Toronto, Ontario — A new report highlights a disturbing rise in overdose deaths in Ontario, revealing a significant increase in cases involving multiple drugs. According to research from the Ontario Drug Policy Research Network and Public Health Ontario, the deadly mix of opioids and stimulants is particularly prevalent and troubling. Since the onset of the COVID-19 pandemic, this trend has become more pronounced, underscoring a grave public health challenge.
Between 2018 and 2022, the monthly rate of fatal overdoses involving a single substance climbed by 75%. More alarmingly, deaths related to the consumption of two drugs jumped by 167%, and those involving three or more substances soared by 186%. The complexity of these cases poses significant hurdles for medical professionals desiring to offer effective interventions.
“The most common fatal scenario now involves a combination of opioids and stimulants,” said Tara Gomes, an epidemiologist at Unity Health and a researcher involved in the study. “However, it’s alarming to also witness increases in deaths involving complex mixtures of opioids, stimulants, benzodiazepines, or alcohol.”
Illicit fentanyl remains dominant among opioids contributing to overdose deaths, found in nearly 84% of cases — translating to over 10,000 individuals in Ontario alone during the study period. Stimulants were detected in almost 62% of the cases, alcohol was present in 13%, and benzodiazepines were found in 9%.
The study further explored how individuals interacted with the healthcare system prior to their deaths. Approximately one-third had some form of medical encounter in the week before they died, and over half had been in contact with healthcare services within 30 days of their death. This frequent interaction highlights potential opportunities for intervention but also reveals gaps in current healthcare practices.
“Unfortunately, our findings suggest that emergency departments are under-resourced in terms of specialized addiction care,” Gomes noted. She advocates for the broader integration of addiction medicine consult services across Ontario, aiming to improve both in-hospital treatment and post-discharge care coordination.
As the province grapples with these issues, it also plans to shift its strategy on addressing opioid use. In response to the significant influx of illicit opioids, particularly fentanyl, which began around 2015 and surged during the pandemic, Ontario is set to close 10 supervised consumption sites by the end of March. These closures are motivated by their proximity to schools and daycare centers.
In their place, the province aims to roll out “homelessness and addiction recovery treatment hubs” by April 1. These hubs are part of a shift toward an abstinence-based treatment model and will be accompanied by the creation of 375 supportive housing units funded by a $378 million investment.
This strategic pivot reflects a broader reassessment of how addiction is managed in healthcare settings and highlights the pressing need for effective, integrated strategies to combat a worsening overdose crisis in Ontario. As the drug landscape continues to evolve, so too must the responses from public health, healthcare providers, and policymakers to address the complexities of drug use and its deadly consequences.