Public Health Crisis from Acute Drug Toxicity Fatalities

"Since the Early 2000s, Canada and the United States have been experiencing an unprecedented public health crisis from acute drug toxicity fatalities (“drug death crisis”) that is estimated to have claimed well beyond 1 million lives. Although initially driven mostly by fatalities from potent prescription opioids, over the past decade this crisis has changed to being propelled mostly by highly potent and toxic illicit/synthetic opioids (ISOs; e.g., fentanyl and analogues) (Ciccarone, 2021; Fischer, 2023). In 2021, Canada recorded 8,006 opioid-toxicity deaths, for an age-adjusted rate of 21.2/100,000 population (Federal, Provincial, and Territorial Special Advisory Committee on the Epidemic of Opioid Overdoses, 2023). During the same year, there were 106,699 drug overdose deaths (32.4/100,000) in the United States (Spencer et al., 2022). Although this death toll in absolute numbers and rates is even graver in the United States than in Canada, it has been shown to adversely affect life expectancy in both countries.

"In Canada, comprehensive intervention efforts have been implemented and expanded over time to address this drug death crisis. These have included, for example, extensive scale-up of supervised consumption (or “overdose prevention”) services, naloxone distribution (for opioid overdose reversal), and treatment availability (including different opioid agonist therapy [OAT] formulations/modalities) for opioid use disorder (OUD) (Antoniou et al., 2020; Kennedy et al., 2022; Papamihali et al., 2020; Piske et al., 2020). These measures, however, have not been able to stem the rising tide of drug deaths. The levels of drug toxicity deaths in Canada have continuously increased (up to and including 2021), and more recent indicators suggest no significant changes moving forward (Federal, Provincial, and Territorial Special Advisory Committee on the Epidemic of Opioid Overdoses, 2023)."