Federal actions on opioids to date

(December 2020)

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Recent highlights

Access to treatment

  • Improved access to treatment services through an Emergency Treatment Fund resulting in a total investment of over $300M when cost-matched by 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.
  • Supported up to 25 more community-based opioid agonist treatment sites in First Nations and Inuit communities.

Access to harm reduction

Awareness and prevention

Tainted drug supply

  • Continued working with domestic and international partners to reduce the illegal opioid supply.
  • Equipped border agents with tools to intercept fentanyl and other dangerous substances at the border.
  • Seized more than 8.95 kg of fentanyl at the border in between April 2018 and June 2020.
  • Continued working with private sector partners to address money laundering of the proceeds of fentanyl trafficking.
  • Opioids were identified 21,725 times in exhibits submitted by law enforcement and public health officials in 2019. From January 1 to September 30, 2020, opioids were identified 13,330 times in exhibits submitted by law enforcement and public health officials
    • An exhibit may contain more than one opioid

Evidence

  • Released the second report of the Canadian Pain Task Force, which summarized pan-Canadian consultations on best practices to improve understanding, prevention, and management of chronic pain in Canada.
  • Continued coordinating national data collection and publishing quarterly reports on opioid-related deaths and harms
    • In December 2020, we expanded surveillance of drug-related harms beyond opioids to include data on toxicity deaths and poisoning hospitalizations where stimulants were involved.
  • Updated modelling projections to show how the opioid overdose crisis may change during the COVID-19 outbreak.

Learn more at Canada.ca/Opioids

Opioid-Related Harms in Canada

From January 2016 to June 2020 there have been:

  • 17,602 apparent opioid toxicity deaths, or nearly 11 per day
  • 21,824 opioid-related poisoning hospitalizations, or 13 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

  • 1,628 apparent opioid toxicity deaths from April to June 2020 is the highest ever recorded in single quarter since national level surveillance began in 2016.

Modelling projections to June 2021 suggest that the number of opioid-related overdose deaths could substantially surpass those seen at the height of the opioid overdose crisis in late 2018.

Crude rate of opioid-related harms per 100,000 population
Harm 2016 2017 2018 2019 2020
(January to June)
Apparent opioid toxicity deaths 7.8 10.7 11.8 10.1 14.6
Opioid-related poisoning hospitalizations 16.8 18.4 17.6 15.5 16.1

Deaths

Between January and June 2020:

  • there were 2,670 apparent opioid toxicity deaths, of which 97% were accidental
  • there was a 58% increase in deaths between April and June 2020 compared to January to March, and a 54% increase compared to April to June 2019

Among accidental apparent opioid toxicity 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)
  • 75% involved fentanyl
  • 85% involved non-pharmaceutical opioids (among deaths with completed investigations from 7 provinces)
  • based on information from 6 provinces and territories, 52% of accidental opioid toxicity deaths between January and June 2020 also involved a stimulant, reflecting the polysubstance nature of this crisis

Hospitalizations

Between January and June 2020:

  • there were 2,368 opioid-related poisoning hospitalizations, of which 66% were accidental
  • there was a 22% increase between April and June 2020 compared to January to March as well as a 7% increase compared to April to June 2019

Among accidental opioid-related poisoning hospitalizations:

  • 2 in 3 were male
  • 52% were among young and middle aged adults (20 to 49 years)
  • 44% were among older adults (50 years or greater)
  • 29% involved fentanyl or fentanyl analogues
  • 29% involved one or more type of non-opioid substances

Emergency Medical Services

According to available Emergency Medical Services (EMS) data from 9 provinces and territories, between January and June 2020:

  • there were more than 12,100 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)
    • 19% were among older adults (50 years or greater)
  • there was a 68% increase between April and June 2020 compared to January and March, as well as a 27% increase compared to the same period in 2019.

Notes on data

  • Data on apparent opioid toxicity 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 data (2018 to 2020) included in national counts only, include deaths related to all illicit drugs including opioids.
  • Data on opioid-related poisoning hospitalizations 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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