Federal actions on the overdose crisis

The Government of Canada's actions to address the overdose crisis to help save lives, including government funding for projects, prevention and education efforts, evidence used to inform decision-making, substance use services and supports, like increased access to treatment and harm reduction programs, and substance controls.

Last updated: June 2024

On this page

• About the overdose crisis
• Snapshot of the overdose crisis
• Highlights of recent federal actions
• Government funding
• Prevention and education
• Evidence
• Substance use services and supports
• Substance controls

About the overdose crisis

The overdose crisis continues to have significant impacts on Canadian communities and families. A number of factors are contributing to Canada's high rates of overdoses, such as:

• the highly toxic and unpredictable illegal drug supply
• barriers in accessing harm reduction and treatment services and supports
• stigma surrounding substance use, which can lead people to hide their drug use, discourage people from seeking health and social services, and can reduce the quality and availability of services received

The Government of Canada is committed to a comprehensive public health and safety approach to the overdose crisis that is focused on reducing harms, saving lives, and getting people the supports they want and need.

Snapshot of the overdose crisis

• Since 2016, there have been:
• over 44 000 opioid-related deaths
• over 42 000 opioid-related hospitalizations
• over 174 000 opioid-related emergency department visits
• About 3 out of 4 opioid-related deaths were among males since 2016
• The toxicity and unpredictability of the illegal drug supply continues to be a major driver of the overdose crisis with over 80% of opioid-related deaths involving fentanyl and fentanyl analogues
• The majority of opioid-related deaths occurred in British Columbia, Alberta, and Ontario

Highlights of recent federal actions

• Released the most recent national data on opioid- and stimulant-related deaths, hospitalizations, emergency department visits and Emergency Medical Services responses in collaboration with provinces and territories
• Updated modelling projections on opioid-related deaths to December 2024 to understand and plan for potential scenarios
• Released a report on multi-drug combinations in national apparent opioid and stimulant toxicity deaths, highlighting the most frequently occurring combinations of substances and substance classes from 2018 to 2022
• Released a report on repeat emergency department visits for opioid-related harms in Alberta, Ontario and the Yukon between 2018 and 2022 summarizing differences in distribution and characteristics between single and repeat emergency department visits
• As part of the new Youth Substance Use Prevention Program:
• Provided funding to seven new projects across four provinces to support the Canadian implementation and adaptation of the Icelandic Prevention Model
• Funded the establishment of a new Knowledge Development and Exchange Hub for Youth Substance Use Prevention in Canada
• Co-organized the National Pain Congress with the Canadian Pain Society and Pain Canada, bringing together pain specialists, researchers, people living with pain, and policy makers to discuss pain priorities and mobilize knowledge
• Collaborated with the Centre for Addiction and Mental Health (CAMH) to develop and disseminate a toolkit for pharmacy professionals that supports increased awareness of stigma and promotes best practices for reducing opioid stigma in pharmacy settings
• Began implementation of the renewed Canadian Drugs and Substances Strategy (CDSS) which guides our government's approach to addressing substance use related harms and the overdose crisis

Government funding

• Budget 2024 announced a commitment of $150 million over three years for an Emergency Treatment Fund that would be open to municipalities and Indigenous communities to help provide a rapid response to emergent, critical needs related to the overdose crisis. In addition:
• $500 million over five years was proposed for the creation of a new Youth Mental Health Fund to help younger Canadians access the mental health care they need
• An additional $1.0 billion was proposed over four years for Reaching Home: Canada's Homelessness Strategy, to stabilize funding under the program. Of this, $50 million will focus on accelerating community-level reductions in homelessness
• An additional $250 million over two years starting in 2024-2025 is proposed to address the urgent issue of encampments and unsheltered homelessness
• The Government of Canada's Working Together to Improve Health Care for Canadians includes $25 billion towards 4 shared priorities, including improving access to quality mental health and substance use services. In addition, $2 billion over 10 years was announced to support Indigenous health initiatives
• The Government has also committed over $1 billion since 2017 to directly address the overdose crisis
• This includes funding community organizations for projects through the Substance Use and Addictions Program (SUAP) to support people who use drugs, for example by:
• Supporting projects related to treatment, including expanding Opioid Agonist Therapy (OAT)
• Supporting pilot projects which provide prescription drugs as an alternative to the toxic illegal drug supply to people who are using illegal drugs and are at high risk of overdose
• Helping reduce stigma and support families affected by the crisis
• Improving harm reduction initiatives to reach key groups, including Indigenous peoples, youth, individuals in the correctional system, and healthcare professionals
• Improving access to peer support and capacity-building projects
• Supporting projects addressing priority actions identified by the Canadian Pain Task Force
• Budget 2023 included $144 million to SUAP to fund community-based supports and other evidence based health interventions. A national call for proposals ran in fall 2023 to support four funding priorities, including:
• Enhancing the role of people with lived and living experience
• Services and programs that target post-treatment aftercare and transition back into the community
• Providing up to $4.5 million over 5 years to support Pain Canada, an initiative dedicated to coordinating national efforts and mobilizing resources for people living with pain
• Provided over $650 million in 2023-2024 towards trauma-informed culturally grounded community-based mental wellness initiatives, including funding for substance use prevention and treatment, ongoing implementation of 75 Mental Wellness Teams supporting 385 First Nations and Inuit communities, the Hope for Wellness Help Line, and more

Prevention and education

• Launched a new Youth Substance Use Prevention Program as part of the CDSS. This community-based program is based on the internationally recognized Icelandic Prevention Model
• Expanded public awareness around opioids and the harms of substance use stigma:
• Continued a multi-year campaign, launched in 2018, to raise awareness of opioids, the signs of an overdose, the Good Samaritan Drug Overdose Act and the impacts of stigma on people who use drugs
• Ran a national campaign to promote help-seeking and resources for men working in physically demanding jobs, who are disproportionately affected by the overdose crisis
• Developed and distributed awareness resources for opioids, such as videos, fact sheets, posters, wallet cards, and an audio series
• Delivered the Know More Opioids awareness program to over 1,500 virtual and 755 in-person high school sessions, and engaged over 185,000 teens and young adults between April 2018 and March 2024
• Reached out to over 600 festival organizers as of May 2024 to provide information about naloxone and encourage the distribution of overdose prevention materials to event goers and staff
• Coordinated federal efforts to respond to the Canadian Pain Task Force recommendations, so that pain is understood, prevented, and effectively treated
• Supported knowledge mobilization of stakeholder developed guidance and resources to improve pain management
• National pediatric pain management standard to help ensure equitable and quality pain management in hospital settings
• Power Over Pain portal, a virtual platform that provides resources and support for health care providers and people living with pain in managing their chronic pain
• A new national, competency-based curriculum for current and future physicians in pain management and addiction medicine
• Updating of the Canadian Guideline for Opioids for Chronic Non-Cancer Pain, with final guidelines expected to be published in 2024
• New Opioids and Pain in Youth Resource Toolkit to support youth living with pain, caregivers, and healthcare providers around the use of opioids for pain management
• Supported the development of Soar Above Stigma, a resource that provides outreach support and stigma education for Indigenous community members dealing with addiction or mental health issues
• Shared best practices for addressing substance use stigma within the Canadian health system, including through use of compassionate and non-stigmatizing language
• Continued engagement activities with law enforcement community to promote uptake of an online Drug Stigma Awareness Training module with free access extended to law enforcement members until December 31, 2023
• Developed a toolkit of resources for employers of Canadians working in the trades and related industries to help reduce the harms of substance use
• Developed a Blueprint for Action and policy paper for schools and community organizations that support youth, outlining practical approaches for schools to prevent substance-related harms among youth
• Adopted non-stigmatizing language in Health Services products and reviewed staff training and education aimed at reducing substance-related stigma in Canada's correctional system (e.g., substance use module of the Correctional Training Program)

Evidence

• Published the data and evidence framework as part of the renewed CDSS
• Published data on supervised consumption sites in Canada, including the number of visits, client demographics, drugs used, overdoses, and referrals to services
• Released the results of a public opinion research survey on Canadians' knowledge and attitudes around drug decriminalization
• Publication of results from the People with Lived and Living Experience Survey on substance use among street involved youth in Canada
• Released results of the 2021-2022 Canadian Postsecondary Education Alcohol and Drug Use Survey
• Released results from the Online New Psychoactive Substances Survey
• Hosted a Knowledge Exchange Series on prescribed alternatives to engage a range of stakeholders in dialogue around current evidence and potential future directions in prescribed alternatives (see the What We Heard Report)
• Established an Expert Advisory Group to provide independent, expert advice on the federal approach to prescribed alternatives, including on findings from federally funded pilot projects, knowledge transfer strategies, and responses to emerging issues
• Supported a National Safer Supply Community of Practice, research, knowledge transfer and exchange projects, to help gather and share the evidence around prescribed alternatives
• Continued engagement with a range of experts on prescribed alternatives, including addiction medicine physicians, to help strengthen the evidence base and better address emerging and potential risks, including diversion
• Held a Best Brains Exchange to share knowledge related to best practices and treatment options for people living with chronic pain and concurrent mental illnesses and/or substance use-related conditions
• Published a spotlight report on the emergence of Xylazine (a prescription drug used in veterinary medicine) in Canada
• Published an at-a-glance report on new psychoactive substances and an infosheet on the emergence of Desalkylgidazepam, a novel benzodiazepine, in Canada
• Renewed investment of $17 million over 6 years to the Canadian Research Initiative in Substance Matters (CRISM) to conduct research and knowledge mobilization activities focused on substance use harms
• Invested $2.85 million over 5 years to support a CRISM-led independent, evaluation of the impacts of the section 56 exemption in British Columbia. Progress updates on interim findings are published at regular intervals
• Conduct wastewater analysis to screen for the presence of over 400 drugs and metabolites in Canada's wastewater and provide data on substance use patterns and new and emerging psychoactive substances
• Released latest results from the Canadian Wastewater Survey on stimulants in the wastewater of Canadian cities
• Established an Expert Task Force on Substance Use that provided independent recommendations on the federal government's drug policy and potential alternatives to criminal penalties for personal possession
• Funded a preliminary qualitative assessment of 10 prescribed alternatives pilot projects to capture early learnings, including effective strategies for program delivery
• Invested $3 million over 4 years to evaluate the impacts of prescribed alternatives pilot projects and to assess the public health impacts of supervised consumption sites (SCS) across Canada
• See the end-of-grant workshop report from the SCS evaluation
• See the summary of findings from the Midpoint Knowledge Exchange Forum on prescribed alternatives
• Released several reports related to furthering knowledge around opioids

Substance use services and supports

Treatment

• Supported the development of guidance for health care providers, including:
• Clinical guidelines and operational guidance for injectable opioid agonist treatment
• National treatment guidelines for opioid use disorders
• Removed barriers to accessing drugs used for the treatment of opioid use disorder by:
• Issuing a class exemption for patients, practitioners, and pharmacists prescribing and providing controlled substances in Canada to ensure continuity of care
• Approving injectable hydromorphone and diacetylmorphine as treatment options for patients with severe opioid use disorder
• Facilitating the prescribing and dispensing of methadone and diacetylmorphine through regulatory amendments
• In January 2024, revised the guideline for Drug Treatment Courts to improve accessibility, to remove barriers to entry into the program, and offer more flexibility in the determination of criteria for graduation from the program
• Developing national standards based deliverables for mental health and substance use services to provide an evidence-based framework for service delivery
• Supported improved access to treatment services by providing $150 million via the 2018 Emergency Treatment Fund which, when cost-matched by provinces and territories, totaled over $300 million
• Supporting federally-funded treatment centres for First Nations and Inuit to create and enhance their virtual treatment services, allowing for increased reach and accessibility to those who may not otherwise seek treatment
• Supporting Opioid Agonist Therapy wraparound supports in 82 First Nations and Inuit Communities
• Revised opioid use disorder guidelines, appointed a national opioid agonist therapy (OAT) medical advisor, and established a national OAT working group to improve provision of OAT in Canada's correctional institutions
• Implemented SMART (Self-Management and Recovery Training) in 27 of Canada's correctional institutions
• Provided funding through the Supporting Pathways to Care for People Who Use Drugs program for projects that support sustainable system-level change to help people access care and reduce barriers

Harm reduction

• Introduced legislative amendments to the Controlled Drugs and Substances Act(CDSA) that will allow us to develop a new regulatory scheme to authorize supervised consumption and drug checking services
• Supported the establishment of supervised consumption sites (SCS) to provide health, social and treatment services. As of April 2024, there are 38 SCS offering services
• Authorized different modes of consumption that include injection, oral (swallowing), intranasal (snorting), and inhalation
• Authorized supportive services at sites including drug checking, peer assistance consumption and drug splitting and sharing
• Streamlined the exemption application process
• Between January 2017 and January 2024:
• SCS received over 4.6 million visits
• SCS attended to over 55,000 overdoses
• SCS made over 470,000 referrals to health and social services
• Improved access to urgent public health needs sites by allowing provinces and territories to establish temporary spaces where people can consume drugs under supervision, to reduce risk of overdose death
• Supported the Good Samaritan Drug Overdose Act, which provides some legal protection related to drug possession for people who seek emergency help during an overdose
• Supported the development of guidance on take-home naloxone programs
• Supported national projects to increase awareness and access to naloxone through training, awareness and distribution of the life saving drug. As of December 2023, these investments have resulted in:
• 2.2 million trained in Canada on how to respond to an overdose
• more than 92,000 nasal naloxone kits distributed across Canada
• Continued to improve access to naloxone, including to remote and isolated First Nations and Inuit communities and people experiencing homelessness, through the coordination of bulk purchases of naloxone, increasing access to take-home naloxone kits, and training in their use
• Funding Thunderbird Partnership Foundation to create and distribute take-home nasal naloxone kits to communities and treatment centres
• Supported a drug checking technology challenge to promote development of new drug checking technologies, which included awarding a grand prize of $1 million to Scatr Inc.
• Opened Overdose Prevention Services at four correctional institutions, with plans for future expansion
• Implemented a prison needle exchange program in 11 correctional institutions
• Ensured naloxone is readily available in correctional institutions and that those at risk of an opioid overdose are offered a take-home naloxone kit upon release back into the community
• Supporting the delivery of harm reduction activities to help reduce risks and connect individuals experiencing homelessness with key health and social services through the Reaching Home program
• Provide targeted supports for veterans experiencing, or at imminent risk of, homelessness through the Veteran Homelessness Program, to support provision of health and medical services (e.g., counselling and substance use supports) and delivery of harm reduction activities

Substance controls

• Granted British Columbia's request for an amendment to the province's exemption to personal possession of certain controlled substances under the CDSA. The changes were granted to the province to help address public drug use when there is a risk to public safety
• Bill C-5 came into force, repealing mandatory minimum penalties for all drug offences in the CDSA, requiring police and prosecutors to consider diversion for simple drug possession offences, and that past and future convictions for drug possession be sequestered apart after a period of time
• Made scheduling amendments to help address the illegal importation and distribution of a group of novel synthetic opioids and a new group of emerging fentanyl precursors
• Released guidance for federal prosecutors around considering alternatives to prosecution for simple drug possession offences, including guidance in circumstances where there are serious public safety concerns
• Identified opioids, including nitazenes, 153,546 times from January 2018 to April 2024 in samples submitted to the Drug Analysis Service by law enforcement and public health partners (samples may contain more than one opioid)
• Shared laboratory analysis results on new and emerging drugs with over 400 partners on a monthly basis
• Providing border services officers with tools to safely identify and interdict fentanyl and other toxic substances at the border, including:
• Equipping 82 ports of entry with designated safe examination areas to make it safer for border services officers to examine goods suspected to contain opioids
• Maintaining field drug analysis sites with on-site chemists in Toronto, Montreal, and Vancouver to allow for the local identification of substances
• Seizing illegal drugs and precursor chemicals that can be used in the production of illegal synthetic drugs
• Continuing to investigate and charge criminal actors suspected of manufacturing and/or trafficking illegal substances, including:
• Working with private sector partners to limit the flow of legitimate chemicals for the purpose of manufacturing illegal substances
• Investigating and dismantling clandestine drug labs capable of producing large quantities of synthetic drugs
• Targeting organized crime groups involved in the illegal production and trafficking of synthetic drugs
• Working with private sector partners to address money laundering of the proceeds of fentanyl trafficking
• Introduced legislative amendments to the Criminal Code in 2023 and 2024 to facilitate the investigation and prosecution of the offence of laundering proceeds of crime and other economic crimes, and to facilitate the seizure and restraint of proceeds of crime for possible forfeiture