Today, the co-chairs of the federal, provincial, and territorial Special Advisory Committee on the Epidemic of Opioid Overdoses - Dr. Theresa Tam, Canada's Chief Public Health Officer, and Dr. Yves Léger, New Brunswick's Acting Chief Medical Officer of Health - issued the following statement on the release of the latest monitoring data on opioid- and stimulant-related harms in Canada :
This release provides an update on data collected from January to September 2023 and builds on historical data that has been collected every quarter since 2016. The volume of opioid-related harms in the first three quarters of 2023 remains close to what was seen at the peak of the COVID-19 pandemic in 2021. These numbers are the largest observed since data collection began in 2016, signifying the ongoing worsening of this urgent public health crisis.
These latest data show that in Canada between January and September 2023, there were 5,975 apparent opioid-related deaths and 4,646 hospitalizations for opioid-related poisonings. This means that an average of 22 people died every day.
New data from emergency departments (ED) show that during the same period, there were 21,708 reported opioid poisoning ED visits, which is 80 per day. Based on data from Alberta, Ontario, and Yukon, there may be an increasing trend in the annual number of patients with repeat visits for opioid-related poisonings and opioid use disorders, with a greater proportion among male patients aged 30-39. These new data allow us to better understand the scope of this public health crisis and target interventions and supports for people at increased risk of harm. For example, in 2022, among patients who were discharged home for opioid use disorders and opioid-related poisonings, 2% of patients with repeat ED visits were discharged home with supports from the community at home or referred to services. There is a need to better understand the current barriers - both at an individual and system level - to initiating or providing these supports upon discharge.
As this public health crisis continues to change and evolve so must our response
Over recent years there has been a shift in the composition of the illegal drug supply. Since 2020, non-pharmaceutical benzodiazepines, a new opioid subclass known as nitazenes and the tranquilizer xylazine, have emerged and are being combined with fentanyl and its analogues. This portrait varies regionally, with Ontario and Western Canada having a higher proportion of illegal drug samples containing fentanyl in 2023 compared to Eastern Canada.
These combinations increase the risk of drug poisoning, because they slow vital functions such as breathing, and can make treatment more challenging. While naloxone can reverse the effects of opioids, it cannot address the sedation caused by benzodiazepines or other tranquilizers like xylazine. This means a person could start breathing again, but not regain consciousness, complicating first response protocols and care.
Data from some provinces also show a shift in the mode of drug use from injection to inhalation. In British Columbia, the majority of opioid-related deaths are now related to inhalation rather than injection drug use.
Understanding the ongoing shifts in the composition of the illegal drug supply and patterns of drug use provides essential insights that can inform harm reduction and treatment approaches to help save lives.
This ever evolving crisis is complex, and requires all levels of government, public health and public safety partners, social sectors, affected communities and people with lived and living experience to work together. We are taking many different approaches across the country, and we need to continue to assess the impact of these interventions to inform our way forward.
