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​​​How did we get to an opioid crisis?

Prescription opioids can reduce pain and improve function. Prescription and illicit opioids can also produce a feeling of well-being or euphoria, or a “high.” At sufficiently high doses, opioids cause drowsiness, coma and death.

​What is fentanyl?

Fentanyl is a synthetic opioid that can be prescribed, but most recently has been created in illegal laboratories and sold to individuals on the street or used by drug dealers to cut other drugs (such as cocaine, counterfeit oxycodone tablets or powder heroin) to increase dealer profits.

The presence of fentanyl in tablets and powders dramatically increases the risk of overdose because people using them do not know what substances they are using or how much of the active substances are included. Conservative estimates predict one death every three days​ between 2009 and 2014 was related to fentanyl. According to the currently available data, 72% of the accidental apparent opioid-related deaths that occurred in 2017 are attributable to fentanyl or fentanyl analogues.

​The current opioid crisis is a result of multiple complex factors
that include:

  • A misunderstanding of the addictive risk of prescription opioids;

  • Frequent opioid prescribing and high amounts being prescribed for pain relief;

  • Lack of awareness of alternative treatments for pain;

  • Theft of prescription opioids by friends and family
    members;

  • Lack of access to prescription opioids leading to illicit
    opioid use;

  • Illegal drugs that are laced with other substances, such
    as fentanyl;

  • Psychological, social and biological risk factors like genetics, mental health, early life experiences, trauma, poverty, lack of secure housing and other social determinants of health; and​

  • Stigma towards substance use disorders, discouraging individuals from seeking help.

Scale of the opioid crisis

Recent estimates indicate 13.1% of Canadian adults used opioids in 2015, and among these individuals, 2.2% (82,000 Canadians representing 0.3% of the total population) reported using them for non-medical purposes. There were 3,987 apparent opioid-related deaths in 2017​. These lives lost make the opioid crisis a leading public health and safety concern. 

What is naloxone?

Naloxone is a rescue medication that can reverse the effects of an opioid overdose for a short period. This reversal provides time for emergency services to arrive or for the individual to be taken to the hospital. Naloxone is available without a prescription from many pharmacies in Canada. Unfortunately, at this time, not all pharmacies stock naloxone. Learn more about naloxone and questions to ask your healthcare provider.      

Measures that provide a better understanding of the harms associated with opioid use, such as numbers of deaths, hospitalizations and emergency department visits, are a high priority.

CCSA and the Canadian Institute for Health Information released a joint report in 2016, Hospitalizations and Emergency Department Visits Due to Opioid Poisoning in Canada.

The following key findings come from the report:

  • Opioid poisonings result in more than 13 hospitalizations
    a day in Canada.

  • The rate of hospitalizations due to opioid poisoning in Canada increased more than 30% between 2007–2008 and 2014–2015.

To illustrate further the scope of the opioid crisis, we have reproduced below a map from Health Canada’s National report: Apparent opioid-related deaths in Canada (released September 2018). The map shows the number and rate (per 100,000 population) of apparent opioid-related deaths by province or territory.​

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