In Focus: The Emergence of Opioids in Canada

Download in PDF format
(2.1 MB, 21 pages)

Date published: 2025-08-06

Drug Analysis Service
Summary
Context: The overdose crisis in Canada
Aim
Data limitations
Data analysis
Opioid drug supply in Canada
Fentanyl supply in Canada
- Trends in benzodiazepine, stimulant, xylazine, and nitazene samples co-occurring with Fentanyl and analogues
- Trends in Fentanyl co-occurrences with Fentanyl analogues
Fentanyl analogues supply in Canada
- Fentanyl analogues
Conclusion
References
Suggested citation

Drug Analysis Service

Health Canada's Drug Analysis Service (DAS) operates laboratories across Canada that analyze illicit drugs and substances submitted by Canadian law enforcement and public health officials. DAS data is based solely on samples submitted to the laboratories and as such, samples analyzed by DAS may not be completely representative of drug seizures in Canada, including substances circulating on the market. DAS data should therefore be used with caution when determining trends or drawing conclusions about the type and nature of substances circulating in the illicit market. The data in this report represents the number of times a substance was identified in samples submitted to DAS. A single sample may contain more than one substance.

Summary

Since 2012, the Drug Analysis Service (DAS) has consistently identified Fentanyl, Heroin, Hydromorphone, Oxycodone, and Morphine as the most frequently encountered opioids in samples submitted by Canadian law enforcement and public health officials.
In 2017, Fentanyl replaced Heroin as the most frequently identified opioid.
As the prevalence of Fentanyl has increased over the years, the co-occurrence patterns have also evolved. In 2021, benzodiazepines became the most frequently observed co-occurring substances with Fentanyl, found in approximately 36% of samples containing Fentanyl. Methamphetamine has been increasingly found alongside Fentanyl. Lastly, new and emerging substances of concern, Xylazine and nitazenes, have consistently co-occurred with Fentanyl and Fentanyl analogues.
Recently, a Fentanyl analogue, para-Fluorofentanyl was the second most frequently identified opioid after Fentanyl in samples analyzed by DAS in 2023.
Prior to 2023, Fentanyl identifications were ten times higher than those of Fentanyl analogues. However, the rise of para-Fluorofentanyl in 2023 has lowered this ratio with Fentanyl identifications being approximately 2 times higher than Fentanyl analogue identifications. In 2021 and 2022, Carfentanil and para-Fluorofentanyl were the most frequently identified Fentanyl analogues, with para-Fluorofentanyl being the most common in 2023. These analogues were predominantly found in co-occurrence with Fentanyl and, in recent years, sometimes alongside benzodiazepines.

Context: The overdose crisis in Canada

Canada is currently facing an opioid crisis stemming from the abuse of both illegal and prescription opioids. Opioids are substances that can reduce pain. Research indicates that the escalation of the overdose crisis in Canada can be partly attributed to the growth in use of prescription opioids in recent decades, subsequently leading to an increase in reported harms associated with their use. Additionally, there has been a surge in the consumption of non-prescription opioids. The COVID-19 pandemic has further exacerbated the situation. Recognizing the urgency of this crisis, the Government of Canada has made substantial investments in harm reduction, introducing various initiatives aimed at preventing opioid-related harms and reducing the excessive prescription of opioids ^{Note de bas de page 1} ^{Note de bas de page 2}.

Recent data reveals that from all accidental apparent opioid toxicity deaths in 2023, 88% of deaths were linked to non-pharmaceutical opioids, and 82% of these deaths involved Fentanyl ^{Note de bas de page 3}.

In Canada, a total of 44,592 fatalities due to apparent opioid toxicity were recorded from January 2016 to December 2023. 2023 witnessed an alarming average of 22 deaths per day. In comparison, the number of deaths per day was approximately 8 in 2016 and 12 in 2018, underscoring a significant increase over recent years. The evolving toxicity of the opioid supply in Canada stands as a major contributing factor to the devastating rise in opioid-related deaths ^{Note de bas de page 3}.

Aim

This In Focus report outlines the trends observed in the opioid supply in Canada since 2012 based on samples submitted to the DAS by law enforcement and public health officials. Specifically, it aims to characterize trends related to opioids, and particularly, patterns observed in co-occurrences with Fentanyl, including with benzodiazepines, Heroin, Fentanyl analogues, and multiple drug classes.

Data limitations

This report is based on data made available by the DAS, which analyzes illicit drugs and substances submitted by Canadian law enforcement and public health officials. Certain limitations are associated with the present data. Firstly, law enforcement officials submit samples for laboratory analysis based on investigation needs and priorities. Thus, analyzed samples may not be completely representative of substances circulating on the market as a number of factors may influence substances submitted by Canadian law enforcement officials. Additionally, DAS' mandate is to report substances that are controlled under the Controlled Drugs and Substances Act (CDSA). As such, it is possible that not all noncontrolled substance were reported.

Data analysis

Results of analyzed samples submitted by Canadian law enforcement and public health officials are reported in a centralized database called the Laboratory Information Management System (LIMS). The presented data were retrieved from the LIMS and cover the period between January 1, 2012, and December 31, 2023, inclusively.

Identifications refer to the number of times a substance is identified in samples submitted. Multiple substances may be identified in a single sample. For example, a sample containing Fentanyl, Morphine, and Isotonitazene would be interpreted as one identification of Fentanyl, one identification of Morphine, and one identification of Isotonitazene. Therefore, the number of identifications does not necessarily equal the number of samples.

For the purposes of this report, we have categorized opioids into 4 distinct subclasses:

Fentanyl & Analogues: This subclass includes Fentanyl, its derivatives, and other analogues, all of which are controlled under Schedule I Item 16 of the CDSA.

Opiates: This subclass comprises opium or opium derivatives derived from the poppy plant, as well as compounds that have the core chemical structure of morphine. Drugs falling under this subclass are controlled under Schedule I Item 1 and 10 of the CDSA.

Nitazenes: This subclass includes all nitazenes controlled under Schedule I, Item 13 of the CDSA, excluding Brorphine (classified in Other (Opioids)). Nitazenes are potent synthetic opioids.

Other opioids: This subclass encompasses all other synthetic opioids that share similar properties with Fentanyl & Analogues, Opiates, and Nitazenes. Drugs under this subclass are controlled under Schedule I, Item 3, 4, 5, 6, 7, 8, 9, 11, 12, 17, 22, 23, 24, 25, 26, 27. Some substances in this subclass are also not controlled.

The analysis of data presented was performed in R 4.2.3. Data wrangling and visualization was done using the tidyverse package ^{Note de bas de page 4}.

Opioid drug supply in Canada

Opioids are potent analgesic drugs used for pain relief. Due to their capacity to induce euphoria (a sense of being high), opioids carry a significant risk for problematic use. The prolonged use of opioids can lead to severe side effects, including physical dependence, substance use disorder, and overdose ^{Note de bas de page 5}. Naloxone, a fast-acting medication, can be administered to temporarily reverse the effects of an overdose from opioid use ^{Note de bas de page 6}. The sale, possession and production of opioids are illegal, unless authorized for medical, scientific or industrial purposes. They are controlled under Schedule I of the CDSA ^{Note de bas de page 7}.

Most frequently identified opioids

The most frequently identified opioids by DAS in samples submitted by Canadian law enforcement and public health officials in 2023 are Fentanyl, para-Fluorofentanyl, Hydromorphone, Oxycodone, and Heroin (Figure 1, Table 1) ^{Note de bas de page 8}. In 2017, Fentanyl emerged as the primary opioid in the Canadian drug supply, surpassing Heroin (Figure 1). Fentanyl is a potent opioid used in medical settings for pain management. Illicit Fentanyl can be mixed with other substances to increase the potency of the product, which increases the risk of an accidental overdose ^{Note de bas de page 9}.

Year	Fentanyl	Heroin	Hydromorphone	Oxycodone	para-Fluorofentanyl	Total
2012	217	2339	1149	2477	-	6182
2013	446	2609	1730	2021	-	6806
2014	809	3079	1877	1857	-	7622
2015	1732	3883	2121	1970	-	9706
2016	3492	3664	1973	1692	-	10821
2017	6542	4443	2203	1983	4	15175
2018	8189	3936	1991	1844	-	15960
2019	10798	3783	1835	1797	-	18213
2020	13351	2408	1427	1390	-	18576
2021	16330	1636	2151	1717	83	21917
2022	15260	1174	2426	2045	582	21487
2023	13359	1081	2230	1901	5309	23880
Total	90525	34035	23113	22694	5978	176345

Table 1: Most frequently identified opioids in samples submitted to DAS for analysis in 2023
Opioid	Subclass	General Information	Therapeutic Uses
Fentanyl	Fentanyl & Analogues	Fentanyl is a synthetic opioid, 50 to 100 times more potent than morphine, and has played a significant role in the Canadian overdose crisis ^{Note de bas de page 9}.	It is prescribed to manage severe pain, particularly after surgical procedures ^{Note de bas de page 9}.
para-Fluorofentanyl	Fentanyl & Analogues	Para-Fluorofentanyl is a synthetic opioid. It is a Fentanyl analogue. There is little information in the literature concerning its potency, but it is likely similar to Fentanyl ^{Note de bas de page 10}.	Para-Fluorofentanyl is not a prescription medicine and has no approved therapeutic use.
Hydromorphone	Opiates	Hydromorphone is a semi-synthetic opioid that can be synthesized from Morphine, a minor constituent of opium ^{Note de bas de page 11}. It is approximately 5 times more potent than morphine ^{Note de bas de page 12}.	Hydromorphone is indicated for the relief of moderate to severe pain ^{Note de bas de page 11}.
Oxycodone	Opiates	Oxycodone is a semi-synthetic opioid derived from Thebaine (a minor constituent of opium) ^{Note de bas de page 11}. It is 1.5 times more potent than morphine ^{Note de bas de page 12}.	Oxycodone is indicated for the management of moderate to severe pain ^{Note de bas de page 11}.
Heroin	Opiates	Heroin is a semi-synthetic opioid derived from morphine. It is 2 to 4 times more potent than morphine and is primarily used as an illegal recreational substance ^{Note de bas de page 13}.	Under medical supervision, prescriptions for Heroin may be obtained through the Urgent Public Health Need process for treating problematic opioid use ^{Note de bas de page 14}.

Trends in the opioid-related drug supply

Trends are represented by way of identifications (see "Data analysis" section).

Opiates, specifically Heroin, Oxycodone, and Hydromorphone, were the most commonly identified opioids in the illicit drug supply in Canada until 2016.

By 2018, Fentanyl and its analogues had surpassed all other opioid subclasses combined in the number of identifications, becoming the dominant subclass of opioids identified and displacing the opiates subclass. Fentanyl analogues are substances chemically similar to Fentanyl. Often manufactured by modifying the chemical structure of Fentanyl, they have a high potential for misuse and dependence. ^{Note de bas de page 15}

Since 2020, Heroin identifications have notably decline, and there has been an emerging presence of non-Fentanyl and non-opiate opioids, specifically nitazenes. Nitazenes are potent synthetic opioids only present in the illicit drug supply. Certain nitazenes are estimated to have greater potencies than Fentanyl ^{Note de bas de page 16}.

Overall, trends observed in Canada in the past decade indicate a shift in the opioid supply towards more potent substances (Figure 2, Table 2).

Figure 2. Number of opioid identifications per subclass and year in Canada (2012 to 2023)

Note: Samples may contain multiple substances and other substances than those listed.

Figure 2: Text description

The data presented in this figure is available in Table 2.

Table 2. Number of opioid identifications per class and year in Canada (2012 to 2023)
Substance	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023	Total
Fentanyl & analogues
Acetylfentanyl	-	48	29	45	232	138	51	111	404	16	35	40	1149
Carfentanil	-	-	-	-	32	740	977	1766	312	890	1116	810	6643
Cyclopropylfentanyl	-	-	-	-	-	199	328	106	36	5	-	6	680
Fentanyl	217	446	809	1721	3491	6538	8187	10795	13349	16325	15260	13359	90497
Furanylfentanyl	-	-	-	-	164	637	278	78	47	12	10	7	1233
para-Fluorofentanyl	-	-	-	-	-	4	-	-	-	83	582	5309	5978
Other - Fentanyl & Analogues	-	-	-	15	139	89	318	134	52	34	105	321	1207
Total - Fentanyl & Analogues	217	494	838	1781	4058	8345	10139	12990	14200	17365	17108	19852	107387
Nitazenes
Etodesnitazene	-	-	-	-	-	-	-	-	84	255	145	21	505
Isotonitazene	-	-	-	-	-	-	-	8	166	176	251	31	632
Metonitazene	-	-	-	-	-	-	-	-	-	342	346	334	1022
N-pyrrolidino Protonitazene	-	-	-	-	-	-	-	-	-	-	-	25	25
N-desethyl Isotonitazene	-	-	-	-	-	-	-	-	-	-	-	69	69
Protonitazene	-	-	-	-	-	-	-	-	-	171	415	302	888
Other - Nitazenes	-	-	-	-	-	-	-	-	-	46	144	21	305
Total - Nitazenes	-	-	-	-	-	-	-	8	250	990	1301	803	3352
Opiates
6-Acetylmorphine	28	18	27	58	39	34	37	66	139	57	78	62	643
Buprenorphine	28	33	77	127	185	272	301	337	324	360	359	248	2651
Codeine	482	529	541	671	696	757	568	571	383	404	367	367	6336
Heroin	2339	2609	3079	3883	3664	4443	3935	3781	2408	1636	1174	1081	34032
Hydromorphone	1149	1730	1877	2121	1972	2203	1991	1835	1427	2151	2426	2230	23112
Morphine	620	836	700	734	739	811	657	633	425	574	723	578	8030
Opium	105	176	151	104	129	126	98	85	111	166	211	192	1654
Oxycodone	2477	2021	1857	1970	1690	1983	1843	1797	1390	1717	2045	1901	22691
Other - Opiates	37	17	14	34	35	22	27	28	40	29	31	29	343
Total - Opiates	7265	7969	8323	9702	9149	10651	9457	9133	6647	7094	7414	6688	99492
Other opioids
Furanyl UF-17	-	-	-	-	-	-	-	37	258	218	100	38	651
Methadone	110	137	112	145	154	168	136	106	131	117	82	129	1527
Tramadol	46	24	49	45	103	101	52	112	86	78	69	71	836
U-47700	-	-	-	-	208	451	228	92	27	1	1	1	1009
Other – Other (opioids)	30	46	48	39	81	122	94	80	76	76	80	35	807
Total - Other (opioids)	186	207	209	229	546	842	510	427	578	490	332	274	4830
Note: Samples may contain multiple substances and other substances than those listed.

Opiates continue to dominate as the most prevalent substances in the eastern provinces (Maritimes and Quebec). In 2023, the eastern provinces had higher proportions of opiates, while the rest of the country had a higher proportion of Fentanyl and Fentanyl analogue identifications (Figure 3).

**Figure 3. Percentage of opioid identifications by subclass and by Province/Territory in 2023**

Province/Territory	Fentanyl	Fentanyl analogues	Nitazenes	Opiates	Other opioids	Total
Canada	13,358 (48.9%)	6,278 (23.0%)	765 (2.8%)	6,631 (24.3%)	270 (1.0%)	27,302
British Columbia	3,827 (60.9%)	1,485 (23.6%)	8 (0.1%)	908 (14.5%)	56 (0.9%)	6,284
Alberta	2,737 (57.2%)	1,452 (30.4%)	16 (0.3%)	542 (11.3%)	37 (0.8%)	4,784
Saskatchewan	165 (60.7%)	48 (17.6%)	-	59 (21.7%)	-	272
Manitoba	392 (48.5%)	157 (19.4%)	3 (0.4%)	252 (31.2%)	5 (0.6%)	809
Ontario	5,762 (45.2%)	2,976 (23.3%)	443 (3.5%)	3,491 (27.4%)	76 (0.6%)	12,748
Quebec	296 (17.4%)	105 (6.2%)	249 (14.7%)	973 (57.3%)	74 (4.4%)	1,697
New Brunswick	128 (33.5%)	38 (10.0%)	39 (10.2%)	174 (45.6%)	3 (0.8%)	382
Nova Scotia	15 (8.5%)	7 (4.0%)	2 (1.1%)	139 (79.0%)	13 (7.4%)	176
Prince Edward Island	12 (30.8%)	1 (2.6%)	2 (5.1%)	23 (59.0%)	1 (2.6%)	39
Newfoundland and Labrador	6 (7.9%)	2 (2.6%)	3 (4.0%)	60 (79.0%)	5 (6.6%)	76
Yukon	12 (60.0%)	5 (25.0%)	-	3 (15.0%)	-	20
Northwest Territories	6 (42.9%)	2 (14.3%)	-	6 (42.9%)	-	14
Nunavut	-	-	-	1 (100%)	-	1

Sample forms in the opioid-related drug supply

The form of analyzed substances differs by opioid type. Fentanyl and analogue-class opioids have a high proportion of samples in powder form. In contrast, opiate-class opioids are more frequently found in tablet/capsule form (Figure 4, Table 3). Opioid samples in powder form often contain a greater variety of substances than those in tablet or capsule forms. This is especially true in recent years, where the proportion of the number of co-occurring substances has increased in powered samples (Figure 5).

The most common form of opioid samples found varies geographically, with Eastern provinces generally exhibiting fewer powder form samples of each opioid class, whereas Western provinces having a higher proportion of samples in powder form across all opioid classes compared to the Eastern provinces (Figure 4, Table 3).

Figure 4a — **Figure 4. Percentage of opioid identifications by subclass and form per Province/Territory for 2021 – 2023**

Figure 4b — **Figure 4. Percentage of opioid identifications by subclass and form per Province/Territory for 2021 – 2023**

Table 3. Percentage of opioid identifications by subclass and form per Province/Territory for 2021 – 2023

a) Fentanyl and analogues
Province	Capsule(s)	Powder and/or grainy substance	Tablet(s)	Other	Total
Canada	13 (0.0%)	42,315 (89.4%)	948 (2.0%)	4,041 (8.5%)	47,317
British Columbia	1 (0.0%)	11,194 (90.0%)	331 (2.7%)	910 (7.3%)	12,436
Alberta	1 (0.0%)	7,605 (93.4%)	134 (1.7%)	402 (4.9%)	8,142
Saskatchewan	-	427 (92.2%)	9 (1.9%)	27 (5.8%)	463
Manitoba	-	777 (68.6%)	33 (2.9%)	323 (28.5%)	1,133
Ontario	11 (0.1%)	21,269 (89.4%)	355 (1.5%)	2,145 (9.0%)	23,780
Quebec	-	772 (78.5%)	37 (3.8%)	174 (17.7%)	983
New Brunswick	-	168 (70.3%)	36 (15.1%)	35 (14.6%)	239
Nova Scotia	-	33 (68.8%)	2 (4.2%)	13 (27.1%)	48
Prince Edward Island	-	10 (52.6%)	1 (5.3%)	8 (42.1%)	19
Newfoundland and Labrador	-	10 (52.6%)	8 (42.1%)	1 (5.3%)	19
Yukon	-	43 (93.5%)	1 (2.2%)	2 (4.4%)	46
Northwest Territories	-	7 (77.8%)	1 (11.1%)	1 (11.1%)	9
Nunavut	-	-	-	-	-

b) Opiates
Province	Capsule(s)	Powder and/or grainy substance	Tablet(s)	Other	Total
Canada	3,114 (14.8%)	4,294 (20.4%)	12,285 (58.3%)	1,388 (6.6%)	21,081
British Columbia	310 (12.3%)	429 (17.0%)	1,721 (68.1%)	68 (2.7%)	2,528
Alberta	168 (10.0)	221 (13.1%)	1,244 (73.6%)	57 (3.4%)	1,690
Saskatchewan	55 (24.8%)	30 (13.5%)	124 (55.9%)	13 (5.9%)	222
Manitoba	36 (6.4%)	61 (10.9%)	385 (68.9%)	77 (13.8%)	559
Ontario	1,458 (12.5%)	2,913 (25.0%)	6,373 (54.8%)	889 (7.6%)	11,633
Quebec	576 (19.7%)	561 (19.2%)	1,562 (53.4%)	227 (7.8%)	2,926
New Brunswick	323 (43.9%)	55 (7.5%)	330 (44.8%)	28 (3.8%)	736
Nova Scotia	126 (29.9%)	12 (2.9%)	259 (61.5%)	24 (5.7%)	421
Prince Edward Island	19 (18.3%)	4 (3.9%)	79 (76.0%)	2 (1.9%)	104
Newfoundland and Labrador	41 (16.8%)	7 (2.9%)	193 (79.1%)	3 (1.2%)	244
Yukon	2 (25.0%)	-	6 (75.0%)	-	8
Northwest Territories	-	1 (11.1%)	8 (89.0%)	-	9
Nunavut	-	-	1 (100.0%)	-	1

c) Nitazenes
Province	Capsule(s)	Powder and/or grainy substance	Tablet(s)	Other	Total
Canada	-	1,608 (57.1%)	1,141 (40.5%)	68 (2.4%)	2,817
British Columbia	-	52 (98.1%)	-	1 (1.9%)	53
Alberta	-	75 (81.5%)	16 (17.4%)	1 (1.1%)	92
Saskatchewan	-	10 (100.0%)	-	-	10
Manitoba	-	3 (50.0%)	3 (50.0%)	-	6
Ontario	-	1,362 (79.3%)	308 (17.9%)	47 (2.7%)	1,717
Quebec	-	94 (12.3%)	655 (86.0%)	13 (1.7%)	762
New Brunswick	-	6 (4.0%)	142 (93.4%)	4 (2.6%)	152
Nova Scotia	-	2 (13.3%)	11 (73.3%)	2 (13.3%)	15
Prince Edward Island	-	1 (20.0%)	4 (80.0%)	-	5
Newfoundland and Labrador	-	3 (60.0%)	2 (40.0%)	-	5
Yukon	-	-	-	-	-
Northwest Territories	-	-	-	-	-
Nunavut	-	-	-	-	-

**Figure 5. Proportion of the number of substances per opioid samples in powder and tablets or capsule form per year**

Number of substances	Description	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023
1	Tablets or Capsules	3303	3518	3389	3891	3905	4500	3899	3155	2367	3474	4048	3756
Powder	89	111	142	122	460	1085	929	769	611	695	664	935
2	Tablets or Capsules	796	841	866	913	1221	1159	1020	1542	1435	1742	1889	1738
Powder	629	822	1092	804	855	1611	2787	4226	5398	4968	4384	2803
3	Tablets or Capsules	260	257	447	718	380	348	261	354	275	278	287	282
Powder	107	83	111	163	404	1267	2402	4050	4283	5778	5076	4872
4 or more	Tablets or Capsules	5	11	20	111	46	24	17	38	38	33	35	70
Powder	15	29	33	159	309	742	1085	2072	2242	4230	5083	6060

Fentanyl supply in Canada

Trends in this section are based on analysis results of samples submitted to the DAS by Canadian law enforcement and public health officials. Trends are presented by way of samples.

Fentanyl is routinely used in clinical settings for anesthesia and analgesia, however illicit Fentanyl has become prevalent nationwide, changing the composition of the illicit opioid supply across Canada. Its distinct pharmacological profile has led to unprecedented rates of mortality and morbidity among people who use drugs. ^{Note de bas de page 17}

The number of samples that were found to contain Fentanyl and analogues varied across the country, with high quantities of samples found in Ontario, British Columbia and Alberta in 2023. Adjusting for the population of each Province, the highest rates were in British Columbia and Alberta followed closely by Ontario. Yukon Territory and Manitoba had moderately high rates as well, with the rest of the country being lower (Figure 6).

**Figure 6. Number of samples containing Fentanyl and analogues analyzed per 100,000 population by Province/Territory for 2023**

Province/Territory	Fentanyl and analogues samples	Rate per 100,000
Canada	15115	37.3
British Columbia	3982	71.4
Alberta	3041	63.9
Saskatchewan	174	14.3
Manitoba	407	27.8
Ontario	7004	44.3
Quebec	319	3.6
New Brunswick	134	16.0
Nova Scotia	18	1.7
Prince Edward Island	12	6.8
Newfoundland and Labrador	6	1.1
Yukon	12	26.6
Northwest Territories	6	13.4
Nunavut	-	-

Trends in benzodiazepine, stimulant, xylazine, and nitazene samples co-occurring with Fentanyl and analogues

Polysubstance use (defined as the use of 2 or more substances simultaneously, or close in time) presents a serious risk to people who use drugs, including poor health outcomes and death. Exposure to polysubstance use is not always intentional or expected, whereby products from the illicit drug market are inherently uncontrolled and unpredictable. ^{Note de bas de page 18}

The simultaneous consumption of benzodiazepines and opioids may increase the risk of overdose since both drug types cause sedation and supress breathing ^{Note de bas de page 19}. 2021 saw a marked increase in the number of benzodiazepine samples, with the majority of these samples also containing Fentanyl and/or Fentanyl analogues (Figure 7). This trend varied regionally, with Quebec and the Maritimes having a lower proportion of benzodiazepine samples that contained Fentanyl and/or Fentanyl analogues compared to the rest of the country (Figure 8).

There has been a slight decrease in the proportion of opiates class substance samples that also contain Fentanyl and/or Fentanyl analogues (Figure 7), a trend observed nationwide (Figure 8).

The prevalence of co-occurrence of Fentanyl and/or Fentanyl analogues and stimulants is driven by samples from British Columbia, Alberta and Ontario. In general, Fentanyl and/or Fentanyl analogues have not frequently been identified in Cocaine samples (Figure 7) and this pattern is consistent across regions (Figure 8). Over time, there has been a slight increase in Methamphetamine samples that also contain Fentanyl and/or Fentanyl analogues, rising from 0% in 2012 to just over 4% in 2023 (Figure 7). However, this trend is region-specific, with British Columbia and Manitoba showing the greatest rise in recent years (Figure 8).

Since the emergence of nitazenes in 2019, a significant proportion of nitazene samples have been found to also contain Fentanyl and/or Fentanyl analogues (Figure 7). Regional differences are notable, with the largest proportion of nitazene samples co-occurring with Fentanyl and/or Fentanyl analogues in British Columbia and Ontario (Figure 8).

Xylazine is a non-opioid analgesic, sedative and muscle relaxant used in veterinary medicine ^{Note de bas de page 20}. Since its emergence in 2019, the majority of Xylazine samples have been found to also contain Fentanyl and/or Fentanyl analogues (>90%) (Figure 7). This is consistent across regions, with nearly all samples of Xylazine across the country containing Fentanyl and/or Fentanyl analogues (Figure 8).

**Figure 7. Samples of Cocaine, Methamphetamine, benzodiazepines, opiates, nitazenes, and Xylazine co-occurring with Fentanyl and/or Fentanyl analogues**

Benzodiazepines
Year	With Fentanyl and/or Analogues	Without Fentanyl and/or Analogues	Total
2012	-	964 (100.0%)	964
2013	4 (0.3%)	1,172 (99.7%)	1,176
2014	-	1,259 (100.0%)	1,259
2015	33 (2.0%)	1,663 (98.1%)	1,696
2016	29 (1.6%)	1,836 (98.5%)	1,865
2017	82 (3.2%)	2,473 (96.8%)	2,555
2018	31 (1.1%)	2,759 (98.9%)	2,790
2019	284 (9.6%)	2,661 (90.4%)	2,945
2020	1,348 (32.7%)	2,780 (67.3%)	4,128
2021	5,892 (64.7%)	3,218 (35.3%)	9,110
2022	6,205 (67.4%)	3,001 (32.6%)	9,206
2023	7,240 (72.7%)	2,722 (27.3%)	9,962

Opiates
Year	With Fentanyl and/or Analogues	Without Fentanyl and/or Analogues	Total
2012	5 (0.1%)	7,145 (99.9%)	7,150
2013	50 (0.6%)	7,806 (99.4%)	7,856
2014	97 (1.2%)	8,107 (98.8%)	8,204
2015	353 (3.7%)	9,186 (96.3%)	9,539
2016	1,567 (17.5%)	7,388 (82.5%)	8,955
2017	3,025 (28.9%)	7,428 (71.1%)	10,453
2018	2,959 (31.8%)	6,354 (68.2%)	9,313
2019	2,870 (31.6%)	6,200 (68.4%)	9,070
2020	1,810 (27.3%)	4,812 (72.7%)	6,622
2021	861 (12.2%)	6,213 (87.8%)	7,074
2022	416 (5.6%)	6,974 (94.4%)	7,390
2023	375 (5.6%)	6,271 (94.4%)	6,646

Cocaine
Year	With Fentanyl and/or Analogues	Without Fentanyl and/or Analogues	Total
2012	3 (0.0%)	22,890 (99.9%)	22,893
2013	24 (0.1%)	22,669 (99.9%)	22,693
2014	38 (0.2%)	23,919 (99.8%)	23,957
2015	78 (0.3%)	24,329 (99.7%)	24,407
2016	234 (1.0%)	22,498 (99.0%)	22,732
2017	518 (2.0%)	24,904 (98.0%)	25,422
2018	716 (2.7%)	26,229 (97.3%)	26,945
2019	655 (2.3%)	27,802 (97.7%)	28,457
2020	750 (3.2%)	22,485 (96.8%)	23,235
2021	908 (3.5%)	24,730 (96.5%)	25,638
2022	824 (3.0%)	26,238 (97.0%)	27,062
2023	651 (2.3%)	28,035 (97.7%)	28,686

Methamphetamine
Year	With Fentanyl and/or Analogues	Without Fentanyl and/or Analogues	Total
2012	-	9,185 (100.0%)	9,185
2013	3 (0.0%)	10,491 (99.9%)	10,494
2014	21 (0.2%)	11,708 (99.8%)	11,729
2015	27 (0.2%)	16,208 (99.8%)	16,235
2016	191 (1.0%)	18,451 (99.0%)	18,642
2017	439 (1.9%)	22,736 (98.1%)	23,175
2018	556 (2.2%)	24,775 (97.8%)	25,331
2019	1,011 (3.5%)	27,842 (96.5%)	28,853
2020	1,175 (4.7%)	23,678 (95.3%)	24,853
2021	1,187 (4.8%)	23,628 (95.2%)	24,815
2022	1,003 (4.2%)	22,764 (95.8%)	23,767
2023	1,011 (4.4%)	22,069 (95.6%)	23,080

Nitazenes
Year	With Fentanyl and/or Analogues	Without Fentanyl and/or Analogues	Total
2012	-	-	-
2013	-	-	-
2014	-	-	-
2015	-	-	-
2016	-	-	-
2017	-	-	-
2018	-	-	-
2019	-	8 (100.0%)	8
2020	78 (31.5%)	170 (68.6%)	248
2021	500 (57.3%)	372 (42.7%)	872
2022	589 (49.9%)	591 (50.1%)	1,180
2023	225 (29.3%)	544 (70.7%)	769

Xylazine
Year	With Fentanyl and/or Analogues	Without Fentanyl and/or Analogues	Total
2012	-	1 (100.0%)	1
2013	-	1 (100.0%)	1
2014	-	-	-
2015	14 (87.5%)	2 (12.5%)	16
2016	2 (22.2%)	7 (77.8%)	9
2017	2 (66.7%)	1 (33.3%)	3
2018	4 (80.0%)	1 (20.0%)	5
2019	205 (100.0%)	-	205
2020	196 (99.0%)	2 (1.0%)	198
2021	499 (93.1%)	37 (6.9%)	536
2022	1,242 (92.0%)	108 (8.0%)	1,350
2023	1,409 (94.1%)	89 (5.9%)	1,498

Benzodiazepines
Province	2012 - 2014	2015 - 2017	2018 - 2020	2021 - 2023
Alberta	-	3.1	18.1	84.0
British Columbia	0.9	5.9	41.7	81.4
Manitoba	-	2.1	11.9	69.7
Maritimes	-	2.0	0.7	20.2
Ontario	-	2.3	29.5	77.7
Quebec	-	0.7	2.6	12.6
Saskatchewan	-	1.5	10.3	64.4
Territories	-	-	-	70.6

Cocaine
Province	2012 - 2014	2015 - 2017	2018 - 2020	2021 - 2023
Alberta	0.1	0.6	1.8	2.2
British Columbia	0.3	3.9	6.9	5.8
Manitoba	0.1	0.9	3.1	6.3
Maritimes	-	-	0.2	0.9
Ontario	-	1.0	3.5	4.2
Quebec	-	-	0.2	0.3
Saskatchewan	0.2	0.2	0.7	0.5
Territories	-	0.6	0.5	1.1

Methamphetamine
Province	2012 - 2014	2015 - 2017	2018 - 2020	2021 - 2023
Alberta	0.2	1.0	3.4	5.8
British Columbia	0.2	6.4	11.7	10.8
Manitoba	-	1.2	3.9	12.0
Maritimes	-	-	0.2	1.3
Ontario	-	0.8	4.7	7.5
Quebec	0.1	-	0.1	0.1
Saskatchewan	-	0.1	1.0	0.9
Territories	-	-	-	-

Nitazenes
Province	2012 - 2014	2015 - 2017	2018 - 2020	2021 - 2023
Alberta	-	-	6.7	13.0
British Columbia	-	-	64.7	79.2
Manitoba	-	-	-	33.3
Maritimes	-	-	-	5.1
Ontario	-	-	77.4	68.5
Quebec	-	-	0.8	9.1
Saskatchewan	-	-	-	40.0
Territories	-	-	-	-

Opiates
Province	2012 - 2014	2015 - 2017	2018 - 2020	2021 - 2023
Alberta	0.5	12.7	29.1	7.5
British Columbia	2.1	43.8	74.1	12.8
Manitoba	-	6.1	22.6	5.7
Maritimes	-	0.8	2.0	1.0
Ontario	0.2	8.0	25.4	8.3
Quebec	-	3.6	3.5	6.0
Saskatchewan	1.9	5.1	12.3	7.2
Territories	-	9.5	17.9	-

Xylazine
Province	2012 - 2014	2015 - 2017	2018 - 2020	2021 - 2023
Alberta	-	40.0	99.6	97.8
British Columbia	-	80.0	100.0	95.1
Manitoba	-	-	100.0	100.0
Maritimes	-	-	100.0	100.0
Ontario	-	90.9	100.0	92.9
Quebec	-	-	33.3	71.4
Saskatchewan	-	-	100.0	75.0
Territories	-	-	-	100.0

Table 4. Co-occurrence of Fentanyl with Fentanyl analogues in DAS samples by year 2012-2023
Year	Fentanyl alone	Analogues alone	Fentanyl & analogues	Total
2012	217	-	-	217
2013	446	48	-	494
2014	808	28	1	837
2015	1708	44	13	1765
2016	3256	290	235	3781
2017	5770	966	768	7504
2018	7341	895	846	9082
2019	9804	1068	991	11863
2020	12673	138	676	13487
2021	15557	252	768	16577
2022	13843	365	1417	15625
2023	8837	1757	4521	15115
Note: Samples may contain multiple substances and other substances than those listed.

Table 5. Main Fentanyl analogues
Fentanyl analogues	First DAS identification in Canada	General information
Acetylfentanyl	June 2013 Montreal, Quebec	Studies suggest that Acetylfentanyl is less potent than Fentanyl (30% as effective) but, approximately 16 times more potent than Morphine ^{Note de bas de page 23}. Since its emergence on the illicit market, numerous reports of fatalities and overdose cases associated with Acetylfentanyl have been documented ^{Note de bas de page 24}.
Bromofentanyl	November 2021 Nanaimo, British Columbia	No data available.
Carfentanil	July 2016 Surrey, British Columbia	Carfentanil has been utilized as a veterinary anesthetic for large animals since 1986. It is documented to be approximately 10 000 times more potent than Morphine, and 100 times more potent than Fentanyl. Numerous reports of fatalities and overdose cases associated with Carfentanil have been reported ^{Note de bas de page 24} ^{Note de bas de page 22}.
Cyclopropylfentanyl	September 2017 Surrey, British Columbia	Limited information is available, but some studies suggest that Cyclopropylfentanyl exhibits a potency that is approximately threefold or higher than Fentanyl ^{Note de bas de page 25}.
Furanylfentanyl	July 2016 Surrey, British Columbia	While there are no specific studies on its potency, Furanylfentanyl has been identified in several reports of fatalities ^{Note de bas de page 23}.
Methoxyacetylfentanyl	March 2018 Nanaimo, British Columbia	Limited information is available, but some studies suggest that Methoxyacetylfentanyl has a potency that is approximately 30% of the potency of Fentanyl ^{Note de bas de page 23}.
para-Fluorofentanyl	February 2017 Victoria, British Columbia	There is little information in the literature concerning its potency, but it is likely similar to Fentanyl ^{Note de bas de page 23}.

Page details

Date modified:: 2025-08-06

Language selection

Search

In Focus: The Emergence of Opioids in Canada

On this page

Drug Analysis Service

Summary

Context: The overdose crisis in Canada

Aim

Data limitations

Data analysis

Opioid drug supply in Canada

Most frequently identified opioids

Trends in the opioid-related drug supply

Sample forms in the opioid-related drug supply

Fentanyl supply in Canada

Trends in benzodiazepine, stimulant, xylazine, and nitazene samples co-occurring with Fentanyl and analogues

Trends in Fentanyl co-occurrences with Fentanyl analogues

Fentanyl analogues supply in Canada

Fentanyl analogues

Conclusion

References

Suggested citation

Page details