International Overdose Awareness Day: Drug overdoses remain Canada’s third leading cause of avoidable death

The number of Canadians who died of drug overdoses—unintentional, intentional or undetermined—edged down to 7,775 deaths in 2022 and 7,650 deaths in 2023, but drug overdoses remain the third leading cause of avoidable death in Canada.

In 2023, just under one-quarter (or 80,050) of the 326,215 deaths in Canada were potentially avoidable deaths. 

Avoidable deaths are deaths among people under the age of 75 years that could potentially be prevented with changes in lifestyle or behaviours, or through access to proper health care. 

Just under one-tenth of all avoidable deaths in Canada in 2023 were attributable to a drug overdose, making it the third leading cause of avoidable death in Canada following cancer and diseases of the circulatory system such as heart disease or stroke. 

Drug overdoses represented 9.6% of all avoidable deaths in 2023. Among males, the share was even higher, with drug overdoses responsible for 11.1% of all avoidable deaths that year, compared with 7.1% among females.

There was a notable 59% spike in drug poisoning deaths during the first year of the COVID-19 pandemic (from 4,039 deaths in 2019 to 6,412 deaths in 2020). Over this one-year period, accidental drug poisoning deaths among males rose by over two-thirds (up 69% to 4,847 in 2020), while accidental drug poisoning deaths among females rose by one-third (up 34% to 1,565).

A small ray of hope as we mark this International Overdose Awareness Day is that drug overdose deaths have edged down since peaking in 2021. However, that is small consolation for the families of the 5,455 males and 2,200 females who died from drug overdoses in 2023. 

In the context of the ongoing opioid crisis in many parts of Canada, wastewater data can contribute to a better understanding of drug use and emerging trends.

Norfentanyl is one notable example of a substance that has been measured in wastewater across Canada. Norfentanyl, a byproduct formed when fentanyl breaks down in the body, can be detected in wastewater to estimate fentanyl consumption. Fentanyl is an opioid drug of particular concern. In 2025, 56% of all apparent opioid toxicity deaths involved fentanyl and 60% involved fentanyl analogues, according to the Public Health Agency of Canada.

Overall, 82% of all apparent opioid toxicity deaths in 2025 involved opioids that were non-pharmaceutical.

Statistics Canada’s Canadian Wastewater Survey measures the levels of 10 different drugs—including stimulants such as cocaine and methamphetamine, and opioids such as fentanyl, methadone and oxycodone—in the wastewater of Halifax, Moncton, Montréal, Toronto, Saskatoon, Prince Albert, Edmonton and Metro Vancouver. Monitoring a variety of substances allows for a comprehensive picture of high-risk drug use and emerging trends over time.

Wastewater data reveal that drug usage across Canada varies by region. For example, levels of norfentanyl were four to five times higher in Metro Vancouver compared with all other participating cities throughout 2022 and 2023.

Toronto and Edmonton also had higher levels of norfentanyl in wastewater compared with most other participating cities.

On the other hand, norfentanyl levels in Halifax, Montréal and Saskatoon were well below the levels seen in Edmonton, Toronto and Metro Vancouver in 2023. Norfentanyl levels in Saskatoon represented a notable decrease compared with 2022, when levels were closer to those seen in Edmonton and Toronto.

New wastewater data for January 2024 to early 2026 will be released in the fall 2026.