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The per-person cost of cannabis increased 5.2% during this period. Specifically, per-person costs increased 15.8% between 2007 and 2018, and decreased 9.1% between 2018 and 2020 following legalization of its recreational use. In contrast to these increases, the per-person cost of tobacco use decreased by almost 20% (from $365 to $293).
Determine the effectiveness of harm reduction programs. We recently updated our report and online data visualization tool to include the most recent data from 2007 to 2020. Users can explore the costs and harms of substance use by the following categories: Region: province, territory and all of Canada;
- Overview
- On this page
- Ministerial message
- Introduction
- Box 1. The overdose crisis has been driven by a dynamic and complex set of factors-but can generally be divided into four phases
- About the strategy
- Our priorities for action under the Canadian drugs and substances strategy
- Risk factors
- Protective factors
- Box 2. Reducing stigma around substance use disorders
(PDF format, 1.62 MB, 26 pages)
Organization:
Date published: 2023-19-30
Cat.: H134-35/2023E-PDF
ISBN: 978-0-660-68488-8
Pub.: 230529
•Ministerial message
•Introduction
•About the strategy
•The foundational elements
•Guiding principles
•Our priorities for action under the Canadian drugs and substances strategy
Canada is in the midst of one of the most serious and deadly public health crises in our country’s history - the toxic and illegal drug and overdose crisis. No community has been left untouched. Since 2016, more than 38,500 people have died of apparent opioid toxicity in Canada.
This crisis is tragic, and I want to recognize and remember the lives of people in Canada we have lost. Every person who overdoses is somebody who has a family and people that care about them and that we must do everything we can to support and protect them.
People who use substances, their families, and the communities around them, need us to use every tool at our disposal to provide compassionate care and maintain community safety. There is so much to be done and no one government, community or family can end this crisis alone.
That is why we are launching a renewed Canadian Drugs and Substances Strategy (CDSS) that has been designed to support a comprehensive and compassionate approach centered on promoting both public health and public safety. This whole-of-government initiative includes timely access to a full range of strategies to help people access the prevention, harm reduction, treatment, or recovery services and supports they need, when and where they need them.
The renewed CDSS is using an integrated approach that brings together prevention and education, substance use services and supports, evidence, and substance controls. New investments include supporting a wide range of activities such as community-based supports; streamlining authorizations for supervised consumption sites and drug checking services; vital data collection on substance-related harms and lab-based analysis of the illegal drug supply; an overdose monitoring platform for law enforcement and other first responders; and further action to work with our partners to disrupt illegal drug production and trafficking and stem the global flow of these devastating substances.
By using a wide-range of tools, we have the best opportunity to end this crisis, protect communities and save lives.
Canada is experiencing an unprecedented and unrelenting rate of overdose deaths and harms, largely due to the toxic illegal drug supply that has continued to worsen since the start of the COVID-19 pandemic. National data shows that 38,514 apparent opioid toxicity deaths occurred between January 2016 and March 2023 (see Figure 1). The overdose crisis is complex and caused by many factors (see Box 1). In particular, drug traffickers and criminal organizations are seeking to maximize their profits by contaminating the illegal drug supply with inexpensive fentanyl and other opioids at a cost to Canadian lives. While in 2017 Canada saw a spike in fentanyl detected in the illegal drug supply, the overdose crisis continues to evolve and increasing amounts of other toxic substances are now present. This impacts the ability of first responders to reverse overdoses through the use of naloxone and makes the treatment of substance use disorders more complicated. Just under half (48%) of accidental apparent opioid toxicity deaths in 2023 also involved a stimulant, reflecting the role that the mixing of substances (polysubstance use) plays in this crisis.
Figure 1. Canada's crude rate of total apparent opioid toxicity deaths, per 100,000, 2016 to 2023 (January to March) Figure 1 - Text description
Source: Federal, provincial, and territorial Special Advisory Committee on the Epidemic of Opioid Overdoses. Opioid- and Stimulant-related Harms in Canada. Ottawa: Public Health Agency of Canada; September 2023
The increasing toxicity and unpredictability of the illegal drug supply means that anyone is at risk for an overdose, whether they are trying drugs for the first time, or have been using drugs frequently. While anyone is at risk of a drug overdose, some populations in Canada have been disproportionately impacted by the crisis. Males accounted for the majority of apparent opioid toxicity deaths in Canada (70% to 75% since 2016). People living with co-occurring health conditions are also at increased risk of an overdose, including those with mental health conditions and chronic pain. Approximately 20% of Canadians with a substance use disorder (SUD) also have a co-occurring mental health disorder. Meanwhile, up to 55% of people who use drugs are also living with chronic pain.
The late 1990s to 2010 marked phase one of the overdose crisis which consisted of an overreliance on opioid prescriptions. During this phase, opioids were considered legitimate medications prescribed to treat acute or chronic paint, but the healthcare system’s overreliance on opioids resulted in a large numbers of Canadians being exposed to medications with high potential for higher risk use. The years 2010 to 2015 marked the second phase of the overdose crisis, which was characterized by an increase in diverted or illegally produced opioids. During this time period, there was an increase in diverted or illegally produced opioids bought and sold on the illegal market, which enabled opioid exposure among people who use drugs. The years 2015 to 2020 marked the third phase of the crisis where there was an unprecedented rise in synthetic opioids and analogues. During this phase, highly toxic synthetic opioids like fentanyl and its analogues were increasingly contaminating the illegal drug supply and driving the increasing mortality rates. From 2020 to the present is the fourth phase of the crisis where there is fentanyl dominance and widespread toxicity and unpredictability in the illegal drug supply. Currently, fentanyl continues to dominate the illegal drug market. The illegal supply remains highly unpredictable, with the introduction of stimulants, depressants and other emerging contaminants. There is increasing uncertainty as to what drugs are circulating in the illegal supply. In 2023, the illegal drug supply is more toxic than ever with fentanyl being widespread, both as a drug of choice as well as one of many contaminants found in other substances.
Indigenous populations in Canada also face an increased risk of overdose deaths and other substance use related harms. According to the First Nations Health Authority, First Nations people died of opioid toxicity deaths at 5.9 times the rate of other residents in British Columbia in 2022, a disproportionate impact on Indigenous populations that has also been seen across other provinces and territories. Historical and intergenerational trauma, including the impact of colonization, loss of traditional culture and language, and experiences with Indian Residential Schools, have contributed significantly to the elevated risk of overdose death and broader substance use related harms amongst Indigenous Peoples. Systemic racism arising from Canada's colonial history has also created inequities for African, Caribbean and Black populations, which has resulted in higher rates of poverty, unemployment, and precarious housing among these populations, placing them at greater risk of substance use harms.
In addition to the overdose crisis, Canada continues to see harms from other substances, such as tobacco and alcohol. In addition to the overdose crisis, Canada continues to see harms from other substances, such as tobacco and alcohol. According to the Canadian Costs of Substance Use and Harms 2007-2020 report, substance use and its related harms from all substances cost Canadians more than $49 billion and led to the loss of nearly 74,000 lives or 200 lives per day in 2020 (see Figure 2). In 2020, tobacco use was the leading cause of substance attributable deaths with 46,366 deaths in 2020, followed by alcohol use with 17,098 deaths and opioid use with 6,491 deaths. The harms related to substance use are not limited to the loss of lives alone, but also include increased costs to our health care system, from hospitalizations, emergency visits and specialized treatment for substance use disorders, which amounted to $13.4 billion in 2020. Substance use also has economic impacts due to lost productivity from premature deaths and time off work due to disability, which cost $22.4 billion in 2020. The enforcement of substance use laws cost Canada’s criminal justice system $10.0 billion in 2020.
Figure 2. Costs of substance use and harms in Canada, in billions of dollars Figure 2 - Text description
Source: Canadian Substance Use Costs and Harms Scientific Working Group. (2023). Canada Profile: Canadian Substance Use Costs and Harms (2007–2020). (Prepared by the Canadian Institute for Substance Use Research and the Canadian Centre on Substance Use and Addiction.) Ottawa, Ont.: Canadian Centre on Substance Use and Addiction. Information generated by the online data visualization tool
People use substances for many different reasons, such as medical purposes, personal enjoyment, religious or ceremonial purposes, or to cope with stress, trauma or pain. Substance use looks different for everyone and has varying stages of benefits and harms. Substance use related harms occur when substances are used in a manner, situation, amount, or frequency that harms the person using the substance or those around them. Examples of substance use related harms can include infection, hospitalization, risk of mental health disorders, including the risk of a substance use disorder; and the loss of income or housing. Harms may also occur in the illegal production, processing, and distribution of those substances such as community violence that disproportionately affects marginalized populations. Social and economic factors also impact a person's substance use, such as unemployment, housing insecurity or homelessness, poverty, trauma, colonialism, systemic racism, and stigma and can contribute to their marginalization from society.
The CDSS is the federal government's comprehensive response to substance use related harms and the overdose crisis in Canada. The CDSS is an all-substances, public health and public safety strategy that covers a broad range of legal and illegal substances, such as tobacco, cannabis, alcohol opioids and stimulants. The goal of the CDSS is to improve the health and safety of all Canadians by minimizing substance-related harms for individuals, families, and communities. In particular, it prioritizes children and youth who are more susceptible to the negative impacts of substance use as they are still growing and developing and focuses on providing them the supports, tools and help they need to prevent, delay and lower the rates of substance use related harms. It also focuses on connecting people to evidence based substance use services and supports, while also keeping communities safe by taking action against criminal organizations who are trafficking and producing illegal drugs.
The CDSS is a horizontal initiative that is led by the Minister of Mental Health and Addictions and Associate Minister of Health, who is supported by Health Canada and over 15 federal government departments and agencies. As addressing substance use related harms is a shared responsibility between federal, provincial and territorial governments, the CDSS focuses on areas of federal jurisdiction, such as:
•legislation and regulation
•funding to support the adoption of innovative approaches
•national surveillance and research
•services and supports for populations served by the federal government
Prevention and education
Prevention and education initiatives support communities, and raise awareness to influence the health and wellbeing of people living in Canada. They aim to: educate people living in Canada by providing factual information that helps them make informed choices around substance use related harms and where to get help prevent, delay or reduce substance use related harms by reducing the factors that increase their risk, while increasing those that help protect against them reduce healthcare, social, economic and criminal justice system costs by preventing substance use harms Addressing known risk and protective factors, especially early in life, is key in reversing the current trends of substance use related harms (see Figure 3). Risk factors are characteristics or experiences that increase the likelihood of a negative health outcome or harm due to substance use, whereas protective factors promote an person's overall health and well-being and decrease their likelihood of experiencing harms related to their substance use. Figure 3. Risk and protective factors for substance use related harms
•Trauma
•Childhood adversity
•Mental illness
•Poverty
•Unstable housing
•Drug availability
•Caregiver involvement
•Coping skills
•Social inclusion
•Safe neighbourhoods
•Quality school environment
•Permanent housing
The Substance Use and Addictions Program (SUAP) supports projects that aim to reduce stigma associated with substance use disorders through public education, capacity building and research. With support from SUAP, the Sinai Health System redeveloped Effective Prescribing of Opioids for Chronic Pain (EPOCH), a training programfor primary health care providers to help build their competencies in treating substance use disorder. Beyond Stigma is a public and professional education program focused on stigma that complements the EPOCH training program and includes two videos:
•The Treating Pain in Opioid Use Disorder video which explores the impact of stigma on all aspects of treatment for people living with a opioid use disorder
•The Nurturing Circle of Care video which explores the impact of colonialism and institutional racism on stigma for Indigenous Peoples with opioid use disorders
Working with our partners to address the root causes of substance use related harms
We will work with our partners to leverage existing federal initiatives to address underlying inequities that are the root causes of substance use related harms and support the provision of social services, such as:
•reducing homelessness with the implementation of Reaching Home: Canada's Homelessness Strategy
The market price, if firms take into account the harm to society, is P*. So, the market price is actually set too low when firms ignore the harm to society. The market price is set too high. The market price will be P*. The market price is set too low. The market underproduces the good or service. UNIT 3 — MILESTONE 3 23/ CONCEPT
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Mar 1, 2023 · There is recent precedent for using our food safety laws to regulate chronic food illness. In 2015, the FDA banned artificial trans fats from food on the grounds that it caused heart disease, another chronic illness linked to diet. The agencies should use this same authority to regulate the design of ultra-processed foods.
The cost of eating healthy in KFL&A in 2023. Everyone deserves the right to adequate, healthy, safe, affordable and culturally appropriate food. People who live with food insecurity cannot afford to buy the food they want and need for good health. Request your PDF copy of the Cost of Eating Healthy report
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Dec 1, 2021 · In fact, FWL makes up almost 60% of the food industry’s environmental footprint. When food ends up in a landfill, it creates a methane gas that is 25 times more damaging to the environment than carbon dioxide. 5. $49.46 billion is the annual cost of FWL in Canada. Based on the consumer value of food, the total avoidable food waste and loss
