431-00041 (Health)

The Government of Canada is deeply concerned about problematic substance use in Canada, including the ongoing opioid overdose crisis and the devastating impact it is having on the well-being of individuals, families, and communities. Tragically, there were 13,319 apparent opioid-related deaths in Canada between January 2016 and June 2019. 

The Government of Canada is using the broad range of powers at its disposal to address this complex public health crisis.

The Government of Canada is committed to taking a public health approach to substance use through the Canadian Drugs and Substances Strategy.  The Strategy includes four pillars – prevention, treatment, harm reduction and enforcement – and is designed to be comprehensive, collaborative, compassionate and evidence-based.  The Government is placing particular focus on:

• ensuring that life-saving harm reduction measures are available to Canadians who need it;
• working with stakeholders to reduce stigma directed at people who use drugs, which acts as a barrier to accessing critical health and social services and often leads to social isolation;
• working with provinces and territories to improve access to evidence-based treatment options; and
• implementing additional surveillance and research activities that will further build the evidence base and allow us to pursue innovative solutions to this public health crisis. 

The Government of Canada recognizes that the overwhelming majority of deaths caused by the opioid overdose crisis are due to a street drug supply that is contaminated with highly toxic substances, such as fentanyl. The Government is taking a series of actions to address this issue, including:

• funding the development of national guidelines for injectable opioid agonist treatment;
• removing federal regulatory barriers to effective, evidence-based treatment options, including making it easier for health practitioners to prescribe diacetylmorphine and methadone to patients with opioid use disorder, and facilitating community delivery models for opioid agonist treatment;
• allowing the importation of drugs approved in other countries (but not yet in Canada) to address urgent public health needs, including diacetylmorphine for the treatment of opioid use disorder;
• supporting pilot projects to provide pharmaceutical hydromorphone to eligible patients with opioid use disorder in British Columbia; and,
• working with provinces, territories, and stakeholder groups to address this issue and identify what additional steps can be taken.

The Government of Canada has made substantial investments to address the overdose crisis. Recent examples of key federal investments in this area include:

• investing $76.2 million to take action to protect Canadians and prevent overdose deaths. This investment will be used to scale-up key lifesaving measures and increase access to a safer drug supply as an alternative to the contaminated supply. These measures build on the Budget 2019 investment of $30.5 million over five years, with $1 million ongoing, to expand access to safer alternatives to the illegal drug supply and support better access to opioid overdose response training and naloxone in underserved communities;

• providing $231.4 million over five years through Budget 2018 for additional measures to help address the opioid overdose crisis, including a one-time $150 million emergency treatment fund for provinces and territories to improve access to evidence-based treatment services;
• providing emergency funding to British Columbia ($10 million) and Alberta ($6 million) to address the ongoing crisis in these two jurisdictions, plus $5 million in targeted health care funding for Manitoba to assist with priority needs, including their opioid response;
• providing an additional $200 million, with $40 million per year ongoing, to enhance the delivery of culturally appropriate addictions treatment and prevention services in First Nations communities; and,
• allocating $13 million over five years to launch a new national, multi-year public education campaign to help reshape Canadians’ attitudes and perceptions about people who use drugs.

In order to prevent and reduce the harms of problematic substance use, including to enable access to evidence-based treatment and support recovery, the Government has undertaken a broad range of policy, legislative and regulatory actions, including:

• Approving supervised consumption sites (with 40 currently in operation across Canada), and providing class exemptions to facilitate the establishment of overdose prevention sites;
• supporting the passage of the Good Samaritan Drug Overdose Act, which encourages people to call for emergency help at the scene of an overdose by providing protection against simple drug possession charges;
• establishing effective Federal, Provincial and Territorial public health emergency governance, including the Special Advisory Committee on the Epidemic of Opioid Overdoses and the Federal/Provincial/Territorial Assistant Deputy Minister Committee on Problematic Substance Use & Harms;
• collaborating with provinces and territories to better understand the evolving crisis, and undertaking timely monitoring and reporting of opioid-related deaths and harms in Canada;
• deploying public health officers from the Public Health Agency of Canada to support public health surveillance systems in  provinces and territories; and,
• supporting the development and dissemination of national clinical practice guidelines to treat opioid use disorder, which include a recommendation for medication-assisted treatment as a front-line option for patients, through the Canadian Research Initiative in Substance Misuse.

We are focusing on a safer supply and building the evidence base for this public health intervention. The use of pharmaceutical-grade opioids to treat opioid use disorder is an established medical practice, supported by research and peer-reviewed clinical guidance. The federal government has taken steps towards increasing access to pharmaceutical-grade medications, including making prescription opioids used in the treatment of severe opioid disorder more easily accessible to healthcare practitioners, reducing regulatory barriers, and funding national clinical guidelines for the management of opioid use disorders.

Certain programs, sometimes referred to as “safer supply”, build on these established models in an attempt to reach a wider range of people at risk of overdose and create additional pathways to health and social services. The federal government is supporting pilot projects to increase access to pharmaceutical-grade medications as a safer alternative to the contaminated illegal drug supply. As part of its approach, the federal government is also supporting a comprehensive evaluation of the pilot projects to develop valuable evidence on effective service models and help develop best practices.

To protect the health and safety of all Canadians, any prescription-grade medications, including those that may be used in safer supply programs, may only be provided with the appropriate oversight of a qualified healthcare provider (e.g., a physician or a nurse practitioner), as per the parameters of the Controlled Drugs and Substances Act and its regulations, as well as applicable provincial, territorial, and professional regulatory requirements.

In Canada, our circumstances require that we undertake a comprehensive and collaborative approach across all provinces and territories.  No single organization or level of government alone can solve the opioid overdose crisis.  All levels of government, a wide range of stakeholders and all Canadians who are impacted by opioid use must work together to reduce opioid-related overdoses and deaths, and improve the health and well-being of Canadians who use drugs.

Through the Canadian Drugs and Substances Strategy, the Government of Canada remains firmly committed to addressing all forms of problematic substance use with a public health approach that is comprehensive, collaborative, compassionate, and evidence based.