National report: Apparent opioid-related deaths in Canada
(released September 2018)

Suggested citation

Special Advisory Committee on the Epidemic of Opioid Overdoses. National report: Apparent opioid-related deaths in Canada (January 2016 to March 2018) Web-based Report. Ottawa: Public Health Agency of Canada; September 2018.

Key findings

The opioid crisis has affected every part of the country, but there are clear differences in death rates and the substances involved across provinces and territories. According to available data reported as of September 12, 2018:

  • there were more than 8,000 apparent opioid-related deaths between January 2016 and March 2018 (3,005 in 2016 and 3,996 in 2017)
  • from January to March 2018, there were at least 1,036 apparent opioid-related deaths; 94% were accidental (unintentional)
  • national trends in 2018 (from January to March) continue to reflect those observed in 2017
    • most accidental apparent opioid-related deaths involved fentanyl or fentanyl analogues (73%)
    • most accidental apparent opioid-related deaths occurred among males (77%)
    • individuals between the ages of 30 and 39 represent the highest proportion (27%) of accidental apparent opioid-related deaths
  • the number of accidental apparent opioid-related deaths involving fentanyl or fentanyl analogues increased by 16% compared to the same time frame in 2017, and doubled compared to the same time frame in 2016

It is expected that these numbers will change as additional data become available.

On this page:

Background

Canada continues to experience a serious opioid crisis. Across the country, it is having devastating effects on families and communities. The Government of Canada works closely with the provinces and territories to collect and share data on apparent opioid-related deaths. Accurate information about the crisis is needed to help guide efforts to reduce opioid-related harms, including deaths. 

The data in this report:

  • are updated four times a year
  • may change based on review and refinement
  • have been collected by the provinces and territories from their respective office of the Chief Coroner or Medical Examiner
  • have been shared through the Special Advisory Committee on the Epidemic of Opioid Overdoses

Changes from the last report include:

  • the addition of available preliminary data from January to March 2018
  • updates to previously reported data from January 2016 to December 2017
  • an option to view graphics by year

1.0 Apparent opioid-related deaths in Canada

The opioid crisis has affected every part of the country, but some provinces and territories have been impacted more than others. According to data reported as of September 12, 2018:

  • there were 8,037 apparent opioid-related deaths between January 2016 and March 2018
    • in 2016, there were 3,005 apparent opioid-related deaths (corresponding to a death rate of 8.3 per 100,000 population) and 3,996 in 2017 (corresponding to a death rate of 10.9 per 100,000 population)
    • from January to March 2018, there were at least 1,036 apparent opioid-related deaths (Figure 1, Table 1)
  • the number of apparent opioid-related deaths between January and March 2018 increased by 5% compared to the same time period in 2017 and 44% compared to the same time period in 2016

Figure 1. Number and rate (per 100,000 population) of apparent opioid-related deaths by province or territory.

2016

Figure 1 2016

Text Description

In 2016

  • 3005 apparent opioid-related deaths
  • death rate of 8,3 per 100,000 population
Figure 1, 2016 data
Province or territory Number of deaths in 2016 Rate per 100,000 population
British ColumbiaFigure 1 2016 Footnote 1 1011 21,2
Alberta 600 14,2
SaskatchewanFigure 1 2016 Footnote 2 83 7,2
Manitoba 88 6,7
Ontario 867 6,2
QuebecFigure 1 2016 Footnote 2 235 2,8
New Brunswick 33 4,4
Nova Scotia 53 5,6
Prince Edward IslandFigure 1 2016 Footnote 2 5 3,3
Newfoundland and LabradorFigure 1 2016 Footnote 2 18 3,4
YukonFigure 1 2016 Footnote 2 7 18,4
Northwest Territories 5 11,2
Nunavut Suppressed Suppressed
Figure 1 2016 Footnote 1

Includes deaths related to all illicit drugs including, but not limited to, opioids.

Figure 1 2016, Return to footnote 1 referrer

Figure 1 2016 Footnote 2

Includes deaths with completed investigations only.

Figure 1 2016, Return to footnote 2 referrer

2017

Figure 1 2017

Text Description

In 2017

  • 3996 apparent opioid-related deaths
  • death rate of 10,9 per 100,000 population
Figure 1, 2017 data
Province or territory Number of deaths in 2017 Rate per 100,000 population
British ColumbiaFigure 1 2017 Footnote 1 1473 30,6
Alberta 745 17,4
SaskatchewanFigure 1 2017 Footnote 2 65 5,6
Manitoba 122 9,1
Ontario 1265 8,9
QuebecFigure 1 2017 Footnote 3 181 2,2
New Brunswick 36 4,7
Nova Scotia 64 6,7
Prince Edward IslandFigure 1 2017 Footnote 2 4 2,6
Newfoundland and LabradorFigure 1 2017 Footnote 2 33 6,2
YukonFigure 1 2017 Footnote 2 7 18,2
Northwest Territories 1 2,2
Nunavut Suppressed Suppressed
Figure 1 2017 Footnote 1

Includes deaths related to all illicit drugs including, but not limited to, opioids.

Figure 1 2017, Return to footnote 1 referrer

Figure 1 2017 Footnote 2

Includes deaths with completed investigations only.

Figure 1 2017, Return to footnote 2 referrer

Figure 1 2017 Footnote 3

Includes unintentional deaths with ongoing investigations related to all illicit drugs including, but not limited to, opioids, from July to December only.

Figure 1 2017, Return to footnote 3 referrer

 
2018 (Jan to Mar)

Figure 1 2018

Text Description

From January to March 2018, there were at least 1,036 apparent opioid-related deaths

Figure 1, 2018 data
Province or territory Number of deaths
British ColumbiaFigure 1 2018 Footnote 1 390
Alberta 203
SaskatchewanFigure 1 2018 Footnote 2 13
Manitoba N/A
Ontario 320
QuebecFigure 1 2018 Footnote 3 82
New Brunswick 6
Nova Scotia 17
Prince Edward IslandFigure 1 2018 Footnote 2 0
Newfoundland and LabradorFigure 1 2018 Footnote 2 4
YukonFigure 1 2018 Footnote 2 0
Northwest Territories 1
Nunavut Suppressed
Figure 1 2018 Footnote 1

Includes deaths related to all illicit drugs including, but not limited to, opioids. 

Figure 1 2018, Return to footnote 1 referrer

Figure 1 2018 Footnote 2

Includes deaths with completed investigations only.

Figure 1 2018, Return to footnote 2 referrer

Figure 1 2018 Footnote 3

Includes unintentional deaths with ongoing investigations related to all illicit drugs including, but not limited to, opioids. N/A Data were not available at the time of this publication.

Figure 1 2018, Return to footnote 3 referrer

N/A Data were not available at the time of this publication.

Table 1. Summary of apparent opioid-related deaths, 2016, 2017 and January to March 2018.Table 1 Footnote 1
  2016 2017 2018 (Jan to Mar)
Number 3005 3996 1036
Rate per 100,000 population 8.3 10.9 Not available
Percent male 71% 76% 76%
Percent by age group (years) 19 and under 2% 2% 1%
20 to 29 18% 20% 20%
30 to 39 26% 27% 27%
40 to 49 21% 22% 21%
50 to 59 23% 20% 22%
60 to 69 8% 8% 8%
70 and over 2% 1% 2%
Percent involvingTable 1 Footnote 2 fentanyl or fentanyl analogues 50% 69% 70%
Percent also involving non-opioid substancesTable 1 Footnote 3 75% 72% 71%
Table 1 Footnote 1

Data reported by some provinces and territories do not include all manners of death (accident, suicide, undetermined), stages of investigation (ongoing, completed) or time periods; refer to Table 4 for more details. Updates to previously reported data will be provided in future reports. Data from British Columbia and available data from Quebec for 2017 (June to December) and 2018 include deaths related to all illicit drugs including, but not limited to, opioids.

Table 1 Return to footnote 1 referrer

Table 1 Footnote 2

Given jurisdictional differences in death classification methods, the term “involving” includes deaths where the substance was either detected and/or directly contributed to the death. Data from British Columbia and available data from Quebec (July to December 2017, 2018) on deaths related to illicit drugs where fentanyl was detected is used here to approximate apparent opioid-related deaths involving fentanyl.

Table 1 Return to footnote 2 referrer

Table 1 Footnote 3

These percentages do not include data from British Columbia, Quebec, or Nunavut as these data were not available for all time periods. For Alberta, only data on deaths with completed investigations were included in these percentages. Data for non-opioid substances from Ontario between January 2016 and April 2017 were based on their detection and do not include alcohol; as of May 1, 2017, data on non-opioid substances are based on their direct effects and include alcohol. Refer to Opioids and other substances for more details.

Table 1 Return to footnote 3 referrer

1.1 Apparent opioid-related deaths by manner of death

The following section presents apparent opioid-related death data according to the manner of death assigned by the coroner or medical examiner during, or following an investigation (Table 2). Collecting data on how deaths occurred, including whether they were intentional or not, is critical in understanding how the opioid crisis is affecting Canadians.

Accident: Deaths with completed investigations where the coroner or medical examiner determined that the death was unintentional. This category also includes deaths with ongoing investigations where the manner of death was believed to be unintentional or had not been assigned at the time of reporting.

Suicide: Deaths with completed investigations where the coroner or medical examiner determined that the opioids were consumed with the intent to die. This category also includes deaths with ongoing investigations where suicide was believed to be the manner of death at the time of reporting.

Undetermined: Deaths with completed investigations where a specific manner of death (e.g. accident, suicide) could not be assigned based on available or competing information.

According to available data reported as of September 12, 2018, most (94%) apparent opioid-related deaths between January and March 2018 were accidental (unintentional), similar to both 2016 (88%) and 2017 (92%) (Table 2).

In other words, these data indicate that the vast majority of apparent opioid-related deaths were of individuals who did not intend to die. This distinction is important to inform an appropriate public health response. For example, the high percent of unintended deaths reinforces the concern that a variety of street drugs are tainted with toxic substances, such as fentanyl, without the knowledge of the people consuming them. Public health officials will be able to use this information in developing strategies to address these hidden risks in order to reduce harms and effectively prevent unintended apparent opioid-related deaths.

Table 2. Number and percent of apparent opioid-related deaths in Canada by manner of death, 2016, 2017 and January to March 2018.Table 2 Footnote 1
Manner of death 2016 2017 2018 (Jan to Mar)
Number Percent Number Percent Number Percent
Accident (unintentional) 2643 88% 3679 92% 973 94%
Suicide 266 9% 194 5% 39 4%
Undetermined 96 3% 123 3% 24 2%
TotalTable 2 Footnote 2 3005 - 3996 - 1036 -
Table 2 Footnote 1

Data reported by some provinces and territories do not include all manners of death (accident, suicide, undetermined), stages of investigation (ongoing, completed) or time periods; refer to Table 4 for more details. Updates to previously reported data will be provided in future reports.

Table 2 Return to footnote 1 referrer

Table 2 Footnote 2

Data from British Columbia and available data from Quebec for 2017 (June to December) and 2018 include deaths related to all illicit drugs including, but not limited to, opioids.

Table 2 Return to footnote 2 referrer

2.0 Accidental apparent opioid-related deaths

The following section provides detailed information on accidental apparent opioid-related deaths, which are deaths with completed investigations where the coroner or medical examiner determined that the death was unintentional. This category also includes deaths with ongoing investigations where the manner of death was believed to be unintentional or had not been assigned at the time of reporting.

Table 2a. Number of accidental apparent opioid-related deaths by quarter and province or territory, January 2016 to March 2018.Table 2a Footnote 1
Province or territory 2016 2017 2018
Jan to Mar Apr to Jun Jul to Sep Oct to Dec Jan to Mar Apr to Jun Jul to Sep Oct to Dec Jan to Mar
British ColumbiaTable 2a Footnote 2 218 192 196 371 396 408 325 286 371
Alberta 118 130 144 153 152 162 176 200 195
Saskatchewan 25 14 22 15 20 16 10 11 12
Manitoba 11 15 14 30 28 27 17 14 N/A
Ontario 174 180 174 198 191 276 380 280 287
QuebecTable 2a Footnote 2 46 41 39 30 N/A N/A 93 88 82
New Brunswick 11 3 6 6 8 7 7 9 5
Nova Scotia 14 8 15 3 17 16 12 13 16
Prince Edward IslandTable 2a Footnote 3 N/A N/A N/A N/A Suppressed Suppressed Suppressed Suppressed 0
Newfoundland and Labrador Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed 4
Yukon 0 2 0 3 3 0 1 2 0
Northwest Territories 1 0 1 2 0 0 1 0 1
Nunavut Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed

N/A – Data were not available at the time of this publication.

Suppressed – Data may be suppressed in provinces or territories with low numbers of cases. Please see Considerations and Limitations for more information.

Table 2a Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed); refer to Table 4 for more details. Updates to previously reported data will be provided in future reports.

Table 2a Return to footnote 1 referrer

Table 2a Footnote 2

Data from British Columbia and available data from Quebec for 2017 (June to December) and 2018 include deaths related to all illicit drugs including, but not limited to, opioids.

Table 2a Return to footnote 2 referrer

Table 2a Footnote 3

Only annual totals were available for 2016 data from Prince Edward Island; quarterly data were not available at the time of this publication.

Table 2a Return to footnote 3 referrer

2.1 Annual, sex, and age trends of accidental apparent opioid-related deaths

This crisis has affected Canadians from all walks of life; however, available data reported as of September 12, 2018 indicate that the impact of the crisis differs by year, sex, and age.
 
Although these trends vary by province or territory, at the national level:

  • there were 973 accidental apparent opioid-related deaths between January to March 2018 (Table 2a, Table 2b)
    • the number of deaths in 2018 increased by 8% compared to the same time period in 2017 and more than doubled compared to the same time period in 2016 (Table 2a)
  • in-line with previous trends observed in 2016 and 2017, most (77%) accidental apparent opioid-related deaths from January to March 2018 occurred among males (Figure 2.1)
  • the highest percent (27%) of accidental apparent opioid-related deaths between January to March 2018 occurred among individuals between the ages of 30 and 39 (Figure 2.2)
Table 2b. Number and rate (per 100,000 population) of accidental apparent opioid-related deaths, and percent involving fentanyl or fentanyl analogues, by province or territory, 2016, 2017 and January to March 2018.Table 2b Footnote 1
Province or territory 2016 2017 2018
(Jan to Mar)
Number Rate Percent involving fentanyl or fentanyl analogues Number  Rate Percent involving fentanyl or fentanyl analogues Number Percent involving fentanyl or fentanyl analogues
British ColumbiaTable 2b Footnote 2 977 20.5 67% 1415 29.4 84% 371 86%
Alberta 545 12.9 64% 690 16.1 81% 195 87%
Saskatchewan 76 6.6 11% 57 4.9 23% 12 50%
Manitoba 70 5.3 46% 86 6.4 49% N/A N/A
Ontario 726 5.2 45% 1127 7.9 69% 287 67%
QuebecTable 2b Footnote 2 156 1.9 22% 181 2.2 16% 82 12%
New Brunswick 26 3.4 15% 31 4.1 23% 5 0%
Nova Scotia 40 4.2 18% 58 6.1 12% 16 19%
Prince Edward Island 5 3.3 20% 4 2.6 0% 0 Not applicable
Newfoundland and Labrador 13 2.5 Suppressed 23 4.3 Suppressed 4 Suppressed
Yukon 5 13.1 80% 6 15.6 83% 0 Not applicable
Northwest Territories 4 9.0 25% 1 2.2 0% 1 0%
Nunavut Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed
Total 2643 7.3 54% 3679 10.0 72% 973 73%

N/A – Data were not available at the time of this publication.

Suppressed – Data may be suppressed in provinces or territories with low numbers of cases. Please see Considerations and Limitations for more information.

Table 2b Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed) or time periods; refer to Table 4 for more details. Updates to previously reported data will be provided in future reports.

Table 2b Return to footnote 1 referrer

Table 2b Footnote 2

Data from British Columbia and available data from Quebec for 2017 (June to December) and 2018 include deaths related to all illicit drugs including, but not limited to, opioids.

Table 2b Return to footnote 2 referrer

Figure 2.1 Sex distribution of accidental apparent opioid-related deaths by province or territory.Footnote 1

2016

Figure 2.1 2016

Text Description
Figure 2.1, 2016 dataFigure 2.1 2016 Footnote 1
Province or territory  Percent of apparent opioid-related deaths 
Percent male Percent female
British ColumbiaFootnote 2 80% 20%
Alberta 73% 27%
Saskatchewan 59% 41%
Manitoba 61% 39%
Ontario 71% 29%
Quebec 69% 31%
New Brunswick 62% 38%
Nova Scotia 77.5% 22.5%
Prince Edward Island Suppressed Suppressed
Newfoundland and Labrador 62% 38%
Yukon Suppressed Suppressed
Northwest Territories Suppressed Suppressed
Nunavut Suppressed Suppressed
Total 74% 26%
Figure 2.1 2016 Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed); refer to Table 4 for more details. Updates to previously reported data will be provided in future reports.

Figure 2.1 2016, Return to footnote 1 referrer

Figure 2.1 2016 Footnote 2

Data from British Columbia include deaths related to all illicit drugs including, but not limited to, opioids.

Figure 2.1 2016, Return to footnote 2 referrer

2017

Figure 2.1 2017

Text Description
Figure 2.1, 2017 dataFigure 2.1 2017 Footnote 1
Province or territory  Percent of apparent opioid-related deaths 
Percent male Percent female
British ColumbiaFigure 2.1 2017 Footnote 2 82% 18%
Alberta 77% 23%
Saskatchewan 58% 42%
Manitoba 72% 28%
Ontario 75% 25%
QuebecFigure 2.1 2017 Footnote 2 74% 26%
New Brunswick 61% 39%
Nova Scotia 69% 31%
Prince Edward Island Suppressed Suppressed
Newfoundland and Labrador 70% 30%
Yukon Suppressed Suppressed
Northwest Territories Suppressed Suppressed
Nunavut Suppressed Suppressed
Total 77% 23%
Figure 2.1 2017 Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed) or time periods; refer to Table 4 for more details. Updates to previously reported data will be provided in future reports.

Figure 2.1 2017 Return to footnote 1 referrer

Figure 2.1 2017 Footnote 2

Data from British Columbia and available data for 2017 from Quebec (July to December) include deaths related to all illicit drugs including, but not limited to, opioids.

Figure 2.1 2017 Return to footnote 2 referrer

2018 (Jan to Mar)

Figure 2.1 2018

Text Description
Figure 2.1, 2018 dataFigure 2.1 2018 Footnote 1
Province or territory  Percent of apparent opioid-related deaths 
Percent male Percent female
British ColumbiaFigure 2.1 2018 Footnote 2 82% 18%
Alberta 77% 23%
Saskatchewan 83% 17%
Manitoba N/A N/A
Ontario 74% 26%
QuebecFigure 2.1 2018 Footnote 2 73% 27%
New Brunswick Suppressed Suppressed
Nova Scotia 75% 25%
Prince Edward Island Not applicable Not applicable
Newfoundland and Labrador Suppressed Suppressed
Yukon Not applicable Not applicable
Northwest Territories Suppressed Suppressed
Nunavut Suppressed Suppressed
Total 77% 23%
Figure 2.1 2018 Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed); refer to Table 4 for more details. Updates to previously reported data will be provided in future reports.

Figure 2.1 2018 Return to footnote 1 referrer

Footnote 2

Data from British Columbia and Quebec include deaths related to all illicit drugs including, but not limited to, opioids.

Figure 2.1 2018 Return to footnote 2 referrer

N/A Data were not available at the time of this publication.

Suppressed – Data may be suppressed in provinces or territories with low numbers of cases. Please see Considerations and Limitations for more information.

Figure 2.2 Percent of accidental apparent opioid-related deaths by age group and province or territory.Footnote 1

2016

Figure 2.2 2016

Text Description
Figure 2.2, 2016 dataFigure 2.2 2016 Footnote 1
Province or territory Age group
 19 year and under 20 to 29 years 30 to 39 years 40 to 49 years 50 to 59 years 60 years and over
British ColumbiaFigure 2.2 2016 Footnote 2 2,8% 19,2% 26,7% 23,3% 22,6% 5,3%
Alberta 2,2% 20,7% 36,5% 17,6% 17,4% 5,5%
Saskatchewan 0,0% 11,8% 44,7% 13,2% 21,1% 9,2%
Manitoba 4,3% 30,0% 28,6% 15,7% 14,3% 7,1%
Ontario 1,9% 19,3% 24,0% 22,0% 24,8% 8,0%
Quebec 0,6% 14,1% 19,2% 26,3% 27,6% 12,2%
New Brunswick 0,0% 11,5% 23,1% 26,9% 23,1% 15,4%
Nova Scotia 2,5% 20,0% 30,0% 12,5% 22,5% 12,5%
Prince Edward Island Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed
Newfoundland and Labrador Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed
Yukon 0,0% 20,0% 40,0% 20,0% 20,0% 0,0%
Northwest Territories 0,0% 50,0% 0,0% 0,0% 25,0% 25,0%
Nunavut Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed
Total 2,2% 19,3% 28,0% 21,3% 22,3% 6,9%
Figure 2.2 2016 Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed); refer to Table 4 for more details. Updates to previously reported data will be provided in future reports.

Figure 2.2 2016 Return to footnote 1 referrer

Figure 2.2 2016 Footnote 2

British Columbia reports deaths related to all illicit drugs including, but not limited to, opioids.

Figure 2.2 2016 Return to footnote 2 referrer

2017

Figure 2.2 2017

Text Description
Figure 2.2, 2017 dataFigure 2.2 2017 Footnote 1
Province or territory Age group
 19 year and under 20 to 29 years 30 to 39 years 40 to 49 years 50 to 59 years 60 years and over
British ColumbiaFigure 2.2 2017 Footnote 2 2,3% 18,0% 28,1% 23,6% 19,8% 8,1%
Alberta 2,8% 23,9% 32,4% 18,7% 17,1% 5,1%
Saskatchewan 5,3% 24,6% 24,6% 21,1% 15,8% 8,8%
Manitoba 1,2% 30,2% 29,1% 20,9% 8,1% 10,5%
Ontario 2,4% 21,4% 27,1% 21,7% 19,5% 8,0%
QuebecFigure 2.2 2017 Footnote 3 Suppressed 13,3% 22,7% 24,9% 23,8% 11,0%
New Brunswick 3,2% 22,6% 25,8% 19,4% 22,6% 6,5%
Nova Scotia 5,2% 10,3% 25,9% 24,1% 29,3% 5,2%
Prince Edward Island Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed
Newfoundland and Labrador Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed
Yukon 0,0% 16,7% 66,7% 16,7% 0,0% 0,0%
Northwest Territories Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed
Nunavut Suppressed Suppressed Suppressed Suppressed Suppressed Suppressed
Total 2,4% 20,3% 28,4% 22,1% 19,1% 8,1%
Figure 2.2 2017 Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed) or time periods; refer to Table 4 for more details. Updates to previously reported data will be provided in future reports.

Figure 2.2 2017 Return to footnote 1 referrer

Figure 2.2 2017 Footnote 2

Data from British Columbia include deaths related to all illicit drugs including, but not limited to, opioids.

Figure 2.2 2017 Return to footnote 2 referrer

Figure 2.2 2017 Footnote 3

The percentages for Quebec do not add up to 100% as individuals 19 and under and 70 and over were suppressed due to low numbers of cases. Available 2017 data from Quebec (July to December) include deaths related to all illicit drugs including, but not limited to, opioids.

Figure 2.2 2017 Return to footnote 3 referrer

2018 (Jan to Mar)

Figure 2.2 2018

Text Description
Figure 2.2, 2018 dataFigure 2.2 2018 Footnote 1
Province or territory Age group
 19 year and under 20 to 29 years 30 to 39 years 40 to 49 years 50 to 59 years 60 years and over
British ColumbiaFigure 2.2 2018 Footnote 2 1,6% 21,8% 26,1% 19,9% 22,6% 7,8%
Alberta 0,5% 25,1% 33,8% 16,9% 17,4% 6,2%
Saskatchewan 0,0% 25,0% 41,7% 16,7% 8,3% 8,3%
Manitoba Not available
Ontario 0,3% 17,1% 25,1% 24,7% 21,6% 11,1%
QuebecFigure 2.2 2018 Footnote 3 Suppressed 13,4% 22,0% 22,0% 26,8% 14,6%
New Brunswick Suppressed
Nova Scotia 0,0% 18,8% 25,0% 31,3% 18,8% 6,3%
Prince Edward Island Not applicable
Newfoundland and Labrador Suppressed
Yukon Not applicable
Northwest Territories Suppressed
Nunavut Suppressed
Total 0,9% 20,1% 27,2% 21,3% 21,4% 8,9%
Figure 2.2 2018 Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed) or time periods; refer to Table 4 for more details. Updates to previously reported data will be provided in future reports.

Figure 2.2 2018 Return to footnote 1 referrer

Figure 2.2 2018 Footnote 2

Data from British Columbia include deaths related to all illicit drugs including, but not limited to, opioids.

Figure 2.2 2018 Return to footnote 2 referrer

Figure 2.2 2018 Footnote 3

The percentages for Quebec do not add up to 100% as data for individuals 19 and under and 70 and over were suppressed due to low numbers of cases. Data from Quebec include deaths related to all illicit drugs including, but not limited to, opioids.

Figure 2.2 2018 Return to footnote 3 referrer

Suppressed – Data may be suppressed in provinces or territories with low numbers of cases. Please see Considerations and Limitations for more information.

2.2 Fentanyl, fentanyl analogues, and other substances involved in accidental apparent opioid-related deaths

Apparent opioid-related deaths often involveFootnote a multiple substances including one or more opioids as well as non-opioid substances. Knowing the opioid and non-opioid substances involved in these deaths can help public health officials and other government agencies communicate risks and target harm reduction efforts.

Available data reported as of September 12, 2018, suggest that:

  • between January and March 2018, 73% of accidental apparent opioid-related deaths involved fentanyl or fentanyl analogues (Table 2a, Figure 2.3)
  • the number of accidental apparent opioid-related deaths involving fentanyl or fentanyl analogues increased by 16% compared to the same time frame in 2017, and doubled compared to the same time frame in 2016 (Figure 2.3)

In addition, available data suggest approximately 76% of accidental apparent opioid-related deaths between January 2016 and March 2018Footnote b also involved one or more types of non-opioid substances.

Figure 2.3. Number of accidental apparent opioid-related deaths involving or not involving fentanyl or fentanyl analogues by quarter, January 2016 to March 2018.Figure 2.3 Footnote 1Figure 2.3 Footnote 2

Figure 2.3

Text Description
Figure 2.3 dataFigure 2.3 Footnote 1 Figure 2.3 Footnote 2
Year and quarter Number of apparent opioid-related deaths
Deaths not involving fentanyl or fentanyl analogues Deaths involving fentanyl or fentanyl analogues
2016 Jan to Mar 332 286
Apr to Jun 275 310
Jul to Sep 322 289
Oct to Dec 271 540
2017 Jan to Mar 247 568
Apr to Jun 229 683
Jul to Sep 281 741
Oct to Dec 279 624
2018 Jan to Mar 311 658
Figure 2.3 Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed) or time periods; refer to Table 4 for more details. Updates to previously reported data will be provided in future reports. This graph does not include data from Prince Edward Island, Newfoundland and Labrador, or Nunavut. Data from British Columbia and available data from Quebec for 2017 (June to December) and 2018 include deaths related to all illicit drugs including, but not limited to, opioids; data on deaths related to illicit drugs where fentanyl was detected is used here to approximate apparent opioid-related deaths involving fentanyl.

Figure 2.3 Return to footnote 1 referrer

Figure 2.3 Footnote 2

These data are preliminary and subject to change; observed trends should be interpreted with caution until additional data become available.

Figure 2.3 Return to footnote 2 referrer

Figure 2.3 Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed) or time periods; refer to Table 4 for more details. Updates to previously reported data will be provided in future reports. This graph does not include data from Prince Edward Island, Newfoundland and Labrador, or Nunavut. Data from British Columbia and available data from Quebec for 2017 (June to December) and 2018 include deaths related to all illicit drugs including, but not limited to, opioids; data on deaths related to illicit drugs where fentanyl was detected is used here to approximate apparent opioid-related deaths involving fentanyl.

Figure 2.3 Return to footnote 1 referrer

Figure 2.3 Footnote 2

These data are preliminary and subject to change; observed trends should be interpreted with caution until additional data become available.

Figure 2.3 Return to footnote 2 referrer

3.0 Apparent opioid-related deaths: suicide

The following section provides information on apparent opioid-related deaths where the coroner or medical examiner determined that the opioids were consumed with the intent to die. This section also includes deaths with ongoing investigations where the manner of death was believed to be suicide at the time of reporting.

Table 3. Summary of apparent opioid-related deaths classified as, or believed to be suicide, in Canada, 2016, 2017, and January to March 2018.Table 3 Footnote 1
  2016 2017 2018
(Jan to Mar)
Number 266 194 39
Rate per 100,000 population 0.7 0.5 Not available
Percent male 46% 52% 62%
Percent by age group (years) 19 and under 2% 1% 3%
20 to 29 8% 12% 15%
30 to 39 12% 15% 10%
40 to 49 19% 15% 13%
50 to 59 29% 28% 33%
60 to 69 22% 18% 18%
70 and greater 10% 11% 8%
Percent involvingTable 3 Footnote 2 fentanyl or fentanyl analoguesTable 3 Footnote 3 13% 16% 18%
Percent also involving non-opioid substancesTable 3 Footnote 4 83% 79% 64%
Table 3 Footnote 1

Data reported by some provinces and territories do not include all stages of investigation (ongoing, completed) or time periods; refer to Table 4 for more details. Suicide data from Quebec (July to December 2017, 2018), Prince Edward Island, and Nunavut were not available at the time of this publication. British Columbia reports deaths related to all illicit drugs including, but not limited to, opioids. Updates to previously reported data will be provided in future reports.

Table 3 Return to footnote 1 referrer

Table 3 Footnote 2

Given jurisdictional differences in death classification methods, the term “involving” includes deaths where the substance was either detected and/or directly contributed to the death.

Table 3 Return to footnote 2 referrer

Table 3 Footnote 3

These percentages do not include data from Quebec, Prince Edward Island, or Nunavut as these data were not available for both time periods.

Table 3 Return to footnote 3 referrer

Table 3 Footnote 4

These percentages do not include data from British Columbia, Quebec, Prince Edward Island, and Nunavut as these data were not available for all time periods. For Alberta and Ontario, only data on deaths with completed investigations were included in these percentages. Data for non-opioid substances from Ontario between January 2016 and April 2017 were based on their detection and do not include alcohol; as of May 1, 2017, data on non-opioid substances were based on their direct effects and include alcohol. Refer to Opioids and other substances for more details.

Table 3 Return to footnote 4 referrer

Considerations and Limitations

Definition of an apparent opioid-related death

An apparent opioid-related death is a death caused by an intoxication/toxicity (poisoning) resulting from substance use, where one or more of the substances is an opioid, regardless of how it was obtained (e.g. illegally or through personal prescription).

How apparent opioid-related deaths are counted

Counts are provided by the provinces and territories that collect data from their respective offices of Chief Coroners or Medical Examiners. Rates are calculated using the most current population data from Statistics Canada.

The data provided by the provinces and territories can include deaths:

  • with completed or ongoing investigations
  • where manner of death is classified as accident, suicide, or undetermined

These data do not include deaths due to:

  • the medical consequences of long term substance use or overuse (for example, alcoholic cirrhosis)
  • medical assistance in dying
  • trauma where use of the substance(s) contributed to the circumstances of the injury that lead to the death, but was not directly involved in the death
  • homicide

However, some provincial and territorial differences remain in the type of data reported and in the time periods for which data are available (refer to Table 4).

Table 4. Reporting periods and manners of death included in apparent opioid-related deaths data used for this report by province or territory.
  BCTable 4 Footnote 1 AB SK MB ONTable 4 Footnote 2 QCTable 4 Footnote 3 NB NS PE NLTable 4 Footnote 4 YT NT NUTable 4 Footnote 5
Reporting period (as of September 12, 2018)
2016 January to December       (C)       (C)       (C)   (C)   (C)    
2017 January to December       (C)     INC       (C)   (C)   (C)    
2018 January to March       (C) N/A           (C)   (C)      
Classification of deaths included in the reported data 
Accident Completed investigations                         N/A
Ongoing investigations where manner of death was believed to be unintentional   - N/A   -       N/A N/A N/A   N/A
Ongoing investigations where manner of death had not been assigned at the time of reporting -   N/A     N/A     N/A - -   N/A
Suicide Completed investigations                 N/A       N/A
Ongoing investigations where  the manner of death was believed to be suicide   N/A N/A   - N/A     N/A N/A N/A   N/A
Deaths with completed investigations and an undetermined manner of deathTable 4 Footnote 6                 N/A       N/A
  •   These data have been reported by the province or territory and are reflected in this report, unless otherwise specified
  • (C) Data includes deaths with completed investigations only
  • INC Data were not reported for the full time period
  • - The classification is not used in the province or territory
  • N/A Data were not available at the time of this publication
Table 4 Footnote 1

British Columbia reports deaths related to all illicit drugs (including opioids) used alone or in combination with prescribed/diverted medication.

Table 4 Return to footnote 1 referrer

Table 4 Footnote 2

As of May 1, 2017, apparent opioid-related death data in Ontario were captured using an enhanced data collection tool by the Office of the Chief Coroner.

Table 4 Return to footnote 2 referrer

Table 4 Footnote 3

Data from Quebec for 2016 were available for deaths with completed investigations only; 12% of deaths for 2016 were under investigation. Following the launch of Québec’s opioid surveillance system, data on apparent opioid-related deaths with ongoing investigations, where manner of death was believed to be unintentional, were reported from July to December 2017; data from January to June 2017 were not available at the time of this publication. The available 2017 and 2018 data include deaths related to all illicit drugs including, but not limited to, opioids. Preliminary data for deaths related to all illicit drugs, for which toxicology information was available, indicate that 59% of deaths between July 2017 and March 2018 involved an opioid. Updates to previously reported data will be provided in future reports.

Table 4 Return to footnote 3 referrer

Table 4 Footnote 4

Available 2018 data from Newfoundland and Labrador included accidental deaths with completed investigations only.

Table 4 Return to footnote 4 referrer

Table 4 Footnote 5

Data from Nunavut were not included in national counts, rates, or percentages.

Table 4 Return to footnote 5 referrer

Table 4 Footnote 6

For this manner of death category, provinces and territories report only completed investigations with the exception of British Columbia which also includes data from ongoing investigations.

Table 4 Return to footnote 6 referrer

Data suppression

The suppression of data in this report is based on the preferences of individual provinces or territories to address concerns around releasing small numbers for their jurisdiction.

  • Prince Edward Island suppressed counts between one and four for quarterly data, and for any data related to sex or age distribution.
  • Newfoundland and Labrador suppressed counts between one and four for quarterly data, and data related to substances involved and sex or age distribution.
  • Quebec suppressed counts less than five for deaths with ongoing investigations (July to December 2017, 2018).
  • Nunavut suppressed all counts less than five.

In addition, suppression was applied in some instances where all data for a province or territory fell in a single category of a given table or figure.

Opioids and other substances

Fentanyl and fentanyl analogues include, but are not limited to:

  • 3-methylfentanyl
  • acetylfentanyl
  • butyrylfentanyl
  • carfentanil
  • cyclopropyl fentanyl
  • despropionyl-fentanyl
  • fentanyl
  • furanylfentanyl
  • methoxyacetylfentanyl
  • norfentanyl

Non-fentanyl-related opioids include, but are not limited to:

  • buprenorphine metabolites
  • codeine
  • dihydrocodeine
  • heroin
  • hydrocodone
  • hydromorphone
  • loperamide
  • meperidine
  • methadone
  • monoacetylmorphine
  • morphine
  • normeperidine
  • oxycodone
  • tapentadol
  • tramadol
  • U-47700

Non-opioid substances include, but are not limited to:

  • alcohol
  • benzodiazepines
  • cocaine
  • gabapentin
  • methamphetamine
  • W-18

Limitations of these apparent opioid-related deaths data

Data presented in this report should be interpreted with caution.

  • This report is based on data submitted to the Public Health Agency of Canada on or before September 12, 2018. New or revised data reported after this date will be reflected in future reports.
  • Data released by provinces and territories may differ from the data provided in this report due to the availability of updated data, differences in the type of data reported (e.g. manners of death), the use of alternate age groupings, differences in time periods presented and/or population estimates used for calculations, etc.
  • As some data are based on ongoing investigations by coroners and medical examiners, they are considered preliminary and subject to change. The time required to complete an investigation and related administrative processes is case-dependent and can range from approximately three to twenty-four months.
  • This report is based on data that do not specify how the opioids were obtained (e.g. illegally or through personal prescription); the level of toxicity may differ depending on the opioid (substance(s) involved, concentration, and dosage).
  • Jurisdictional differences in the death investigation process, death classification method, toxicology testing, and the manners of death reported may impact the interpretation and comparability of the data presented in this report.
  • Information related to changes over time at the national level is based only on jurisdictions where data were available for all time periods of interest.
  • Rates reported here have not been adjusted for existing differences in provincial and territorial age distributions.
  • Rates for jurisdictions with relatively smaller populations may change substantially with even slight changes in the number of deaths. As a result, comparisons over time and between provinces and territories should be interpreted with caution.

Footnotes

Footnote a

Given jurisdictional differences in death classification methods, the term “involve” includes deaths where the substance was either detected and/or directly contributed to the death.

Return to footnote a referrer

Footnote b

Data were not available from British Columbia, or Nunavut. For Alberta and Ontario, only data on deaths with completed investigations were included in these percentages. Data for non-opioid substances from Ontario between January 2017 and April 2017 were based on their detection and do not include alcohol; as of May 1, 2017, data on non-opioid substances are based on their direct effects and include alcohol. Data for non-opioid substances from Quebec were available for 2016 only.

Return to footnote b referrer

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