Federal actions on the overdose crisis

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Organization: Health Canada

Date published: December 2024

Cat. no.: H134-39/2024E-PDF

ISBN: 218-9507

Pub.: 240692

The Government of Canada's actions to address the overdose crisis to help save lives, including government funding for projects, prevention and education efforts, evidence used to inform decision-making, substance use services and supports, like increased access to treatment and harm reduction programs, and substance controls.

Last updated: December 2024

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About the overdose crisis

The illegal toxic drug and overdose crisis continues to have significant impacts on Canadian families and communities. A number of factors are contributing to Canada's high rates of overdoses, such as:

  • the highly toxic and unpredictable illegal drug supply
  • barriers to accessing harm reduction, treatment services and supports
  • stigma surrounding substance use, which can lead people to hide their drug use, discourage people from seeking health and social services, and can reduce the quality and availability of services received

The Government of Canada is committed to a comprehensive public health and safety approach to the illegal toxic drug and overdose crisis that is focused on reducing harms, saving lives, and getting people the supports they want and need.

Snapshot of the overdose crisis

  • Since 2016, there have been:
    • over 49,105 opioid-related deaths
    • over 45,707 opioid-related hospitalizations
    • over 187,511 opioid-related emergency department visits
  • About 3 out of 4 opioid-related deaths were among males since 2016
  • The toxicity and unpredictability of the illegal drug supply continues to be a major driver of the overdose crisis with over 75% of opioid-related deaths involving fentanyl and/or fentanyl analogues
  • The majority of opioid-related deaths occurred in British Columbia, Alberta, and Ontario

Highlights of recent federal actions

  • On October 11, 2024, the Government launched a call for proposals for the Emergency Treatment Fund. The fund was announced in Budget 2024 ($150 million over three years) and is open to municipalities and Indigenous communities. It aims to provide a rapid response to emergent, critical needs related to the illegal toxic drug and overdose crisis. The first call for proposals closed on November 8, 2024 and applications are being reviewed
  • Launched the Canadian Drug and Substance Watch, an innovative surveillance tool with early warning capabilities, that helps monitor, predict and respond to the rise of new and emerging psychoactive substances
  • Launched the Youth Mental Health Fund with $500 million in funding over five years to help younger Canadians access the mental health care they need
  • Released the most recent national data on opioid- and stimulant-related deaths, hospitalizations, emergency department visits and Emergency Medical Services responses in collaboration with provinces and territories
  • Updated modelling projections on opioid-related deaths to June 2025 to understand and plan for potential scenarios

Government funding

Since 2017, the Government has committed over $1 billion, in addition to the Bilateral Agreements with provinces, directly to address the illegal toxic drug and overdose crisis; below are examples of funded initiatives.

  • The Government of Canada's Working Together to Improve Health Care for Canadians includes $25 billion towards four shared priorities, including improving access to quality mental health and substance use services. Additionally, $2 billion over 10 years was announced to support Indigenous health initiatives
  • Through the Substance Use and Addictions Program (SUAP), funding has been provided to community organizations for projects to support people who use drugs, for example:
  • Budget 2023 included $144 million for SUAP to fund community-based supports and other evidence-based health interventions. A national call for proposals ran in fall 2023 to support four funding priorities, including:
    • Supporting and enhancing the role of people with lived and living experience within organizations that address substance use;
    • Services and programs that target post-treatment aftercare and transition back into the community;
    • Addressing alcohol use disorder; and
    • Addressing adult tobacco cessation
  • Provided up to $4.5 million over five years to support Pain Canada, an initiative dedicated to coordinating national efforts and mobilizing resources for people living with pain
  • Provided over $650 million in 2024-2025 towards trauma-informed, culturally grounded, community-based mental wellness initiatives, including funding for substance use prevention and treatment, the ongoing implementation of 75 Mental Wellness Teams supporting 385 First Nations and Inuit communities, the Hope for Wellness Help Line, and more
  • An additional $1.0 billion over four years for Reaching Home: Canada's Homelessness Strategy to stabilize funding under the program, bringing the total investment to $5 billion over nine years, through 2027-2028. Of this, $50 million will focus on accelerating community-level reductions in homelessness
  • Invested $250 million over two years starting in 2024-2025 to address the urgent issue of encampments and unsheltered homelessness
  • Through the Canadian Institutes of Health Research and the Canadian Drugs and Substances Strategy (CDSS), funding has been provided to the Canadian Research Initiative in Substance Matters (CRISM) to create a Network Coordinating Centre ($4M over 5 years) and an Indigenous Engagement Platform ($2M over 5 years). This will support the development of a Coordinating Centre, providing a national governance structure for CRISM, to support knowledge mobilization efforts, coordinate training and capacity building, and engaging with Indigenous Peoples

Prevention and education

Prevention and education efforts support communities and raise awareness to influence the health and well-being of people living in Canada.

  • Launched the Youth Substance Use Prevention Program as part of the CDSS and provided funding to seven projects across four provinces to support its implementation. This community-based program is based on the internationally recognized Icelandic Prevention Model approach to preventing substance use among youth
  • Funded the establishment of a Knowledge Development and Exchange Hub for Youth Substance Use Prevention in Canada
  • Since 2018, implemented public education campaigns to raise awareness of the overdose crisis, with a focus on prevention, reducing stigma, supporting help-seeking behaviours, and providing links to resources. Key initiatives include activities on opioids and the harms of substance use stigma, including:
    • In 2022, Health Canada began a national advertising campaign, entitled Ease the Burden, which promotes resources and support for men working in physically demanding jobs who are disproportionately affected by the overdose crisis, and students who are studying in the trades. The campaign also aims to reduce stigma associated with addiction and help-seeking
      • Between September 2022 and July, 2024, digital ads were shown 246.9 million times, audio and video ads were completed 52.9 million times and users clicked on ads a total of 709.2 thousand times
    • Delivered the Know More Opioids awareness program, engaging over 187,000 teens and young adults through more than 1,600 virtual sessions and 755 in-person high school sessions between April 2018 and October 2024
    • Conducted outreach to over 2,435 festival organizers from January to November 2024 to provide information about naloxone and encourage the distribution of overdose prevention materials to event goers and staff
  • Developed a toolkit of resources for employers of Canadians working in the trades and related industries to help reduce the harms of substance use
  • Collaborated with the Centre for Addiction and Mental Health (CAMH) to develop and disseminate a toolkit for pharmacy professionals that supports increased awareness of stigma and promotes best practices for reducing opioid stigma in pharmacy settings
  • Coordinated federal efforts to respond to the Canadian Pain Task Force recommendations, so that pain is understood, prevented, and effectively treated
  • Co-organized the National Pain Congress with the Canadian Pain Society and Pain Canada, bringing together pain specialists, researchers, people living with pain, and policy makers to discuss pain priorities and mobilize knowledge
  • Supported knowledge mobilization of stakeholders and developed guidance and resources to improve pain management:
  • Worked with the Standards Council of Canada to develop a series of guidelines and resources to promote better understanding, alignment, and integration among mental health and substance use health care providers throughout the country
  • Shared best practices for addressing substance use stigma within the Canadian health system, including the use of compassionate and non-stigmatizing language
  • Continued to make available to Canadian law enforcement members an online Drug Stigma Awareness Training module
  • Developed a Blueprint for Action and policy paper for schools and community organizations that support youth, outlining practical approaches for schools to prevent substance-related harms among youth
  • Adopted non-stigmatizing language in Health Services products and reviewed staff training and education aimed at reducing substance-related stigma in Canada's correctional system (for example, substance use module of the Correctional Training Program)

Evidence

Evidence is essential to provide accurate, timely, and reliable data to policy development and decision-making.

  • Published the data and evidence framework as part of the renewed CDSS
  • Published data on supervised consumption sites (SCS) in Canada, including the number of visits, client demographics, drugs used, overdoses, and referrals to services
  • Released the results of a public opinion research survey on Canadians' knowledge and attitudes around drug decriminalization
  • Released the results of a public opinion research survey and qualitative research on controlled substances awareness, knowledge, and behaviours for public education
  • Published results from the People with Lived and Living Experience Survey on substance use among street involved youth in Canada
  • Released results of the 2021-2022 Canadian Postsecondary Education Alcohol and Drug Use Survey
  • Released results from the Online New Psychoactive Substances Survey
  • Hosted a Knowledge Exchange Series on prescribed alternatives to engage a range of stakeholders in dialogue around current evidence and potential future directions in prescribed alternatives (see the What We Heard Report)
  • Deployed Federal Public Health Officers (PHOs) to Provinces and Territories since 2017 to support substance-related harms data and surveillance capacity building. The PHOs, currently funded through CDSS, are placed in a range of Public Health and in Coroners and Medical Examiner's office settings. They support surveillance advancements, public facing data, and data sharing between the federal government and the Provinces and Territories
  • Established an Expert Advisory Group to provide independent, expert advice on the federal approach to prescribed alternatives, including on findings from federally funded pilot projects, knowledge transfer strategies, and responses to emerging issues
  • Supported a National Safer Supply Community of Practice, research, knowledge transfer and exchange projects, to help gather and share the evidence around prescribed alternatives
  • Continued engagement with a range of experts on prescribed alternatives, including addiction medicine physicians, to help strengthen the evidence base and better address emerging and potential risks, including diversion
  • Held a Best Brains Exchange to share knowledge related to best practices and treatment options for people living with chronic pain and concurrent mental illnesses and/or substance use-related conditions
  • Published a spotlight report on the emergence of Xylazine (a prescription drug used in veterinary medicine) in Canada
  • Published an at-a-glance report on 2023 New Psychoactive Substances in Canada
  • Published an at-a-glance report on new psychoactive substances and an infosheet on the emergence of Desalkylgidazepam, a novel benzodiazepine, in Canada
  • Launched the Drug Analysis Service and Cannabis laboratories. Their classification framework for psychoactive substances in the illicit drug market supports the efforts of public health professionals, forensic scientists, and data specialists to better integrate timely drug analysis data, into their surveillance systems for routine monitoring and early warning purposes
  • Renewed investment of $17 million over six years to CRISM to conduct research and knowledge mobilization activities focused on substance use harms
  • Invested $2.85 million over five years to support a CRISM-led independent, evaluation of the impacts of the section 56 exemption in British Columbia. Progress updates on interim findings are published at regular intervals
  • Conduct wastewater analysis to screen for the presence of over 543 drugs and metabolites in Canada's wastewater and provide data on substance use patterns and new and emerging psychoactive substances
  • The Canadian Wastewater Survey (CWS) measures the levels of 10 different drugs—including opioids such as fentanyl—in the wastewater of selected Canadian cities. The latest data from the CWS can be accessed through a new interactive dashboard entitled "Levels of Drugs in the Wastewater of Canadian Cities"
  • Established an Expert Task Force on Substance Use that provided independent recommendations on the federal government's drug policy and potential alternatives to criminal penalties for personal possession
  • Funded a preliminary qualitative assessment of 10 prescribed alternatives pilot projects to capture early learnings, including effective strategies for program delivery
  • Invested $3 million over four years to evaluate the impacts of prescribed alternative pilot projects and assess the public health impacts of SCS across Canada
  • Released several reports related to furthering knowledge around opioids

Substance use services and supports

Substance use is different for each person, and there is no single service that will meet everyone's needs. Providing people with different services and supports based on their needs is one of the most effective ways to support their health and wellness.

Treatment

  • Supported the development of guidance for health care providers, including:
  • Removed barriers to accessing drugs used in the treatment of opioid use disorder by:
    • Issuing a class exemption for patients, practitioners, and pharmacists prescribing and providing controlled substances in Canada to ensure continuity of care
    • Approving injectable hydromorphone and diacetylmorphine as treatment options for patients with severe opioid use disorder
    • Facilitating the prescribing and dispensing of methadone and diacetylmorphine through regulatory amendments
  • In January 2024, the Public Prosecution Service of Canada revised its Deskbook guideline about Drug Treatment Courts to improve accessibility, to remove barriers to entry into the program, and offer more flexibility in the determination of criteria for graduation from the program
  • Supported access to treatment services by providing $150 million through the 2018 Emergency Treatment Fund, which, when cost-matched by provinces and territories, totaled over $300 million
  • Supported 45 federally-funded treatment centres for First Nations, including three virtual pilot projects to create and enhance virtual treatment services, allowing for increased reach and accessibility to those who may not otherwise seek treatment
  • Supported OAT wraparound services at 83 sites in approximately 100 First Nations and Inuit Communities
  • Revised opioid use disorder guidelines, appointed a national OAT medical advisor, and established a national Substance Use Services oversite committee to coordinate policy and service delivery for patients with substance use related health needs in Canadian correctional facilities
  • Ongoing implementation of SMART (Self-Management and Recovery Training) across Canada's correctional institutions
  • Provided funding through the Supporting Pathways to Care for People Who Use Drugs program for projects that support sustainable system-level change to help people access care and reduce barriers

Harm reduction

  • Supported the establishment of SCS to provide health, social and treatment services. As of October 2024, there are 39 SCS offering services
    • Authorized different modes of consumption that include injection, oral (swallowing), intranasal (snorting), and inhalation
    • Authorized supportive services at sites including drug checking, peer assistance consumption and drug splitting and sharing
    • Streamlined the exemption application process
    • Between January 2017 and August 2024:
      • SCS received over 4.9 million visits
      • SCS attended to over 60,000 overdoses
      • SCS made over 547,000 referrals to health and social services
  • Improved access to urgent public health needs sites by allowing provinces and territories to establish temporary spaces where people can consume drugs under supervision, to reduce risk of overdose death
  • Supported the Good Samaritan Drug Overdose Act, which provides some legal protection related to drug possession for people who seek emergency help during an overdose
  • Supported the development of guidance on take-home naloxone programs
  • Supported national projects to increase awareness and access to naloxone through training, awareness and distribution of the life saving drug. As of December 2023, these investments have resulted in:
    • 2.2 million people trained in Canada on how to respond to an overdose
    • more than 92,000 nasal naloxone kits distributed across Canada
  • Continued to improve access to naloxone, including to remote and isolated First Nations and Inuit communities and people experiencing homelessness, through the coordination of bulk purchases of naloxone, increasing access to take-home naloxone kits, and training in their use
  • Funding Thunderbird Partnership Foundation to create and distribute take-home nasal naloxone kits to communities and treatment centres
  • Supported a drug checking technology challenge to promote development of new drug checking technologies, which included awarding a grand prize of $1 million to Scatr Inc
  • Implemented Overdose Prevention Services at five correctional institutions, with plans for expansion in 2024-2025
  • Implemented a prison needle exchange program in 13 sites in 12 federal correctional institutions, with plans for expansion in 2024-2025
  • Expanded the availability of naloxone directly to inmates in living units in correctional institutions and offer take home naloxone kits to all offenders upon release back into the community
  • Supporting the delivery of harm reduction activities to help reduce risks and connect individuals experiencing homelessness with key health and social services through the Reaching Home program
  • Provide targeted supports for Veterans experiencing, or at imminent risk of, homelessness through the Veteran Homelessness Program, to support provision of health and medical services (for example, counselling and substance use supports) and delivery of harm reduction activities

Substance controls

  • Bill C-5 came into force in 2022, repealing mandatory minimum penalties for all offences in the CDSA, and requiring police and prosecutors to consider diversion for simple drug possession offences. As of November 17, 2024, Bill C-5 also requires that past and future convictions for simple drug possession be kept separate and apart from other records of conviction after a period of time
  • Made scheduling amendments to allow law and border enforcement to take action against the illegal importation, production, and sale of a group of emerging fentanyl precursors
  • Released guidance for federal prosecutors about offences under section 4(1) of the CDSA (possession of a controlled substance for personal use) requiring a prosecution for only the most serious manifestations of those offences
  • Identified opioids, including nitazenes, 165,930 times in samples submitted to the Drug Analysis Service by law enforcement and public health partners from January 2018 to September 2024 (samples may contain more than one opioid)
  • Shared laboratory analysis results on new and emerging drugs with over 400 partners on a monthly basis
  • Shared laboratory drug notifications with law enforcement agencies and public health partners
  • Provided confirmatory analysis to help community groups that are offering drug checking services build and strengthen their analytical capacity
  • Provided border services officers with tools to safely identify and interdict fentanyl and other toxic substances at the border, including:
    • Equipping 82 ports of entry with designated safe examination areas to make it safer for border services officers to examine goods suspected to contain opioids
    • Maintaining field drug analysis sites with on-site chemists in Toronto, Montreal, and Vancouver to allow for the local identification of substances
    • Seizing illegal drugs and precursor chemicals that can be used in the production of illegal synthetic drugs
  • Implemented new measures that are used by law and border enforcement to take action against the illegal importation, distribution, and use of certain emerging fentanyl precursors
  • Continuing to investigate and charge criminal actors suspected of manufacturing and/or trafficking illegal substances, including:
    • Working with private sector partners to limit the flow of legitimate chemicals used for manufacturing illegal substances
    • Investigating and dismantling clandestine drug labs capable of producing large quantities of synthetic drugs
    • Targeting organized crime groups involved in the illegal production and trafficking of synthetic drugs
  • Worked with private and public sector partners to address money laundering of the proceeds of fentanyl trafficking
  • Introduced legislative amendments to the Criminal Code in 2023 and 2024 to facilitate the investigation and prosecution of the offence of laundering proceeds of crime and other economic crimes, and to facilitate the seizure and restraint of proceeds of crime for possible forfeiture

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