Fewer overdose deaths, but no clear reason why

Hey there, time traveller!
This article was published 02/04/2025 (360 days ago), so information in it may no longer be current.

Drug overdose deaths are falling in most Canadian provinces, and that is leading to a series of questions as to what is causing the decline, whether it signals a long-term trend and what impact it will have on addictions policies going forward.

According to Government of Canada data, there was an 11.1 per cent drop in opioid overdose deaths in Canada in the first half 2024 compared to the same time period in 2023. For the period of January to September, the number was even higher, at 12 per cent.

In British Columbia, the drop for the January to June time period was a more modest 7.5 per cent, but data from the British Columbia Coroners Service reveals that deaths in that province due to toxic drug overdoses are down by more than 30 per cent since January 2024.

In Alberta, the decline in opioid overdose deaths was a massive 34.5 per cent. Overall overdose deaths in that province fell to 1,182 in the first half of 2024 from 1,873 in the same time period in 2023 — a decrease of almost 37 per cent. In Saskatchewan, the drop in opioid overdose deaths from January to June of 2023 to the same period in 2024 was even greater, at 43.4 per cent.

In Ontario, the number of opioid overdose deaths in the first half of 2024 were 6.7 per cent lower than occurred during the first half of 2023, but the latest data from the Ontario Drug Policy Research Network reveals that drug-related deaths in that province from December 2024 to February 2025 were 13 per cent lower than the previous quarter, 30 per cent lower from than the same time period last year, and 37 per cent lower than the same period three years ago.

Those are impressive numbers, but the same data reveals that opioid overdose deaths in Manitoba, Quebec and the Atlantic provinces were higher in the first half of 2024 than during the same period of 2023. The number of deaths rose by 13.8 per cent in Manitoba, by 14.9 per cent in Atlantic Canada, and by a staggering 35.2 per cent in Quebec.

The general trend of lower opioid-related overdose deaths is not limited to just Canada. In the United States, overdose fatalities fell by approximately 17 per cent nationally between 2023 to 2024, but increased in some states.

The drop in overdose deaths is good news, but scientists and policy-makers are struggling to identify and explain the precise reason why it is happening.

For example, why did fewer deaths occur in some jurisdictions, but not others? How can there be a dramatic decline in Saskatchewan, yet an increase in deaths in Manitoba, which has a very similar demographic composition?

Given the vastly different approaches taken by governments that have experienced a drop in the overdose death rate, it is unlikely that ideology and political factors are playing a critical role in the trend.

Rather, some experts point out the increased distribution of naloxone medication, as well as the proliferation of addiction and harm reduction services in many provinces. It is possible that users are becoming more educated and careful in their usage of the drugs, reducing their risk of death.

Others suggest that, as law enforcement’s war on fentanyl is causing shortages of that drug, it is being mixed with other less-lethal drugs, resulting in fewer deaths.

More ominously, some experts also theorize that fewer overdose deaths may be due to the possibility that many opioid drug users who were at the greatest risk of dying by overdose have already died.

The reason for the reduction in deaths is likely a combination of some of those factors, and possibly others, but the troubling reality is that we don’t know which ones. That uncertainty has to change, and quickly.

Up to now, Canada’s approach to the addictions crisis has consisted of a haphazard patchwork quilt of measures in the various provinces and territories, based on a blend of educated guesswork and ideology. Now that several jurisdictions are making progress in reducing overdose deaths, however, it is important for researchers, advocates and governments gain a clear understanding of which approaches are getting results, and those that are not.

Once that happens, we can finally develop a uniform, nationwide addictions strategy that has the best chance of success. Time is of the essence, however. The earlier that strategy is in place, the more lives will be saved.