Overdose in Canada: An Epidemic Within a Pandemic


31 Aug 2021

Overdoses are a complex health and social issue with devastating consequences for individuals, families, and society as a whole. At the same time, the COVID-19 pandemic has also highlighted existing structural barriers and inequities in the health of the population that include an individuals’ social-economic status, geographical location, racism, and other forms of discrimination.

Today is International Overdose Awareness Day, a day where communities come together to campaign to end overdose, remember those lost and recognize the grief of those left behind. We recognize that the expertise, strengths, innovation, and leadership of people who use drugs have been central in implementing programs and services to respond to the overdose crisis and the toxic drug supply.

Reduced access

As the COVID-19 pandemic emerged in the midst of an ongoing overdose epidemic, public health measures to reduce the impact of COVID-19 in Ontario increased the risks of drug-related overdose and death. Despite the best efforts and continued dedication of health care and support professionals providing services to those who use drugs, these measures resulted in changes in services for pharmacies, outpatient clinics, and harm reduction sites that provide care to people who use drugs, impacting the supports that this population relied on for safe drug use and treatment.

Following the declaration of a State of Emergency on March 17, 2020, there was a 79% increase in monthly opioid-related deaths in Ontario between February and December last year. The vast majority of these deaths were accidental with an increased number being among people who were using drugs alone when no one was present to intervene.

Populations most affected

The number of opioid-related deaths more than doubled among people experiencing homelessness, with 1 in 6 opioid-related deaths during the pandemic having occurred within this population, reinforcing the importance of safe, affordable housing as a social determinant of health.

While the deaths among women by month increased almost 44% from February to December 2020, it was the male population that was hit the hardest with an increase of 93% over the same period.

It is important to understand the circumstances that contribute to these deaths to better inform interventions and policies to reduce opioid-related overdoses and deaths in the midst of the COVID-19 pandemic.

Find out more about the factors that contributed to opioid-related overdose and deaths during the pandemic, and the populations affected in Changing Circumstances Surrounding Opioid-Related Deaths in Ontario during the COVID-19 Pandemic, a recent report (English only) co-authored by PHO experts.

Drug supply and polysubstance use

A progressively toxic drug supply is having an impact on the increased number of opioid-related deaths across the country. During the pandemic more than 25% of these deaths were linked to a non-prescription benzodiazepine (tranquilizer), compared to approximately 5% pre-pandemic. Many of these are not approved for use in Canada, which suggests that they are contaminating the unregulated opioid supply. Polysubstance use (consumption of more than one drug at once) also increased during the pandemic, further highlighting the ongoing volatility of the unregulated opioid supply.

There was also a significant increase in stimulants contributing to opioid-related deaths, with their involvement rising from 50% to 58% during the pandemic.

Facts and Figures

  • 79% increase in monthly opioid-related deaths between February and December 2020
  • 54% of opioid-related deaths during the pandemic occurred among people aged 25 to 44
  • 76% of opioid-related deaths during the pandemic occurred among men
  • 73% of opioid-related deaths during the pandemic occurred among those using drugs alone
  • 139% increase in opioid-related deaths among those experiencing homelessness

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Published 31 Aug 2021