Why is Canada's illicit drug supply so deadly and what's being done about it?

Canada's overdose crisis has worsened during the pandemic, with the number of people dying from illicit drugs soaring to new heights in many provinces. 

The Public Health Agency of Canada (PHAC) says 2020 was the deadliest year for overdose deaths since it started recording the numbers in 2016. From January 2020 to June 2021, more than 9,800 Canadians died from an opioid overdose. 

According to those who research and work with drug users, the country's increasingly toxic drug supply is to blame. 

Data suggests that the pandemic has a part to play in how toxic the supply has become. Supply volatility increased dramatically once pandemic lockdowns were declared in March 2020, according to the Canadian Centre on Substance Use and Addiction (CCSA). 

"The entire drug supply has gotten a lot more messy since COVID started.… The borders closed, and the drug supply routes aren't the same and people are just using what they can," said Doris Payer, a co-ordinator and researcher with the CCSA. 

Prescription opioid OxyContin was introduced in 1996 and is widely seen as a catalyst to the opioid crisis that has claimed hundreds of thousands of lives across North America. Drug manufacturers marketed opioids aggressively, particularly OxyContin, which lawsuits claim they falsely suggested was safer and less prone to misuse than other opioids. 

However, as more people began using the drug, more people started misusing it. Dealers turned huge profits as the painkiller became a popular street drug, and OxyContin eventually made its way from cities into remote communities.

In 2012, the manufacturers of OxyContin, Purdue Pharmaceuticals, reformulated the drug to make it harder to crush or melt down, with the intent of discouraging abuse. But making pharmaceutical opioids less available didn't change the fact that thousands of people were addicted to them, so many people turned to the streets and to other opioids, including heroin.

As the demand for illicit opioids increased, drug dealers began adding the powerful synthetic opioid fentanyl to the illicit supply of heroin to maximize profits.

In 2016, a study by Public Health Canada found that fentanyl was fuelling a rise in opioid-related deaths. The study said fentanyl, which was becoming more prevalent on the illegal drug market, was being increasingly mixed in with other illicit drugs, increasing the risk of an overdose. 

Much more potent than oxycontin, the relatively cheap-to-make opioid has been increasingly mixed into other street drugs, killing hundreds of people across Canada, but particularly in B.C. and Alberta. In 2016, PHAC recorded more than 2,800 opioid-related deaths. 

Data from drug-checking services Toronto and B.C. that test the substances used by people and inform them on what they contain shows fentanyl now dominates the market. 

In 2020, 69 per cent of opioids seized by law enforcement agencies across Canada consisted of fentanyl or fentanyl analogues, according to Health Canada's Drug Analysis Service (DAS).

But Paxton Bach, an addiction medicine physician and co-medical director of the B.C. Centre on Substance Use, said fentanyl itself isn't the only reason people are overdosing and dying.