Provincial Data on the Decline in Fatal Fentanyl Overdoses

Fentanyl-related deaths have decreased in three of Canada’s largest cities this year, showing a drop compared to levels from 2023 and 2022.

In Edmonton, data indicates a significant reduction in non-pharmaceutical opioid deaths.

The number of deaths due to drugs like fentanyl fell from 43 in May 2022 to 31 in May 2024. Overall, Edmonton reported 554 fatal overdoses in 2022, 655 in 2023, and 217 between January and May of 2024.

In Vancouver, the British Columbia Coroner Service reports a decrease in unregulated drug deaths from 53 in July 2023 to 37 in July 2024.

Fentanyl accounted for 86% of drug-related deaths in 2022, 85% in 2023, and 83% so far this year.

Toronto also saw a decline, with the average number of fatal overdose calls attended by paramedics dropping from 26 in July 2023 to 23 in July 2024.

Toronto had 508 confirmed and two probable fatal overdoses in 2022, compared to 493 confirmed and 31 probable in 2023.

While the specific drugs responsible were not detailed, Toronto Public Health has indicated that fentanyl remains dominant in the city's illegal drug supply.

Wastewater Analysis

The reduction in fentanyl-related deaths in these cities is corroborated by wastewater analysis across several Canadian urban areas.

According to Statistics Canada, fentanyl use in 2023 fell below 2022 levels for several months. Analysis of wastewater from Vancouver and Toronto, which have the highest fentanyl use, showed lower levels of fentanyl from mid-February through mid-October 2023.

In Edmonton, fentanyl use didn’t fall below 2022 levels until mid-March but remained lower for the rest of the year.

The Canadian Wastewater Survey, which tested for norfentanyl (a compound found in the urine of fentanyl users), indicated that fentanyl use in Vancouver was four to five times higher than in other cities but still lower for most of 2023 compared to 2022.

Norfentanyl levels rose again in the fall of 2023 but remained at or below late 2022 levels.

Toronto and Edmonton also saw decreases in norfentanyl levels in 2023 compared to 2022, although the levels were higher than in other participating cities like Halifax, Montreal, and Saskatoon.

Saskatoon experienced a notable decrease in norfentanyl levels compared to 2022.

Fentanyl Use

Fentanyl, a highly potent opioid, is 100 times stronger than morphine and 50 times stronger than heroin.

Most street fentanyl in Canada is illegally produced and sold as a powder, which can be swallowed, smoked, snorted, or injected.

Despite the recent decline in use, fentanyl continues to be a major factor in Canadian overdose deaths since 2019.

Federal Mental Health and Addictions Minister Ya’ara Saks has attributed the rise in overdoses to the growing supply of fentanyl and other synthetic opioids.

“Powerful drugs like fentanyl, and other emerging synthetic opioids are flooding the illegal drug supply and resulting in an increase in harms and deaths,” Saks said in a June statement.

She noted that 82% of overdose deaths in 2023 were linked to fentanyl, a 44% increase from 2016. “No community has been left untouched. The tragic impacts are seen and felt among our friends, our families, and our neighbours,” she added.