Federal actions on opioids to date

(March 2021)

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Recent highlights

Access to treatment

  • Improved access to treatment services through an Emergency Treatment Fund with over $300M for provinces and territories
  • Funding pilot projects through the Substance Use and Addictions Program, to provide a full spectrum of care options, including prescribed medications through safer supply models and injectable opioid agonist treatment services
  • Issued and extended a temporary exemption to the Controlled Drugs and Substances Act to allow prescribing with flexible treatment options to help patients adhere to public health measures during the COVID-19 outbreak
  • Supported the development of clinical guidelines and operational guidance by the Canadian Research Initiative in Substance Misuse for injectable opioid agonist treatment
  • Added diacetylmorphine to the List of Drugs for an Urgent Public Health Need which allows all provinces and territories to import the medication  for the treatment of opioid use disorder
  • Approved injectable hydromorphone for treatment of severe opioid use disorder in adults
  • Facilitated the prescription and dispensing of methadone and diacetylmorphine through regulatory amendments
  • Supporting Opioid Agonist Therapy wraparound supports in 72 First Nations and Inuit Communities

Access to harm reduction

  • Approved 37 supervised consumption sites (currently operating), which have:
    • been visited more than 2.6 million times
    • reversed nearly 22,000 overdoses without a single death
    • made over 112,000 referrals to health and social services
  • 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 communities and isolated First Nations and Inuit communities and to the homeless-serving sector
  • Announced finalists of the Drug Checking Technology Challenge
  • Funding safer drug supply projects to provide people with substance use disorder with pharmaceutical medication from a licensed prescriber as an alternative to the toxic illegal drug supply
  • Sent a letter from the Minister of Health to Provincial and Territorial Ministers of Health and regulatory colleges to encourage better care of people who use drugs, with a full spectrum of options for practitioners, including safer supply prescribing
  • Consulted Canadians on a proposal to develop new regulations for supervised consumption sites and services (August 15, 2020 to October 14, 2020)

Awareness and prevention

Tainted drug supply

  • Working with domestic and international partners to reduce the illegal opioid supply
  • Equipping border agents with tools to intercept fentanyl and other highly toxic substances at the border in addition to constructing regional sampling facilities in Toronto and Montreal
  • Seized more than 15.2 kg of fentanyl at the border between April 2018 and December 2020
  • Working with private sector partners to address money laundering of the proceeds of fentanyl trafficking
  • In 2020, opioids were identified 20,559 times in exhibits submitted to the Drug Analysis Service (DAS) by law enforcement and public health officials
    • Note: Exhibits may contain more than one opioid and COVID has impacted the activities of the DAS including the identification of opioids in exhibits

Evidence

  • Strengthened and accelerated the Canadian Pain Task Force mandate to provide recommendations on priority actions to ensure people with pain are recognized and supported and that pain is understood, prevented, and effectively treated across 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
  • Updated modelling projections to show how the opioid overdose crisis may change during the COVID-19 outbreak
  • CIHR funding to evaluate program implementation and impact of safer supply pilot interventions and supervised consumption sites

Learn more at Canada.ca/Opioids

Opioid-Related Harms in Canada

From January 2016 to September 2020 there have been:

  • 19,355 apparent opioid-related deaths, or nearly 12 per day
  • 23,240 hospitalizations for opioid-related overdoses, or 14 per day

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

  • 1,705 apparent opioid-related deaths from July to September 2020 is the highest ever recorded in a single quarter since 2016.
  • In the six months following the implementation of the COVID-19 prevention measures (April to September 2020), there was a 74% increase in apparent opioid-related deaths (3,351), a 31% increase in hospitalizations for opioid-related overdoses (2,706) and an 86% increase in Emergency Medical Services (EMS) responses to suspected opioid-related overdoses (16,200) compared to the six months prior (October 2019 to March 2020 – 1,923 deaths, 2,065 hospitalizations, and 8,689 EMS responses).
Crude rate of opioid-related harms per 100,000 population
Harm 2016 2017 2018 2019 2020
(January to September)
Apparent opioid-related deaths 7.8 10.7 11.8 10.2 16.0
Hospitalizations for opioid-related overdoses 16.8 18.4 17.6 15.5 17.1

Deaths

  • Between January and September 2020, there were 4,395 apparent opioid-related deaths, of which 96% were accidental
  • The number of apparent opioid-related deaths in April to June 2020 was 60% higher compared to January to March 2020. The latest data from July to September 2020 (1,705 apparent opioid-related deaths) indicate a 4% increase compared to April to June 2020

Among accidental apparent opioid-related deaths:

  • 3 in 4 were male
  • 68% were among young and middle aged adults (20 to 49 years)
  • 30% were among older adults (50 years or greater)
  • 82% involved fentanyl and 7% involved fentanyl analogues
  • 86% involved non-pharmaceutical opioids (among deaths with completed investigations from 7 provinces)
  • based on information from 6 provinces and territories, 60% of accidental opioid-related deaths between January and September 2020 also involved a stimulant, reflecting the polysubstance nature of this crisis

Hospitalizations

  • Between January and September 2020, there were 3,784 hospitalizations for opioid-related overdoses, of which 67% were accidental
  • The number of hospitalizations for opioid-related overdoses in April to June 2020 was 22% higher compared to January to March 2020. The latest data from July to September 2020 (1,400 hospitalizations for opioid-related overdoses) indicate a 7% increase compared to April to June 2020

Among accidental hospitalizations for opioid-related overdoses:

  • 2 in 3 were male
  • 53% were among young and middle aged adults (20 to 49 years)
  • 44% were among older adults (50 years or greater)
  • 31% involved fentanyl or fentanyl analogues
  • 20% involved one or more type of stimulant

Emergency Medical Services

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

  • Between January and September 2020, there were more than 20,700 EMS responses for suspected opioid-related overdoses, of which:
    • 3 in 4 were male
    • 77% were among young and middle aged adults (20 to 49 years)
    • 20% were among older adults (50 years or greater)
  • The number of suspected opioid-related overdoses in April to June 2020 was 68% higher compared to January to March 2020. The latest data from July to September 2020 indicate a 13% increase compared to April and June 2020

Notes on data

  • Data on apparent opioid-related deaths are collected from the provincial and territorial offices of Chief Coroners and Chief Medical Examiners. Due to jurisdictional differences in identifying and reporting cases, data should be interpreted with caution. Data from Quebec (2019 and 2020), and British Columbia (2018 to 2020) included in national counts only, reflect deaths related to all illicit drugs including, but not limited to, opioids. Data from Manitoba (October 2019 to September 2020) were not available at the time of this update.
  • Data on apparent opioid-related deaths and stimulant-related deaths are not mutually exclusive. A high proportion of deaths involving a stimulant also involved an opioid. Adding up those numbers would result in an overestimation of the burden of opioids and stimulants.
  • Data on hospitalizations for opioid-related overdoses were available from the Discharge Abstract Database (DAD), a national administrative database from the Canadian Institute for Health Information (CIHI). Data from Quebec were not available at time of analysis.
  • There is currently no national case definition for suspected opioid-related overdoses attended by Emergency Medical Services. Each region reports EMS data based on their respective provincial/territorial case definition.
  • New or revised data reported will be reflected in future updates.
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