Federal actions on opioids to date

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Organization: Health Canada

Date published: June 2022

The Government of Canada's actions to address the opioid overdose crisis and help save lives, including government funding for projects, increased access to treatment and harm reduction programs, as well as awareness, prevention and enforcement efforts.

Last updated: June 2022

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About the opioid overdose crisis

The opioid overdose crisis continues to have significant impacts on Canadian communities and families. The COVID-19 pandemic has worsened long-standing challenges regarding substance use and the opioid overdose crisis, with some communities reporting record high numbers of overdose deaths, hospitalizations, and emergency medical service calls. People who use drugs are also facing additional barriers and risks related to the toxicity of the illegal drug supply and reduced access to health and social services, including life-saving harm reduction and treatment.

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

  • Granted a three-year exemption under the Controlled Drugs and Substances Act, so that adults 18 years and older in British Columbia will not be subject to criminal charges for personal possession of up to 2.5 grams total of opioids, cocaine, methamphetamine, or MDMA, or some combination thereof, between January 31, 2023 and January 31, 2026
  • Announced new federal investments through Budget 2022 to support the national response to the overdose crisis by:
    • providing $100 million to the Substance Use and Addictions Program to support harm reduction, treatment and prevention community-based interventions
    • allocating $140 million for the Wellness Together Canada portal to continue to provide Canadians with tools and services to support their mental health and well-being, including substance use issues
    • providing an additional $562.2 million for the Reaching Home program, which supports people experiencing or at risk of experiencing homelessness, who are also at greater risk of harm from the opioid overdose crisis
    • investing an additional $62 million for the Veteran Homelessness Program to provide Veterans experiencing homelessness with rent supplements and wrap-around services, including harm reduction activities
  • Updated modelling projections through to the end of 2022, to understand and plan for potential scenarios. Under some scenarios, opioid-related deaths may remain high
  • Released a report on homelessness and substance-related acute toxicity deaths in Canada using coroner and medical examiner data from 2016-2017
  • Started developing national standards for mental health and substance use services to provide an evidence-based framework for service delivery
  • Launched a campaign aimed at men working in trades, who are disproportionately affected by the opioid overdose crisis, to promote help-seeking and link to resources and supports

Government funding

  • Committed over $800 million since 2017 to directly address the opioid overdose crisis and support work to save lives, which includes funding community organizations for projects through the Substance Use and Addictions Program and the Supporting Pathways to Care for People Who Use Drugs program to support people who use drugs. For example by:
    • supporting 17 safer supply projects in British Columbia, Ontario, Quebec, and New Brunswick, and one national community of practice, for a total investment of $64 million to provide people at risk of overdose with prescribed medications instead of the toxic illegal drug 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
  • Invested an additional $500 million through the Safe Restart Agreement towards health care to respond to COVID-19, including support for people experiencing challenges with substance use, mental health, or homelessness
  • 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

Evidence

  • Released results of the Canadian Wastewater Survey with information on drugs and drug metabolites in wastewater samples collected from five cities
  • Established the Canadian Pain Task Force that provided advice to the government regarding evidence and best practices for the prevention and management of chronic pain
  • 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 simple possession
  • Continued collaboration with provinces and territories to support ongoing quarterly reporting of national data on opioid- and stimulant-related deaths, hospitalizations and Emergency Medical Services responses
  • 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 the development of a series of national guidance documents and a national qualitative assessment identifying the needs and challenges of people who use drugs during COVID-19
  • 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
  • Released several reports related to furthering knowledge around opioids

Access to treatment

  • Supported provinces and territories to improve access to treatment services by providing $150 million via the Emergency Treatment Fund which were cost-matched to total over $300 million
  • Supported federally-funded treatment centres for First Nations and Inuit to create and enhance their virtual treatment services since the beginning of the COVID-19 pandemic
  • Supported the development of guidance for health care providers, including:
  • 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 as a treatment option for patients with severe opioid use disorder
    • Approving diacetylmorphine as a new treatment option for patients with severe opioid use disorder
    • Facilitating the prescribing and dispensing of methadone and diacetylmorphine through regulatory amendments
    • Supporting Opioid Agonist Therapy wraparound supports in 72 First Nations and Inuit Communities and 11 new sites are in development
  • Added a new temporary category of eligible health and medical service activities and expenses though the Reaching Home program, including addictions support services that are already provided by provinces and territories and hiring health care professionals to provide services to clients
  • Increasing the provision of opioid agonist treatment and implementing SMART (Self-management and Recovery Training) in Canada's correctional institutions

Access to harm reduction

  • Provided exemptions for 38 supervised consumption sites, which have (as of June 2022):
    • been visited more than 3.5 million times
    • reversed nearly 39,000 overdoses without a single death
    • made over 172,000 referrals to health and social services
  • Supported the Good Samaritan Drug Overdose Act, which provides some legal protection from simple drug possession charges for people who seek emergency help during an overdose
  • Continued to improve access to naloxone, including to remote communities and isolated First Nations and Inuit communities and people experiencing homelessness
  • 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
  • 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 stigma:
    • In November 2018, launched a multi-year campaign 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
    • Developed and distributed awareness resources for opioids, such as videos, fact sheets, posters, wallet cards, and an audio series
    • Between April 2018 and May 2022, the Know More Opioids awareness program engaged in 1,109 high school sessions, 68 post-secondary school events, 43 events/festivals and over 169,000 interactions with people on the facts about the overdose crisis, opioids, fentanyl, naloxone and stigma
  • Supported the development of the Soar Above Stigma Campaign, which aims to propel the Indigenous values of hope, belonging, meaning and purpose through the sharing of Indigenous voices and perspectives to ease the tension of stigma due to fears surrounding COVID-19 as well as escalating mental health issues and substance use
  • 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 to promote uptake of an online Drug Stigma Awareness Training module
  • 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 accompanying policy paper for members of school communities 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

Enforcement and the toxic illegal drug supply

  • Introduced Bill C-5 which proposes to repeal mandatory minimum penalties for all drug offences and require police and prosecutors to consider diverting people to treatment programs, giving a warning or taking no further action instead of charging and prosecuting simple drug possession offences
  • Released guidance to consider alternatives to prosecution for simple drug possession offences, except when there are serious public safety concerns
  • Identified opioids 94,293 times from 2018 to March 2022 in exhibits submitted to the Drug Analysis Service by law enforcement and public health officials (exhibits may contain more than one opioid)
  • Working with domestic and international partners to reduce the illegal opioid supply; including but not limited to:
    • Providing border services officers with tools and equipment to safely and effectively detect, identify and interdict fentanyl and other toxic substances at the border:
      • Seized more than 20 kg of fentanyl at the border between April 2018 and April 2022
      • Seized over 27,300 liquid kg and over 7,500 solid kg of precursor chemical quantities, which could have used in the production of illegal drugs
      • Implementing 81 designated safe examination areas at high risk ports of entry to allow officers to safely examine goods and identify shipments containing suspected opioids for further analysis
      • Deployment of 6 new detector dog teams at mail processing centres trained to detect fentanyl and other drugs
      • Constructed regional screening facilities in Toronto, Montreal and Vancouver
    • Working with private sector partners to address money laundering of the proceeds of fentanyl trafficking
  • Continue to investigate and charge criminal actors suspected of diverting chemical products for the purpose of manufacturing illicit substances

Learn more at Canada.ca/Opioids

Opioid-related harms in Canada

From January 2016 to December 2021 there have been:

  • 29,052 apparent opioid-related deaths
  • 30,860 hospitalizations for opioid-related overdoses

Recent data across Canada shows a worrying increase in opioid-related overdoses and deaths since the beginning of the COVID-19 outbreak:

  • During the first year of the pandemic, there was a 96% increase in apparent opioid-related deaths (April 2020 - March 2021, 7,362 deaths), compared to the year before (April 2019 - March 2020, 3,747 deaths). Since then, deaths have remained high.
  • During the first year of the pandemic, there was a 27% increase in hospitalizations for opioid-related overdoses (April 2020 - March 2021, 5,599 hospitalizations), compared to the year before (April 2019 - March 2020, 4,421 hospitalizations). Since then, hospitalizations have continued to increase.
Crude rate of opioid-related harms per 100,000 population
Harm 2016 2017 2018 2019 2020 2021
Apparent opioid-related deaths 7.8 10.7 11.9 9.8 17.5 20.5
Hospitalizations for opioid-related overdoses 16.8 18.4 17.6 15.5 17.8 20.8

Deaths

  • The latest surveillance data shows that 2021 had the highest number of opioid-related deaths in a year (7,560) since surveillance began in 2016.
  • This is approximately 21 deaths per day. In the years prior to the pandemic, there were between 8 (2016) and 12 (2018) deaths per day.
  • Most (97%) apparent opioid-related deaths in 2021 were accidental.

Among accidental apparent opioid-related deaths in 2021:

  • 3 in 4 were male
  • 89% were among young- to middle-aged adults (20 to 59 years)
  • 86% involved fentanyl
  • 81% involved opioids that were only non-pharmaceutical (among deaths with completed investigations from 8 provinces)
  • 59% of accidental opioid-related deaths also involved a stimulant, reflecting the polysubstance nature of this crisis (based on information from 8 provinces and territories)

Hospitalizations

  • The latest surveillance data shows that 2021 had the highest number of hospitalizations for opioid-related overdoses in a year (6,164) since surveillance began in 2016.
  • This is approximately 17 hospitalizations per day. In the years prior to the pandemic, there were between 12 (2019) and 14 (2017) hospitalizations per day.
  • Most (71%) hospitalizations for opioid-related overdoses in 2021 were accidental.

Among accidental hospitalizations for opioid-related overdoses in 2021:

  • Nearly 2 in 3 were male
  • 58% were among young and middle aged adults (20 to 49 years)
  • 35% involved fentanyl or fentanyl analogues
  • 17% involved one or more stimulants

Emergency Medical Services (EMS)

  • 41,686 EMS responses to suspected opioid-related overdoses occurred in 2021, based on available data from nine provinces and territories. In 2019, the year before the pandemic, there were 21,759 EMS responses; this represents a 92% increase.

Among EMS responses to suspected opioid-related overdoses in 2021:

  • Nearly 3 in 4 were male
  • 79% were among young and middle aged adults (20 to 49 years)

Notes on data

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