, where support replaces stigma. And where every person has a real chance at recovery.

Conclusion

The opioid crisis in Canada is not just a medical emergency—it is a deeply rooted social and structural issue that demands a coordinated, compassionate response. The statistics are staggering, but behind each number is a person whose life has been impacted by trauma, stigma, policy failures, or a toxic drug supply. While progress has been made—through harm reduction strategies, integrated care, and evolving public health policy—the opioid crisis persists, and the urgency remains.

To move forward, we must continue to challenge outdated narratives that treat substance use as a criminal issue rather than a public health one. We must ensure that services are accessible, culturally responsive, and built on trust and dignity. Most importantly, we must amplify the voices of those with lived experience because they are the true experts in navigating this crisis.

Addressing the drug toxicity epidemic requires more than policy shifts or medical interventions—it requires a cultural transformation toward empathy, justice, and inclusion. On this August 31^st, Overdose Awareness Day and every day after, let us commit to building a society where no one is left behind, and where every person has the support they need not just to survive, but to thrive.

Support and Resources

For more information, please refer to the Distress and Crisis Ontario (DCO) resources page.

• The Centre for Addiction and Mental Health – www.CAMH.ca

The Centre for Addiction and Mental Health (CAMH) is Canada’s largest mental health teaching hospital and one of the world’s leading research centres in its field.

• Ontario Addiction Treatment Centres – www.OATC.ca

We offer over 50 centres to serve you, all of Ontario, with the country’s largest network of methadone clinics.

• Rapid Access Addiction Medicine Clinics – www.Metaphi.ca/raam-clinics

A rapid access addiction medicine (RAAM) clinic is a low-barrier, walk-in clinic where patients can get help for a substance use disorder without an appointment or formal referral. RAAM clinics provide time-limited medical addiction care (including pharmacotherapy, brief counselling, and referrals to community services).

• Canadian Centre on Substance Use and Addiction – www.CCSA.ca

An Act of Parliament created the Canadian Centre on Substance Use and Addiction (CCSA) in 1988 as a non-governmental organization to provide national leadership on substance use and to advance solutions to address alcohol- and other drug-related harms.

References

1. Adamo, A., Marshall, K., & Woodall, K. L. (2024). Fentanyl-related deaths in Ontario, Canada: Toxicological findings and circumstances of death in 4395 cases (2020-22). Journal of Analytical Toxicology, 48(8), 598–605. https://doi.org/10.1093/jat/bkae061
2. Fischer, B., PhD., & Rehm, J. (2009). Deaths related to the use of prescription opioids: CMAJ. Canadian Medical Association. Journal, 181(12), 881-2. They were retrieved from https://www.proquest.com/scholarly-journals/deaths-related-use-prescription-opioids/docview/204830758/se-2.
3. Government of Canada. (2024, September 13). Opioid- and stimulant-related harms in Canada. Health Infobase. https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/
4. Graveland, B. (2016). “It just shocks me”: Calgary police chief wants action on opioid crisis. The Canadian Press. Canadian Press Enterprises Inc. https://www.thecanadianpress.com
5. Haffajee, R. L., & Mello, M. M. (2017). Drug policy and the opioid epidemic: A public health perspective. New England Journal of Medicine, 376(22), 2181–2183. https://doi.org/10.1056/NEJMp1701624
6. Health Canada. (2023, October 30). The Canadian drugs and substances strategy: The Government of Canada’s approach to substance use-related harms and the overdose crisis. https://www.canada.ca/en/health-canada/services/publications/healthy-living/canadian-drugs-substances-strategy-approach-related-harms-overdose-crisis.html
7. Health Minister Jane Philpott says Ottawa is done trying to arrest its way out of the opioid crisis. Her new health strategy starts by making it easier to open safe injection sites. (2016). In As It Happens. Canadian Broadcasting Corporation. http://www.cbc.ca/news/canada/subury/ontario-health-care-crisis-jane-philpott-1.7359825
8. Nolan, S., Kelian, S., Kerr, T., Young, S., Malmgren, I., Ghafari, C., Harrison, S., Wood, E., Lysyshyn, M., & Holliday, E. (2022). Harm reduction in the hospital: An overdose prevention site (OPS) at a Canadian hospital. Drug and Alcohol Dependence, p. 239, 109608. https://doi.org/10.1016/j.drugalcdep.2022.109608
9. Owens, M. D., Chen, J. A., Simpson, T. L., Timko, C., & Williams, E. C. (2018). Barriers to addiction treatment among formerly incarcerated adults with substance use disorders. Addiction Science & Clinical Practice, 13(1), 19–19. https://doi.org/10.1186/s13722-018-0120-5
10. Priester, M. A., Browne, T., Iachini, A., Clone, S., DeHart, D., & Seay, K. D. (2016). Research Guides: PSY 1462 Substance Abuse: Week 7 Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment, pp. 61, 47–59. https://doi.org/10.1016/j.jsat.2015.09.006
11. Robert, M., Jouanjus, E., Khouri, C., Sam-Laï, N. F., & Revol, B. (2023). The opioid epidemic: A worldwide exploratory study using the WHO pharmacovigilance database. Addiction, 118(4), 771-775. https://doi.org/10.1111/add.16081
12. Volkow, N. D., McLellan, A. T., Longo, D. L., & Longo, D. L. (2016). Opioid abuse in chronic pain — Misconceptions and mitigation strategies. The New England Journal of Medicine, 374(13), 1253–1263. https://doi.org/10.1056/NEJMra1507771