Federal actions on opioids to date

On this page

• About the overdose crisis
• Recent federal actions
• Government funding
• Enforcement and the toxic illegal drug supply
• Access to treatment
• Access to harm reduction
• Awareness and prevention
• Evidence

About the overdose crisis

The overdose crisis continues to have significant impacts on Canadian communities and families. People who use drugs face many barriers and risks, such as:

• the highly toxic and unpredictable illegal drug supply,
• over-burdened health and social services, including life-saving harm reduction and treatment services and supports, and
• ongoing stigma surrounding substance use that discourages 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 approach to the overdose crisis that is focused on reducing harms, saving lives, and getting people the supports they desire and need.

Recent federal actions

• Budget 2023 proposes to provide an additional $359.2 million over 5 years to support a renewed Canadian Drugs and Substances Strategy (CDSS)
  • This builds on the more than $800 million invested since 2017 to address the overdose crisis
• Budget 2023 also delivers an urgent, needed investment of almost $200 billion over the next 10 years to strengthen our public health care system and help ensure Canadians receive the care they need
  • This includes $25 billion for shared health priorities, including increasing access to mental health and substance use services and supports
  • These significant federal investments will support access to a full continuum of evidence-based options as well as innovative strategies, including harm reduction, treatment and recovery, for people who use drugs
• Released the most recent national data on opioid- and stimulant-related deaths, hospitalizations and Emergency Medical Services response in collaboration with the provinces and territories
• Published "Spotlight: The Emergence of Xylazine in Canada", a report about the emergence of Xylazine (a prescription drug for use in veterinary medicine) that is increasing being seen in the toxic illegal drug supply
• Held a Best Brains Exchange to enhance and 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

Government funding

The Government of Canada has committed over $1 billion since 2017 to increase access to evidence-based treatment and harm reduction services; fund awareness, prevention, and stigma reduction activities; and support research and surveillance initiatives to inform our response.

• This includes funding community organizations for projects through the Substance Use and Addictions Program to support people who use drugs, for example by:
  • Supporting projects related to treatment including expanding Opioid Agonist Therapy (OAT) services
  • Supporting prescriber led safer supply service delivery projects to help save lives by providing people at risk of overdose with prescribed medications instead of the highly toxic and unpredictable illegal drug supply
  • Supporting a National Safer Supply Community of Practice and research/knowledge transfer and exchange projects, to help gather and share the evidence around safer supply
  • Increasing awareness and access to naloxone through projects that provide training, awareness and distribution of the life saving drug
  • Helping to reduce stigma and support families affected by the overdose crisis
  • Improving harm reduction initiatives to reach key groups, including Indigenous peoples, youth, post-secondary students, individuals in the correctional system, and healthcare professionals
  • Providing better access to peer support and capacity-building projects to support those disproportionately affected by substance use or who face barriers accessing services, including women and youth
  • Supporting projects addressing priority actions identified by the Canadian Pain Task Force
• 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
• Supported provinces and territories to improve access to treatment services by providing $150 million via the Emergency Treatment Fund which, when cost-matched by provinces and territories, totals over $300 million
• Providing up to $4.5 million over 5 years to support Pain Canada, a national initiative that brings together 14 pain organizations to support national coordination and mobilize resources to build capacity to improve systems of care and supports for people with pain
• Providing over $650 million in 2022-2023 to support culturally grounded community-based mental wellness initiatives which includes funding for substance use prevention and treatment, mental wellness teams, the Hope for Wellness Help Line, and more

Enforcement and the toxic illegal drug supply

• Granted a three-year exemption under the Controlled Drugs and Substances Act (CDSA), so that adults aged 18 and over in British Columbia will not be subject to criminal charges for the possession of up to 2.5 grams of certain illegal drugs for personal use between January 31, 2023 and January 31, 2026
• Former Bill C-5 came into force and repealed mandatory minimum penalties for all drug offences in the CDSA, and requires police and prosecutors to consider diversion for simple drug possession offences
  • It also requires past and future convictions for simple drug possession to be sequestered apart after a certain period of time
• Made scheduling amendments to the CDSA and Precursor Control Regulations to help address the illegal importation and distribution of a group of novel fentanyl precursors that are used in the illegal production of fentanyl and its analogues
  • These scheduling changes will take effect on August 30, 2023
• Released guidance to consider alternatives to prosecution for simple drug possession offences, except when there are serious public safety concerns
• Identified opioids, including Nitazenes, 121,987 times from January 2018 to April 2023 in exhibits submitted to the Drug Analysis Service by law enforcement and public health officials (exhibits may contain more than one opioid)
• Seizing illegal opioids and precursor chemicals that can be used in the production of illegal synthetic drugs
• Providing border services officers with tools to safely identify and interdict fentanyl and other toxic substances at the border, including:
  • Implementing 81 safe examination areas at high-risk ports of entry to help identify and examine shipments suspected to contain opioids
  • Maintaining field drug analysis sites with on-site chemists in Toronto, Montreal, and Vancouver
  • Added fentanyl detection to the scent profile of 6 drug and firearm detector dog teams strategically located across the country
• Working with private sector partners to address money laundering of the proceeds of fentanyl trafficking
• Continuing to investigate and charge criminal actors suspected of diverting chemical products for the purpose of manufacturing illicit substances

Access to treatment

• Supported the development of guidance for health care providers, including:
  • Clinical guidelines (PDF document) and operational guidance (PDF document) for injectable opioid agonist treatment
  • National treatment guidelines for opioid use disorders
• Removed barriers to accessing drugs used for 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
• Developing national standards based deliverables for mental health and substance use services to provide an evidence-based framework for service delivery
• Supporting federally-funded treatment centres for First Nations and Inuit to create and enhance their virtual treatment services, allowing for increased reach and accessibility to those who may not otherwise seek treatment
• Supporting Opioid Agonist Therapy wraparound supports in 78 First Nations and Inuit Communities
• Increasing the provision of opioid agonist treatment and implementing SMART (Self-Management and Recovery Training) in Canada's correctional institutions

Access to harm reduction

• Supported the establishment of supervised consumption sites (SCS) in areas where there are high rates of public drug use to provide health, social and treatment services
  • Authorized different modes of consumption that include injection, oral (swallowing), intranasal (snorting), and inhalation
  • Authorized supportive services at sites including drug checking and peer assistance consumption
  • Streamlined the exemption application process
  • As of March 2023:
    • there are 38 SCS offering services
    • over 4.1 million visits since October 2017
    • reversed over 47,000 overdoses
    • made over 239,000 referrals to health and social services
• Improved access to overdose prevention services 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 for people who seek emergency help during an overdose
• 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 and nasal spray naloxone, increasing access to take-home naloxone kits, and training in their use
• 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.
• Opened the first Overdose Prevention Service in a correctional institution to reduce overdose incidents
• Continuing to support the delivery of harm reduction activities to help reduce risks and connect individuals and families experiencing homelessness with key health and social services through the Reaching Home program

Awareness and prevention

• Expanded public awareness around opioids and the harms of substance use stigma:
  • Launched a multi-year campaign in 2018 to raise awareness of opioids, how to respond to an overdose, the Good Samaritan Drug Overdose Act and the impacts of stigma on people who use drugs
  • Continued a campaign aimed at men working in trades, who are disproportionately affected by the overdose crisis, to promote help-seeking and link to resources and supports
  • Developed and distributed awareness resources for opioids, such as videos, fact sheets, posters, wallet cards, and an audio series
• Delivered the Know More Opioids awareness program to more than 1,400 in-person and virtual high school sessions, 68 post-secondary school events, 43 events/festivals; and engaged over 175,000 people; and placed awareness products such as posters and wallet cards, in high-traffic areas of 16 post-secondary institutions between April 2018 and May 2023
• Reached out to over 2000 festival organizers to provide information about naloxone and encourage the distribution of overdose prevention materials to event goers and staff
• Coordinate federal efforts to respond to the Canadian Pain Task Force recommendations, so that pain is understood, prevented, and effectively treated
• Supported knowledge mobilization of stakeholder developed guidance and resources to improve pain management
  • Pediatric pain management standard to help guide practice, professional development, policy development, and quality improvement initiatives related to pediatric pain management in all hospital healthcare settings
  • Power over pain portal, a virtual platform that provides Canadians rapid access to free evidenced-based virtual resources, interventions and peer-support to help youth and adults manage their chronic pain
  • Development of a new national, competency-based curriculum for current and future physicians in pain management and addiction medicine
• Supported the development of Soar Above Stigma, a resource that provides outreach support and stigma education for Indigenous community members dealing with addiction or mental health issues
• Shared best practices for addressing substance use stigma within the Canadian health system, including through use of compassionate and non-stigmatizing language
• Continued engagement activities with law enforcement community to promote uptake of an online Drug Stigma Awareness Training module with free access extended to law enforcement members until December 31, 2023
• Developed a toolkit of resources for employers of Canadians working in the trades and related industries to help reduce the harms of substance use
• 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 reviewing staff training and education aimed at reducing substance-related stigma in Canada's correctional system

Evidence

• Held a Knowledge Exchange Series on Safer Supply with key stakeholders to discuss evidence around safer supply and how available evidence can help support and scale up successful models then published a report entitled "What We Heard: Knowledge Exchange Series on Safer Supply"
• Updated modelling projections on opioid-related deaths to the end of 2023 to understand and plan for potential scenarios
• Renewed $17 million investment in research to address substance use in Canada to ensure the continuation and expansion of the Canadian Research Initiative in Substance Misuse (CRISM) research and knowledge mobilization activities focused on substance use harms, such as opioids
• Invested $2.8 million over 5 years to support an independent, scientific evaluation led by CRISM of the impacts of the section 56 exemption in British Columbia
• Continued collection of the Canadian Wastewater Survey with information on drugs and drug metabolites in wastewater samples collected
• Established an Expert Task Force on Substance Use that provided independent, expert recommendations on the federal government's drug policy and potential alternatives to criminal penalties for personal possession
• Published a toolkit with resources for stakeholders to respond to a need for information on medications for people at risk of overdose during the pandemic
• Funded a qualitative assessment of 10 safer supply projects through surveys and interviews with safer supply program leads, staff and participants to capture early learnings, including effective strategies for program delivery
• Invested over $2 million to evaluate program implementation and impacts of safer supply pilot projects and to assess the public health impacts of supervised consumption sites located in British Columbia, the Prairies, Ontario and Quebec-Atlantic
  • A summary of findings from the SCSs evaluation projects is available in the end-of-grant workshop report
• Released several reports related to furthering knowledge around opioids