Federal actions on opioids to date

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(December 2021)

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Recent highlights

  • Updated modelling projections during COVID-19 show that opioid-related deaths may remain high through the remainder of 2021 and into 2022
  • Released a report on hospitalizations for neonatal abstinence syndrome, including trends from 2010 to 2020
  • Introduced Bill C-5 (former Bill-C-22) on December 7, 2021 which proposes to repeal mandatory minimum penalties for all drug offences and require police and prosecutors to consider using diversion, including to treatment programs instead of charges, for simple possession of an illegal drug
  • Established an Expert Task Force on Substance Use in March 2021 to provide independent, expert recommendations on the federal government's drug policy, as outlined in the Canadian Drugs and Substances Strategy (CDSS), including alternatives to criminal penalties for personal possession of small amounts of illegal drugs
  • 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
  • Continue to support people who use drugs during the COVID-19 pandemic

Project Funding

  • Budget 2021 committed new funding for many substance-related initiatives, including, but not limited to the Substance Use and Addictions Program, the Wellness Together Canada Portal, the development of national standards for mental health and substance use, access to Drug Treatment Courts, distinctions-based mental health and wellness strategies with First Nations, Inuit, and the Métis, and to address homelessness and housing for at risk populations, including people who use substances
  • Committed $66 million in funding over 2 years through the 2020 Fall Economic Statement for 32 new Substance Use and Addictions Program funded projects related to naloxone, stigma, safer supply and more for community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context
  • Invested $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
  • Continue to fund additional 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 18 safer supply projects across 29 sites in British Columbia, Ontario, Quebec, and New Brunswick for a total investment of $60.2 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 over $2 million to evaluate program implementation and impacts of safer supply pilot projects, and to assess the public health impact of supervised consumption sites located in British Columbia, the Prairies, Ontario and Quebec-Atlantic, in the context of COVID-19

Evidence

  • The Canadian Pain Task Force released its third report in May 2021 - An Action Plan for Pain in Canada, which includes recommendations to ensure people with pain are recognized and supported, and that pain is understood, prevented, and effectively treated throughout Canada
  • Continued collaboration with provinces and territories to support ongoing quarterly reporting of national data on opioid- and stimulant-related deaths and harms, such as 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
  • Developed a series of national guidance documents related to substance use in the context of COVID-19

Access to treatment

Access to harm reduction

  • Provided exemptions for 38 supervised consumption sites (currently operating), which have (as of June 2021):
    • been visited more than 2.9 million times
    • reversed nearly 27,000 overdoses without a single death
    • made over 127,000 referrals to health and social services
  • Consulted Canadians on a proposal to develop new regulations for supervised consumption sites and services
  • Supported the Good Samaritan Drug Overdose Act, which provides some legal protection from 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 to the homeless-serving sector
  • Announced the winner and finalists of the Drug Checking Technology Challenge

Awareness and prevention

Enforcement and tainted drug supply

  • Released a guideline that directs prosecutors to focus on the most serious cases raising public safety concerns for prosecution regarding the possession of a controlled substance and to otherwise pursue suitable alternative measures and diversion from the criminal justice system for simple possession cases
  • Identified opioids 80,094 times from 2018 to September 2021 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:
    • Equipping border agents with tools to intercept fentanyl and other toxic substances at the border
      • Seized more than 18.1 kg of fentanyl at the border between April 2018 and October 2021
      • Implementing 81 designated safe examination areas by early 2023 at high risk ports of entry which allow officers to safely conduct examinations of items suspected to contain opioids and fentanyl
      • Deployment of 6 new detector dog teams at mail processing centres trained to detect fentanyl in addition to other drugs
      • Constructed regional designated safe sampling areas 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 June 2021 there have been:

  • 24,626 apparent opioid-related deaths
  • 27,604 hospitalizations for opioid-related overdoses

Recent data from several jurisdictions across Canada show a worrying increase in opioid-related harms and deaths since the beginning of the COVID-19 outbreak

  • The latest surveillance data show that 2020 (6,306 deaths) had the highest number of deaths in a year since surveillance began in 2016, and the numbers remain high through the first half of 2021 (3,515 deaths)
  • From April to June 2021, the highest quarterly numbers since surveillance began were reported for both hospitalizations for opioid-related overdoses (1,464) and for Emergency Medical Services (EMS) responses to suspected opioid-related overdoses (9,782)
Crude rate of opioid-related harms per 100,000 population
Harm 2016 2017 2018 2019 2020 2021
(Jan to Jun)
Apparent opioid-related deaths 7.8 10.7 11.9 9.8 16.5 19.1
Hospitalizations for opioid-related overdoses 16.8 18.4 17.6 15.5 17.8 19.6

Deaths

  • Between January and June 2021, there were 3,515 apparent opioid-related deaths, or nearly 19 deaths per day, of which 96% were accidental
  • 1,720 apparent opioid-related deaths occurred between April and June 2021, similar to the period from January to March 2021 (1,792), but representing a 2% increase compared to April to June 2020 (1,680 deaths) and a 66% increase compared to April to June 2019 (1,038 deaths)

Among accidental apparent opioid-related deaths in 2021 (January to June):

  • 3 in 4 were male
  • 71% were among young and middle aged adults (20 to 49 years)
  • 28% were among older adults (50 years or greater)
  • 87% involved fentanyl and 14% involved fentanyl analogues
  • 90% involved non-pharmaceutical opioids (among deaths with completed investigations from 8 provinces)
  • based on information from 6 provinces and territories, 59% of accidental opioid-related deaths also involved a stimulant, reflecting the polysubstance nature of this crisis

Hospitalizations

  • Between January and June 2021, there were 2,908 hospitalizations for opioid-related overdoses or nearly 16 hospitalizations per day, of which 69% were accidental
  • 1,464 hospitalizations for opioid-related overdoses occurred between April and June 2021, similar to the period from January to March 2021, but representing an 11% increase compared to April to June 2020 and a 20% increase compared to April to June 2019 (1,216)

Among accidental hospitalizations for opioid-related overdoses in 2021 (January to June):

  • 2 in 3 were male
  • 57% were among young and middle aged adults (20 to 49 years)
  • 39% were among older adults (50 years or greater)
  • 34% involved fentanyl or fentanyl analogues
  • 17% involved one or more stimulants

Emergency Medical Services

According to available Emergency Medical Services (EMS) data from 9 provinces and territories:

  • Between January and June 2021, there were more than 17,400 EMS responses for suspected opioid-related overdoses, of which:
    • Nearly 3 in 4 were male
    • 78% were among young and middle aged adults (20 to 49 years)
    • 20% were among older adults (50 years or greater)
  • 9,782 EMS responses to suspected opioid-related overdoses occurred between April and June 2021, which is 27% higher than the period from January to March 2021. This also represents a 31% increase from April to June 2020 (7,461) and a 63% increase compared to April to June 2019 (6,000)

Notes on data

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