Premature deaths related to opioids doubled between 2019 and 2021 across Canada, with more than one-in-four deaths among young adults aged 20–39 years attributable to opioids, according to new research published in CMAJ (Canadian Medical Association Journal).

Opioid-related deaths have continued to increase over the past decade across Canada, with 6222 deaths occurring in 2021. This trend worsened during the COVID-19 pandemic, although the scale and rapidity of increases varied across provinces and territories. These changes have been attributed primarily to the unregulated drug supply, which became increasingly volatile and unpredictable during the pandemic.

“During the COVID-19 pandemic, the loss of life from opioid toxicities has worsened in nearly every part of Canada, with Alberta, Saskatchewan, and Manitoba experiencing enormous increases in deaths — particularly among their younger population,” says Dr. Tara Gomes, senior author on the study, and scientist at Unity Health Toronto. “Without adequate investments in widespread, accessible treatment and harm-reduction programs, and broader social supports like housing, these preventable deaths are having devastating effects on communities across the country.”

To understand the trends and impact of opioid-related deaths, researchers looked at data on accidental deaths from opioid toxicity across 9 provinces and territories in Canada: British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia, and the Northwest Territories. In just 3 years (2019–2021) the annual number of opioid-related deaths rose from 3007 to 6222. More striking is the number of years of life lost (YLL) to premature death from opioid toxicity, which more than doubled in Canada over the study period, reaching over a quarter of a million in 2021 (256 336 YLL).

“Alarmingly, 1 in 31 deaths among people aged 85 and younger were attributed to opioids in 2021, a number that increases to 1 in 4 deaths among young adults aged 20–39,” said Shaleesa Ledlie, Leslie Dan Faculty of Pharmacy, University of Toronto. “This scale of opioid-related harm — particularly among young people — is unprecedented and illustrates the magnitude of this public health crisis across the country.”

Although the concentration of harm in younger populations was consistent across the 9 Canadian provinces and territories included in this study, some provinces were disproportionately affected. For example, in Alberta, nearly half of all deaths among those aged 20–39 were opioid-related.

In Canada, access to social supports and health care services was severely reduced or restricted during the pandemic, resulting in changes in patterns of drug use and accessibility of community-based services for people who use drugs. However, despite the reopening of services in recent years, the rates of opioid-related deaths remain elevated across the country, identifying an urgent need to work with communities to scale up services designed to support people who use drugs.

“Opioid-related deaths between 2019 and 2021 across nine Canadian provinces and territories” is published April 15, 2024.