Opioid-related deaths dropped in Toronto in 2022, expert says more robust response to crisis needed

Toronto saw a drop in opioid-related deaths in 2022 compared to the previous year, but one expert says there still needs to be a more robust response to the opioid crisis.

There were 499 "confirmed and probable" opioid-related deaths in the city in 2022, which marks 94 fewer than the 593 recorded in 2021, according to City of Toronto statistics.

The numbers for the three previous years are as follows:

• 2018: 309 deaths.
• 2019: 296 deaths.
• 2020: 545 deaths.

Meanwhile, there have been 181 probable and suspected overdose-related deaths recorded in Toronto between January and April of this year, relating to any drugs.

Michael Parkinson, a drug strategy specialist with the Drug Strategy Network of Ontario, says it is not yet clear what might be behind the decrease in overall deaths last year.

"What might be behind it is the ending of COVID restrictions, for sure. That had serious consequences for service provision. It had serious consequences in the drug markets in terms of manufacturing, distribution and supply," Parkinson said on CBC Radio's Metro Morning Monday.

But Parkinson said it could also "just be a fluke," so it's worth waiting to see if the downward trend continues in 2023.

He said if the fatalities for the first four months of 2023 remain constant throughout the year, Toronto will likely see a decrease in deaths compared to 2022, 2021 and 2020. However, he said "nothing is constant in an unregulated drug market, and the number of deaths will remain higher [compared to] pre-COVID periods, and compared to other causes of acute death."

'A really robust response' needed

According to Parkinson, the opioid crisis has not received the same kind of urgent and proportional response as other crises.

"We've seen a really robust response with COVID. I think that's what many of my colleagues in the [Greater Toronto Area] and beyond would like to see with this crisis, because there is no indication that that unregulated market will become healthier or safer," he said. 

"My network and others across Canada have been calling for a really robust response in terms of mitigation measures [like] Naloxone and consumption services, and something more upstream like safe supply. That's the first rule in public health — removing the source of the poison."

In the long term,  Parkinson said there needs to be action on recommendations that have been built up in government quarters over decades that would prevent or delay the onset of substance use among young people.

The City of Toronto opened its first permanent supervised consumption service in August of 2017. Located inside The Works, the city says this service provides a safer and hygienic environment for people to inject pre-obtained drugs under the supervision of qualified staff.

There are more than a dozen such sites operating across the province.

There were 16,751 opioid-related deaths in Ontario from January 2018 to April 2023.

According to Parkinson, the majority of the deaths remain preventable, are accidental, include an opioid, involve more than one substance, occur in private residences, and occur among males.

He said there is no indication that unregulated drug markets will become safer or healthier in 2023, or that interventions proven to reduce death and injuries are being expedited quickly enough.