Injection booths at the Cactus safe-injection site in Montreal in 2017. Supervised drug-use sites can reduce drug-related harms.Paul Chiasson/The Canadian Press
Fewer Canadians died from opioid overdoses last year, new national data show, but a regional breakdown paints a complicated picture of the drug toxicity crisis that eased in some provinces but worsened in others.
The Public Health Agency of Canada (PHAC) released on Wednesday figures on substance-related deaths and harms in 2024. Nearly 7,150 opioid deaths were reported last year, a 13-per-cent decline compared with 2023. There was also a 22-per-cent reduction in stimulant deaths.
British Columbia, Alberta and Ontario – provinces where the majority of deaths take place – recorded decreases between 12 and 37 per cent for opioid-related fatalities. There were also fewer deaths in Saskatchewan, New Brunswick and Yukon.
The opposite was true for Quebec, the Northwest Territories and Newfoundland, which saw deaths increase between 20 and 100 per cent in 2024 when compared with 2023. (NWT recorded six opioid-related deaths in 2024, double that of 2023.)
Other provinces and territories recorded little or no change.
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Gillian Kolla, assistant professor of population health and applied health sciences at Memorial University, said it is a positive sign that the death toll decreased from 2023, the deadliest year on record in Canada. However, she said, the numbers are nothing to celebrate.
“I really, really need to emphasize that this is still an absolute catastrophe that’s happening for communities, for loved ones,” she said. “We’re stabilizing at an incredibly high rate of deaths that 10 years ago would have been completely unheard of.”
Canada began collecting drug-poisoning data in 2016, the same year B.C. declared a public health emergency because of spiking drug deaths. Nearly 3,000 people across the country died that year from opioid overdoses, a number that more than doubled in 2024.
Over the past nine years, the unrelenting crisis has taken the lives of more than 52,000 people.
The United States has also reported a nationwide decline in drug deaths in 2024. Researchers have pointed to a confluence of factors to explain the downward trend, including an evolving drug market, changing behaviours among substance users and access to addictions services.
Gillian Kolla, a public health research at Memorial University, helps set up an overdose prevention site in Toronto’s Parkdale neighbourhood in 2018.Christopher Katsarov
Dr. Kolla said the “No. 1 factor” driving the national trend in Canada, which also explains regional differences in drug deaths, is the potency of the unregulated drug supply – a supply that differs depending on where you are in the country.
“We have different drug supplies, even within different provinces, even within our large cities,” she said.
“There’s quite a level of variation regionally also in terms of the drugs that are used, also in terms of when fentanyl came into the unregulated drug supply, and in terms of what people were using as opioids before fentanyl came.”
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About 74 per cent of all opioid deaths in Canada involved fentanyl in 2024, PHAC data show, an increase of 42 per cent since 2016. The majority of deaths involved non-pharmaceutical opioids.
Dr. Kolla said there are a number of proven interventions that can reduce drug-related harms, such as opioid replacement therapy, safer supply programs where people are given pharmaceutical-grade alternatives to street drugs and harm-reduction supports, such as supervised drug-use sites.
But she said these interventions have not been scaled up to population level and that there has been more “talk and rhetoric” from governments instead of action to adequately fund and build systems of care. In addition, there are few tools available to address the illicit drug market, she added.
Also on Wednesday, provincial and territorial chief medical officers of health (excluding Alberta’s), chief coroners and chief medical examiners issued a joint statement to accompany the PHAC data. (Quebec did not subscribe to the joint statement but “shares the concerns expressed.”)
The group noted that the death toll is still very high compared with previous years and that the national trend “masks” important regional differences. Indigenous people, particularly women, have been disproportionately harmed because of colonization and continued marginalization, the statement said.
“Understanding the drivers of increases and decreases, as well as regional and demographic dynamics is important for tailoring prevention and intervention strategies,” it said.
