Spotlight : The evolution of Fentanyl in Canada over the past 11 years

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Organization: Health Canada

Date published: March 2023

Cat.: H139-46/2022E-PDF

ISBN: 978-0-660-46037-6

Pub.: 220521

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Drug Analysis Service

Health Canada's Drug Analysis Service (DAS) operates laboratories across Canada that analyze suspected illegal drugs seized by Canadian law enforcement agencies. These statistics are based on samples analyzed and may not be representative of all substances seized in Canada, nor of what drugs are circulating on the market. The data below represent the number of times a substance was identified in submitted samples. A single sample may contain more than one substance. Categorization of substances is based on the Controlled Drugs and Substances Act (CDSA).

Summary

Context

Fentanyl was first identified in Canada in 1989 in exhibits submitted by law enforcement agencies. Since 2016, there has been a sharp increase in the number of Fentanyl identifications in Canada (Figure 1, Table 1). Between January 2012 and December 2022, Fentanyl has been identified in 77,141 exhibits submitted for analysis to the Drug Analysis Service (DAS).

Figure 1. Fentanyl identifications across time, per province or territory (2012 to 2022)*
Figure 1. Text version below.

* Decrease of Fentanyl identifications in April 2020 is due to a number of factors related to the COVID-19 pandemic.

The data presented in this figure is available in Table 1

Aim

The aim of this spotlight report is to characterize trends in Fentanyl identifications across Canada since 2012 and draw a more comprehensive picture of Fentanyl in Canada based on exhibits seized and submitted to DAS for analysis by law enforcement agencies.

Fentanyl and Canada's opioid crisis

Data limitations

This report is based on data made available by the Drug Analysis Service (DAS) which regularly analyses suspected illegal drugs seized by Canadian law enforcement agencies and samples submitted by public health partners. Some limitations govern the present data. First, law enforcement agencies submit samples for laboratory analysis based on investigation needs. Thus, analyzed samples may not be representative of substances circulating on the market as a number of factors may influence substances submitted by Canadian law enforcement agencies and reporting, such as increased awareness of substances and law enforcement capacities and priorities. Additionally, the DAS is only required to report substances that are controlled under the Controlled Drugs and Substances Act. As such, it is possible that not all noncontrolled substance were reported.

Analytical methods

Results of analyzed samples submitted by Canadian law enforcement agencies are reported in a centralized database called the Laboratory Information Management System (LIMS). The presented data were retrieved from the LIMS and covers the period between January 1, 2012 and December 31, 2022, inclusively. Fentanyl identifications are defined as the identification of Fentanyl in a unique exhibit.
The analysis of presented data was performed in R4.0.2. Data wrangling and visualization was performed using the tidyverse package Footnote 4. Time trends were computed on a monthly basis and 3-month rolling averages are plotted in line plots.

Geographical locations

From 2012 to 2022, the majority of Fentanyl identifications originated from sample submitted by law enforcement agencies in Ontario (43%), British Columbia (36%) and Alberta (16%) (Table 1). In 2016, there was an increase in Fentanyl identifications from samples submitted by law enforcement agencies in British Columbia. While samples containing Fentanyl from British Columbia represented 35% of all Fentanyl samples in Canada in 2015, they accounted for almost half (49%) of all Fentanyl samples in Canada in 2016. In 2021 and 2022, the majority of samples containing Fentanyl were from samples submitted by Ontario's law enforcement agencies.

Table 1. Fentanyl identifications (count (n) and percent (%)) per province or territory (2012 to 2022)

Province/Territory
Year
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
n % n % n % n % n % n % n % n % n % n % n %

Alberta

18

8.3

60

13.5

182

22.5

565

32.8

746

21.4

874

13.4

1,167

14.3

1,843

17.1

2,048

15.3

2,666

16.3

2,250

14.7

British Columbia

76

35.0

124

27.8

242

29.9

608

35.3

1,713

49.1

3,334

51.0

3,970

48.5

4,211

39.0

4,842

36.3

4,521

27.7

3,755

24.6

Manitoba

2

0.9

8

1.8

5

0.6

15

0.9

42

1.2

63

1.0

86

1.1

131

1.2

273

2.0

308

1.9

411

2.7

New Brunswick

-

-

-

-

-

-

1

0.1

9

0.3

-

-

4

<0.1

4

<0.1

11

0.1

9

0.1

92

0.6

Newfoundland and Labrador

5

2.3

-

-

-

-

1

0.1

5

0.1

15

0.2

9

0.1

5

<0.1

9

0.1

5

<0.1

8

0.1

Northwest Territories

-

-

-

-

4

0.5

3

0.2

11

0.3

-

-

-

-

-

-

-

-

3

<0.1

-

0.0

Nova Scotia

-

-

1

0.2

-

-

2

0.1

-

-

5

0.1

21

0.3

13

0.1

11

0.1

15

0.1

13

0.1

Nunavut

-

-

-

-

3

0.4

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

0.0

Ontario

106

48.8

235

52.7

325

40.2

467

27.1

809

23.2

2,054

31.4

2,730

33.3

4,344

40.2

5,854

43.9

8,258

50.6

8,324

54.5

Prince Edward Island

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

2

<0.1

-

-

7

0.0

Quebec

10

4.6

14

3.1

26

3.2

45

2.6

118

3.4

141

2.2

130

1.6

128

1.2

176

1.3

350

2.1

275

1.8

Saskatchewan

-

-

4

0.9

22

2.7

14

0.8

38

1.1

49

0.7

65

0.8

110

1.0

108

0.8

177

1.1

108

0.7

Yukon

-

-

-

-

-

-

-

-

-

-

3

<0.1

6

0.1

6

0.1

15

0.1

14

0.1

18

0.1

Total

217

100

446

100

809

100

1,721

100

3,491

100

6,538

100

8,188

100

10,795

100

13,349

100

16,326

100

15,261

100

<0.1 indicates that the proportion of identifications is smaller than 0.1%

Physical description

Since 2019, over 85% of exhibits containing Fentanyl were in powder form. Between 2012 and 2016, however, Fentanyl was predominantly identified in tablet form or in a material (Figure 2).
The majority of Fentanyl derma patches analysed by the DAS were from Ontario (87%) and Quebec (11%). Fentanyl found in a material were primarily from exhibits from British Columbia (74%) and Alberta (19%). Finally, 42% of Fentanyl in tablet form were from Alberta, 32% from British Columbia and 16% from Ontario. Fentanyl in tablets form was predominantly found in the provinces of Alberta and British Columbia (data not shown).
Nevertheless, in 2022, Fentanyl in powder appears to be the dominant form in most provinces and territories.

Figure 2. Form of exhibits containing Fentanyl per year (2012 to 2022)
Figure 2. Text version below.
Figure 2 - Text description
Form (count (n)) of exhibits containing Fentanyl per year (2012 to 2022)
Form Year
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Powder

14

61

107

263

869

2,697

5,498

9,046

11,470

14,356

13,693

Residue

5

11

29

40

206

637

712

921

1,045

1,148

948

Material

57

124

80

181

988

1,995

1,190

22

36

17

20

Tablets

90

93

267

698

835

633

306

298

318

358

232

Derma patch

-

97

252

292

277

237

151

119

60

69

24

Other forms

51

60

74

247

316

339

331

389

420

378

344

Form (proportion (%)) of exhibits containing Fentanyl per year (2012 to 2022)

Form
Year
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Powder

6.5%

13.7%

13.2%

15.3%

24.9%

41.3%

67.1%

83.8%

85.9%

87.9%

89.7%

Residue

2.3%

2.5%

3.6%

2.3%

5.9%

9.7%

8.7%

8.5%

7.8%

7.0%

6.2%

Material

26.3%

27.8%

9.9%

10.5%

28.3%

30.5%

14.5%

0.2%

0.3%

0.1%

0.1%

Tablets

41.5%

20.9%

33.0%

40.6%

23.9%

9.7%

3.7%

2.8%

2.4%

2.2%

1.5%

Derma patch

0.0%

21.7%

31.1%

17.0%

7.9%

3.6%

1.8%

1.1%

0.4%

0.4%

0.2%

Other forms

23.5%

13.5%

9.1%

14.4%

9.1%

5.2%

4.0%

3.6%

3.1%

2.3%

2.3%

Co-occurring substances

From 2012 to 2022, there was an increase in the number of Fentanyl exhibits containing multiple co-occurring substances (Figure 3, Table 2). This trend is particularly apparent for provinces of Ontario, Alberta and British Columbia (Figure 4). From 2012 to 2022, there was a general decrease in the proportion of exhibits with only Fentanyl identified and an increase in Fentanyl identifications with 2 or more co-occurring substances (Table 2). In 2022, the proportion of Fentanyl samples containing 2 or more co-occurring substances was 53% in British Columbia, 62% in Alberta and 77% in Ontario. Overall, in 2022, 69% of Fentanyl samples contained 2 or more co-occurring substances (Table 2).

Figure 3. Number of co-occurring substances with Fentanyl, 3-month rolling average (2012 to 2022)
Figure 3. Text version below.

The data presented in this figure is available in Table 2

Table 2. Proportion of Fentanyl identifications (%) per number of co-occurring substances (2012 to 2022)

Number of co-occurring substances
Year Total
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
% % % % % % % % % % % %

Fentanyl only

58.1

57.6

41.4

28.2

19.9

18.9

10.7

6.6

4.6

5.0

4.4

8.8

1

39.2

26.9

39.1

38.5

29.2

22.5

33.1

37.4

41.8

29.9

27.0

32.4

2

1.4

12.1

14.1

21.2

27.4

37.6

38.1

33.4

33.1

36.0

33.0

33.7

3

1.4

2.2

4.1

7.8

15.9

13.2

11.4

14.2

13.1

18.3

20.7

15.5

4

0.0

0.7

0.6

2.4

5.2

5.6

4.6

5.3

5.2

7.3

8.9

6.2

5

0.0

0.4

0.5

1.1

1.6

1.6

1.3

1.9

1.5

2.4

3.4

2.1

6

0.0

0.0

0.0

0.7

0.5

0.4

0.6

1.0

0.4

0.7

1.7

0.8

7 or more

0.0

0.0

0.2

0.2

0.2

0.2

0.2

0.3

0.3

0.3

0.8

0.4

Figure 4. Number of co-occurring substances with Fentanyl per province and territories, 3-month rolling average (2012 to 2022)
Figure 4. Text version below.
Figure 4 - Text description
Number of Fentanyl only identifications across time, per province or territory

Province/ Territory
Year
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Alberta

1

2

8

47

162

303

99

137

43

109

89

British Columbia

13

11

23

25

69

169

119

138

186

332

211

Manitoba

1

4

4

6

18

23

28

8

11

9

31

New Brunswick

-

-

-

1

3

-

-

1

2

-

1

Newfoundland and Labrador

4

-

-

-

2

3

-

5

2

1

5

Northwest Territories

-

-

-

-

-

-

-

-

-

-

-

Nova Scotia

-

1

-

1

-

1

-

2

1

1

-

Nunavut

-

-

-

-

-

-

-

-

-

-

-

Ontario

99

226

277

376

389

662

539

363

348

329

184

Prince Edward Island

-

-

-

-

-

-

-

-

-

-

-

Quebec

8

13

22

28

48

55

72

49

19

27

16

Saskatchewan

-

-

1

2

5

18

15

7

2

4

8

Yukon

-

-

-

-

-

1

4

1

1

-

-

Total

126

257

335

486

696

1,235

876

711

615

812

545

Number of Fentanyl identifications with 1 other co-occurring substance across time, per province or territory

Province/ Territory
Year
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Alberta

17

54

148

385

343

151

491

972

1,265

1,060

636

British Columbia

59

52

114

184

373

834

1,590

2,033

2,574

2,051

1,357

Manitoba

1

4

1

5

10

17

26

40

131

115

72

New Brunswick

-

-

-

-

5

-

1

-

7

3

22

Newfoundland and Labrador

1

-

-

-

2

3

5

-

3

4

-

Northwest Territories

-

-

4

3

10

-

-

-

-

1

-

Nova Scotia

-

-

-

-

-

4

7

6

2

6

4

Nunavut

-

-

3

-

-

-

-

-

-

-

-

Ontario

6

6

29

60

206

424

546

902

1,471

1,519

1,007

Prince Edward Island

-

-

-

-

-

-

-

-

1

-

1

Quebec

1

1

4

14

46

29

16

26

39

33

58

Saskatchewan

-

3

13

11

25

9

25

54

79

88

31

Yukon

-

-

-

-

-

1

-

1

10

8

6

Total

85

120

316

662

1,020

1,472

2,707

4,034

5,582

4,888

3,194

Number of Fentanyl identifications with 2 other co-occurring substances across time, per province or territory

Province/ Territory
Year
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Alberta

-

4

21

95

157

350

445

550

534

995

743

British Columbia

1

46

73

242

664

1,585

1,803

1,343

1,329

1,483

1,110

Manitoba

-

-

-

1

7

14

21

33

62

112

123

New Brunswick

-

-

-

-

1

-

3

2

2

5

39

Newfoundland and Labrador

-

-

-

1

1

8

2

-

1

-

1

Northwest Territories

-

-

-

-

-

-

-

-

-

-

-

Nova Scotia

-

-

-

-

-

-

10

3

4

1

3

Nunavut

-

-

-

-

-

-

-

-

-

-

-

Ontario

1

3

16

23

115

454

792

1,604

2,395

3,063

1,985

Prince Edward Island

-

-

-

-

-

-

-

-

1

-

5

Quebec

1

-

-

2

6

26

26

27

67

145

49

Saskatchewan

-

1

4

-

7

20

16

42

19

69

37

Yukon

-

-

-

-

-

1

-

1

2

6

9

Total

3

54

114

364

958

2,458

3,118

3,605

4,416

5,879

4,104

Number of Fentanyl identifications with 3 other co-occurring substances across time, per province or territory

Province/ Territory
Year
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Alberta

-

-

1

20

66

55

95

150

149

353

329

British Columbia

3

10

25

106

392

473

316

472

532

478

405

Manitoba

-

-

-

2

5

3

3

30

46

51

54

New Brunswick

-

-

-

-

-

-

-

-

-

-

17

Newfoundland and Labrador

-

-

-

-

-

1

2

-

-

-

-

Northwest Territories

-

-

-

-

1

-

-

-

-

1

-

Nova Scotia

-

-

-

-

-

-

3

-

2

3

4

Nunavut

-

-

-

-

-

-

-

-

-

-

-

Ontario

-

-

3

5

77

313

504

861

971

2,011

1,667

Prince Edward Island

-

-

-

-

-

-

-

-

-

-

1

Quebec

-

-

-

-

14

17

4

16

36

77

55

Saskatchewan

-

-

4

1

-

1

4

6

8

9

13

Yukon

-

-

-

-

-

-

2

1

1

-

1

Total

3

10

33

134

555

863

933

1,536

1,745

2,983

2,546

Number of Fentanyl identifications with 4 other co-occurring substances across time, per province or territory

Province/ Territory
Year
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Alberta

-

-

1

9

17

11

17

27

36

111

62

British Columbia

-

3

4

26

144

207

111

132

168

141

142

Manitoba

-

-

-

1

1

5

11

16

14

21

New Brunswick

-

-

-

-

-

-

-

1

-

1

5

Newfoundland and Labrador

-

-

-

-

-

-

-

-

-

-

-

Northwest Territories

-

-

-

-

-

-

-

-

-

1

-

Nova Scotia

-

-

-

1

-

-

1

1

1

2

1

Nunavut

-

-

-

-

-

-

-

-

-

-

-

Ontario

-

-

-

3

16

137

230

391

467

871

736

Prince Edward Island

-

-

-

-

-

-

-

-

-

-

-

Quebec

-

-

-

1

3

12

10

5

6

44

36

Saskatchewan

-

-

-

-

1

-

2

-

-

6

3

Yukon

-

-

-

-

-

-

-

2

1

-

-

Total

-

3

5

41

182

367

376

570

695

1,191

1,006

Number of Fentanyl identifications with more than 4 other co-occurring substances across time, per province or territory

Province/ Territory
Year
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Alberta

-

-

3

9

1

4

20

7

21

38

24

British Columbia

-

2

3

25

71

66

31

93

53

36

75

Manitoba

-

-

-

-

1

6

3

9

7

7

48

New Brunswick

-

-

-

-

-

-

-

-

-

-

7

Newfoundland and Labrador

-

-

-

-

-

-

-

-

3

-

-

Northwest Territories

-

-

-

-

-

-

-

-

-

0

-

Nova Scotia

-

-

-

-

-

-

-

1

1

2

-

Nunavut

-

-

-

-

-

-

-

-

-

-

-

Ontario

-

-

-

-

-

64

119

223

202

465

502

Prince Edward Island

-

-

-

-

-

-

-

-

-

-

-

Quebec

-

-

-

-

1

2

2

5

9

24

19

Saskatchewan

-

-

-

-

-

1

3

1

-

1

3

Yukon

-

-

-

-

-

-

-

-

-

-

1

Total

-

2

6

34

80

143

178

339

296

573

679

Pharmacological classes of substances frequently co-occurring with Fentanyl are opioid, sedative/hypnotic and stimulant. The rise in the co-occurrences of sedative/hypnotics with Fentanyl can be observed since late 2019 (Figure 5).

Figure 5. Number of fentanyl co-occurrences by pharmacological class, 3-month rolling average (2012 to 2022)
Figure 5. Text version below.

§ Includes cutting agents, precursors/key intermediates/reagents, prescription drugs, over the counter drugs and non-drugs.

Figure 5 - Text description
Number of fentanyl co-occurrences by pharmacological class across time (2012 to 2022)

Pharmacological class
Year Total
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Cannabimimetic

-

-

12

3

24

89

129

104

82

77

54

574

Dissociative

-

-

3

-

19

9

47

43

25

55

30

231

Hallucinogen

-

-

-

-

-

-

2

2

3

8

6

21

Opioid

6

52

103

394

2,094

4,192

4,158

4,576

3,477

2,701

2,734

24,487

Performance enhancer

-

-

-

-

8

1

1

2

1

6

6

24

Sedative/ Hypnotic

-

4

-

33

18

32

14

284

1,408

6,300

7,021

15,113

SSRI

-

-

-

-

-

-

-

-

1

-

2

3

Stimulant

4

27

53

108

430

962

1,250

1,643

2,025

2,129

1,846

10,477

Not applicable§

90

197

527

1,607

3,168

5,931

8,627

13,355

17,027

22,206

22,474

95,178

§ Includes cutting agents, precursors/key intermediates/reagents, prescription drugs, over the counter drugs and non-drugs.

Caffeine (cutting agent) has consistently been the most common co-occurrence with Fentanyl in the past 10 years (Figure 6A) but the top 10 co-occurring substances have changed throughout the years. The psychoactive substances that were most often co-occurring with Fentanyl from 2012 to 2016 include Diacetylmorphine (aka Heroin) (opioid), Cocaine and Methamphetamine (stimulant) (Figure 6B). With the increase in co-occurring sedative/hypnotics with Fentanyl since 2020, Etizolam and Flualprazolam were among the top 10 psychoactive substances most often identified alongside Fentanyl between 2017 and 2022 (Figure 6C).

Figure 6. Top 10 co-occurring substances with Fentanyl for (A) 2012 to 2022, (B) 2012 to 2016 and (C) 2017 to 2022
Figure 6. Text version below.

§ Includes cutting agents, precursors/key intermediates/reagents, prescription drugs, over the counter drugs and non-drugs.

Figure 6 - Text description
A) Top 10 co-occurring substances with Fentanyl for 2012 to 2022
Name Pharmacological Class Percent (%)

Caffeine

Not applicable§

84.8

Dimethylsulphone

Not applicable

20.6

Diacetylmorphine

Opioid

16.7

Etizolam

Sedative/Hypnotic

10.5

Methamphetamine

Stimulant

7.1

Cocaine

Stimulant

5.8

Phenacetin

Not applicable

4.3

Carfentanil

Opioid

4.1

Flualprazolam

Sedative/Hypnotic

3.6

Diphenhydramine

Not applicable

3.0

(B) Top 10 co-occurring substances with Fentanyl for 2012 to 2016
Name Pharmacological Class Percent (%)

Caffeine

Not applicable

65.5

Diacetylmorphine

Opioid

29.2

4-Anilino-N-phenethylpiperidine

Not applicable

11.0

Cocaine

Stimulant

5.3

Methamphetamine

Stimulant

3.4

U-47700

Opioid

2.4

Acetylfentanyl

Opioid

2.2

Dimethylsulphone

Not applicable

1.7

3-Methylfentanyl

Opioid

1.3

Diphenhydramine

Not applicable

1.2

(C) Top 10 co-occurring substances with Fentanyl for 2017 to 2022
Name Pharmacological Class Percent (%)

Caffeine

Not applicable

84.8

Dimethylsulphone

Not applicable

20.6

Diacetylmorphine

Opioid

16.7

Etizolam

Sedative/Hypnotic

10.5

Methamphetamine

Stimulant

7.1

Cocaine

Stimulant

5.8

Phenacetin

Not applicable

4.3

Carfentanil

Opioid

4.1

Flualprazolam

Sedative/Hypnotic

3.6

Diphenhydramine

Not applicable

3.0

§ Includes cutting agents, precursors/key intermediates/reagents, prescription drugs, over the counter drugs and non-drugs.

In 2020 to 2022, psychoactive substances frequently co-occurring with Fentanyl include Etizolam (sedative/hypnotic), Methamphetamine (stimulant), Flualprazolam (sedative/hypnotic), and Diacetylmorphine (aka Heroin) (opioid) (Table 3). Emerging new psychoactive substances (NPS) such as Bromazolam (sedative/hypnotic), Metonitazene (opioid) and para-Fluorofentanyl (opioid) can also be found among the top 20 co-occurring substances with Fentanyl in 2020 to 2022.

Table 3. Top 20 co-occurring substances with Fentanyl for 2020 to 2022

Name
Chemical Class Pharmacological Class Count (n) Percent (%)

Caffeine

Cutting Agent

Not applicable

39,977

89.0

Dimethylsulphone

Cutting Agent

Not applicable

11,956

26.6

Etizolam

Benzodiazepine (BZD) Class

Sedative/Hypnotic

7,825

17.4

Methamphetamine

Amphetamine / Methamphetamine (Sub) Class

Stimulant

3,338

7.4

Flualprazolam

Benzodiazepine (BZD) Class

Sedative/Hypnotic

2,794

6.2

Phenacetin

Cutting Agent

Not applicable

2,656

5.9

Diacetylmorphine

Opiate Class

Opioid

2,587

5.8

Cocaine

Tropane (Cocaine) Class

Stimulant

2,396

5.3

Diphenhydramine

Cutting Agent

Not applicable

2,106

4.7

Xylazine

Cutting Agent

Not applicable

1,924

4.3

Carfentanil

Fentanyl (Sub) Class

Opioid

1,653

3.7

Flubromazepam

Benzodiazepine (BZD) Class

Sedative/Hypnotic

1,629

3.6

Bromazolam

Benzodiazepine (BZD) Class

Sedative/Hypnotic

1,299

2.9

Lidocaine

Cutting Agent

Not applicable

1,078

2.4

Dextromethorphan

Other¥

Not applicable

861

1.9

Acetaminophen

Cutting Agent

Not applicable

612

1.4

Metonitazene

Opioid Class (Non-Fentanyl, Non-Opiates)

Opioid

605

1.3

para-Fluorofentanyl

Fentanyl (Sub) Class

Opioid

570

1.3

Flubromazolam

Benzodiazepine (BZD) Class

Sedative/Hypnotic

494

1.1

Furanyl UF-17

Opioid Class (Non-Fentanyl, Non-Opiates)

Opioid

486

1.1

¥Includes prescription and over the counter drugs.

Conclusion

This spotlight report summarises the trends in Fentanyl identifications based on exhibits seized and submitted to DAS by law enforcement agencies in the past 11 years. Between 2012 and 2022, Fentanyl was identified in 77,141 samples and was most often found in exhibits from Ontario and British Columbia. The frequency of Fentanyl without any other co-occurring substances decreased in the past 11 years. Psychoactive substances most often co-occurring with Fentanyl from 2012 to 2016 include Diacetylmorphine (aka Heroin) (opioid), Cocaine (stimulant) and Methamphetamine (stimulant). However, there has been an increase in co-occurring sedative/hypnotics with Fentanyl since 2020. Several emerging new psychoactive substances (NPS) can also be found among the top 20 co-occurring substances with Fentanyl in 2020 to 2022. More information about the emergence of NPS, including nitazenes, can be found in our reports ''At-A-Glance: Newly Reported Psychoactive Substances in Canada'' Footnote 5 and ''At-A-Glance: The Emergence of Nitazenes and Brorphine in Canada'' Footnote 6. Continued monitoring of Fentanyl and its co-occurring substances is required to ensure accurate information is available about concomitant harmful substances with Fentanyl on the Canadian market.

Drug Analysis Service– Health Canada:

  • Marie-Line Gilbert
  • Caroline Maurice-Gélinas
  • James Rodrigues
  • Janike Pitre
  • Benoit Archambault

Public Health Agency of Canada:

  • Cindy Leung Soo

References

Footnote 1

Government of Canada, « Fentanyl, » [Online]. Available: https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/fentanyl.html. [Accessed on July 21, 2022].

Return to footnote 1 referrer

Footnote 2

Government of Canada, « Naloxone, » [Online]. Available: https://www.canada.ca/en/health-canada/services/opioids/naloxone.html. [Accessed on July 21, 2022].

Return to footnote 2 referrer

Footnote 3

Substance-related Overdose and Mortality Surveillance Task Group (SOMS-TG) of the Special Advisory Committee (SAC) on the Epidemic of Opioid Overdoses, « Opioid- and Stimulant-related Harms in Canada, » Public Health Agency of Canada, [Online]. Available: https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/. [Accessed on November 2022].

Return to footnote 3 referrer

Footnote 4

Wickham H, Averick M, Bryan J, Chang W, McGowan LD, François R, Grolemund G, Hayes A, Henry L, Hester J, Kuhn M, Pedersen TL, Miller E, Bache SM, Müller K, Ooms J, Robinson D, Seidel DP, Spinu V, Takahashi K, Vaughan D, Wilke C, Woo K, Yutani H, « Welcome to the tidyverse, » Journal of Open Source Software, vol. 4, n°143, p. 1686, 2019.

Return to footnote 4 referrer

Footnote 5

Government of Canada, « At-A-Glance: Newly Reported Psychoactive Substances in Canada, » Health Canada Drug Analysis Service, 2022. [Online]. Available: https://www.canada.ca/en/health-canada/services/publications/healthy-living/psychoactive-substances-canada-2020-2021.html.

Return to footnote 5 referrer

Footnote 6

Government of Canada, « At-A-Glance: The Emergence of Nitazenes and Brorphine in Canada since 2019, » Health Canada Drug Analysis Service, Royal Canadian Mounted Police, Canada Border Services Agency, 2022. [Online]. Available: https://www.canada.ca/en/health-canada/services/publications/healthy-living/emergence-nitazenes-brorphine-canada-2019.html.

Return to footnote 6 referrer

Suggested citation

Government of Canada. (2023). Health Canada Drug Analysis Service. Spotlight: The evolution of Fentanyl in Canada over the past 11 years. Longueuil (QC), 2023. Retrieved from https://www.canada.ca/en/health-canada/services/publications/healthy-living/evolution-fentanyl-canada-11-years.html.

For more information, please contact Health Canada's Drug Analysis Service.

©His Majesty the King in Right of Canada, as represented by the Minister of Health, 2023
Cat.: H139-46/2022E-PDF ׀ ISBN: 978-0-660-46037-6 ׀ Pub.: 220521

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