Fatal Fentanyl Overdoses Declining in Major Cities, Data Shows

An anti-fentanyl advertisement is seen on a sidewalk in downtown Vancouver on April 11, 2017. The Canadian Press/Jonathan Hayward

Fentanyl-related deaths have dipped in three of Canada’s largest cities this year, falling below 2023 and 2022 levels.

Data from Edmonton, Vancouver, and Toronto says the number of deaths linked to the opioid and other similar drugs have fallen below those of previous years.

Edmonton has seen a marked decrease in the number of non-pharmaceutical opioid deaths, according to provincial statistics. There were 43 deaths in the Alberta city due to drugs like fentanyl in May of 2022 and 41 deaths in 2023 compared to 31 in the same month this year. Overall, there were 554 fatal overdoses in 2022, 655 in 2023, and 217 between January and May of this year.

British Columbia Coroner Service data shows that the number of unregulated drug deaths in Vancouver in July fell from 53 last year to 37 this year. Eighty-six percent of drug-related deaths in the city in 2022 were linked to fentanyl compared to 85 percent in 2023 and 83 percent so far this year, statistics say.

In Toronto, the average number of monthly fatal overdose calls attended by paramedics dipped from 26 last July to 23 in the same month this year, according to a city report.

Toronto had 508 confirmed and two probable fatal overdoses in 2022 compared to 493 confirmed and 31 probable fatal overdoses in 2023. While the report doesn’t specify which drugs were responsible, Toronto Public Health has said the illegal drug supply in the city has been dominated by fentanyl.

Wastewater Analysis

The downward trend for fentanyl-related deaths recorded in the three cities was echoed by wastewater analysis across several of Canada’s most populated urban areas.

Fentanyl use in 2023 fell below 2022 levels for several months of the year, according to newly released data from Statistics Canada.

The analysis of wastewater found use of the highly potent opioid to be lower from mid-February through mid-October last year in both Vancouver and Toronto, the Canadian cities with the highest use of the drug. In Edmonton, 2023 usage didn’t fall below 2022 levels until mid-March, but stayed lower for the remainder of the year.

The Canadian Wastewater Survey measured fentanyl use in the three cities as well as Montreal, Saskatoon, Prince Albert, and Halifax throughout 2022 and 2023.

The analysis provides estimates of the drug’s use within each city by testing for norfentanyl, a compound found in the urine of fentanyl users, StatCan said.

While wastewater data showed that levels of norfentanyl were four to five times higher in Vancouver compared with other participating cities, the levels were still substantially lower for much of 2023 compared to the year prior. Norfentanyl levels rose again in the fall of 2023, but remained either at or below those seen in late 2022, the data showed.

Toronto and Edmonton had higher levels of norfentanyl in 2022 than other participating cities, with the exception of Vancouver, StatCan said. But, like Vancouver, 2023 data for Toronto and Edmonton showed levels for most months were at or below those seen in 2022.

Norfentanyl levels in the other participating cities—Halifax, Montreal, and Saskatoon—were well below the levels seen in Edmonton, Toronto and Vancouver in 2023, the data showed. For Saskatoon, this represents a notable decrease compared with 2022, when levels were more like those seen in Edmonton and Toronto.

Fentanyl Use

Fentanyl is a highly potent opioid that is 100 times stronger than morphine and 50 times as strong as heroin. Most street fentanyl in Canada is produced illegally as a powder that is then swallowed, smoked, snorted, or injected, according to the Centre for Addiction and Mental Health.

Even with the slight decrease in use in recent years, the drug has been identified as a key player in Canadian overdose deaths since 2019 by health and addiction experts alike.

Federal Mental Health and Addictions Minister Ya’ara Saks has blamed the rise in overdoses on a growing supply of drugs and the prevalence of fentanyl.

“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, adding that 82 percent of overdose deaths in 2023 have been connected to fentanyl use, a 44 percent increase since 2016.

“No community has been left untouched. The tragic impacts are seen and felt among our friends, our families, and our neighbours,” she said.