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Canadian Centre on Substance Use and Addiction

The Canadian Community Epidemiology Network on Drug Use (CCENDU) produces alerts and bulletins on topics of immediate concern using sources ranging from scientific literature and news reports to observations from people who use drugs and those who work with people who use drugs.

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Latest Publication 

This alert provides preliminary insights into the impact of the COVID-19 pandemic on the Canadian illegal drug supply and the provision of direct services, and the associated health impacts for people who use drugs. It was developed in response to indications that COVID-19-related disruptions to the drug market could pose significant health risks to people who use drugs. Data were compiled from multiple sources across Canada between March 31 and May 10, 2020.

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Past Alerts and Bulletins

Adulterants, Contaminants and Co-occurring Substances in Drugs on the Illegal Market in Canada (April 2020)

Adulterants, Contaminants and Co-occurring Substances in Drugs on the Illegal Market in Canada


Drugs bought and sold on the illegal market are unregulated, unpredictable and often contaminated with substances in addition to, or instead of, those intended, which increases the probability of drug-related poisoning and other health threats. This bulletin provides a snapshot of drug contents on the illegal market in Canada using 2018–2019 data from drug seizures, drug checking services and a drug content monitoring study. It is accompanied by a technical report that explains the research methods used and provides more detailed findings.

Changes in Stimulant Use and Related Harms: Focus on Methamphetamine and Cocaine (April 2019)

Changes in Stimulant Use and Related Harms: Focus on Methamphetamine and Cocaine


In response to reports of increasing harms related to methamphetamine use in Canada, this bulletin summarizes recent changes in stimulant-related harms in Canadian communities. It includes reports from municipalities, provinces and territories describing notable trends in stimulant use, levels of concern and local responses.

Drug Trends and Related Harms at Canadian Music Festivals (August 2017)

Drug Trends and Related Harms at Canadian Music Festivals


This bulletin provides a snapshot of drug use trends, drug risks and lessons learned emerging from Canadian music festivals between May 1, 2017, and July 31, 2017. This information can be used to inform efforts to safeguard attendees at subsequent festivals.

Calling 911 in Drug Poisoning Situations (March 2017)

Calling 911 in Drug Poisoning Situations


This bulletin provides the first Canadian estimates on rates of calling 911 in drug poisoning situations. People trained to administer naloxone and who had used a naloxone kit to treat an overdose did not call 911 in 30% to 65% of cases. The bulletin recommends that anyone distributing naloxone to laypeople emphasize that calling 911 in drug poisoning incidents is critical.

Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs (June 2016)

Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs


This bulletin aims to outline the implications of newer synthetic opioids for frontline workers and those working in related fields. This bulletin includes information on W-18, although emerging evidence calls into question whether W-18 is an opioid. 

The Availability of Take-Home Naloxone in Canada (March 2016)

The Availability of Take-Home Naloxone in Canada


This bulletin describes the availability of take-home naloxone programs in Canada and the steps required to make naloxone available without a prescription. It notes that access to naloxone, a drug used to temporarily reverse the effects of opioid overdose, is only one part of an overdose prevention strategy, which should also include overdose prevention education, training and services.

Deaths Involving Fentanyl in Canada, 2009–2014 (August 2015)

Deaths Involving Fentanyl in Canada, 2009–2014


This bulletin reports on the marked increase in the number of deaths involving fentanyl in Canada between 2009 and 2014, with data collected from 12 participating provinces and territories. During this period, deaths involving fentanyl increased significantly in Canada’s four largest provinces, ranging from almost doubling to an increase of over 20 times.

Fentanyl-related Overdoses (February 2015)

Fentanyl-related Overdoses


This alert is to advise that, as of February 6, 2015, there continues to be reports of fatal and non-fatal overdoses that are suspected or confirmed to involve non-pharmaceutical (illicit) fentanyl. Most overdoses appear to be in individuals who thought they were using heroin, oxycodone, cocaine or another substance, but have mistakenly taken fentanyl.

Drug-related Harms at Canadian Music Festivals (September 2014)

Drug-related Harms at Canadian Music Festivals


This bulletin addresses drug-related deaths and illnesses that occurred at Canadian music festivals during the summer of 2014. The bulletin issues a call for additional information and announces the assembly of a group of experts to develop recommendations for preventing, preparing for and responding to drug-related overdoses at large festivals.

Synthetic Cannabinoids (March 2014)

Synthetic Cannabinoids


This bulletin contains an overview of synthetic cannabinoids and their presence in Canada.

Increasing Availability of Counterfeit Oxycodone Tablets Containing Fentanyl (February 2014)

Increasing Availability of Counterfeit Oxycodone Tablets Containing Fentanyl


This alert is to advise that counterfeit oxycodone (popular brand name OxyContin®) pills containing fentanyl have become increasingly available in several Canadian communities. The presence of fentanyl in these counterfeit pills increases the risk of overdose among people using them. 

No Confirmed Reports of Desomorphine (“Krocodil”/“Crocodile”) in Canada (November 2013)

No Confirmed Reports of Desomorphine (“Krocodil”/“Crocodile”) in Canada


This bulletin finds that, as of November 21, 2013, there have been no confirmed reports of desomorphine in Canada or the United States. Unconfirmed reports might have resulted from the observation of severe wounds at injection sites among drug users.

Illicit Fentanyl (July 2013)

Illicit Fentanyl


This alert notes that reports from Canada and the United States indicate that illicit fentanyl produced in clandestine laboratories, rather than diverted prescription-grade fentanyl, has been appearing for sale on the streets.

Misuse of Opioids in Canadian Communities (May 2013)

Misuse of Opioids in Canadian Communities


This bulletin provides a series of short snapshots describing opioid misuse and local responses in Vancouver, Saskatoon, Winnipeg, Toronto, Ottawa and St. John’s.

Bath Salts (June 2012)

Bath Salts


This alert provides information on a new and emerging synthetic amphetamine-type drug referred to as “bath salts.”  


Past Alerts and Bulletins

Adulterants, Contaminants and Co-occurring Substances in Drugs on the Illegal Market in Canada (April 2020)

Adulterants, Contaminants and Co-occurring Substances in Drugs on the Illegal Market in Canada


Drugs bought and sold on the illegal market are unregulated, unpredictable and often contaminated with substances in addition to, or instead of, those intended, which increases the probability of drug-related poisoning and other health threats. This bulletin provides a snapshot of drug contents on the illegal market in Canada using 2018–2019 data from drug seizures, drug checking services and a drug content monitoring study. It is accompanied by a technical report that explains the research methods used and provides more detailed findings.

Changes in Stimulant Use and Related Harms: Focus on Methamphetamine and Cocaine (April 2019)

Changes in Stimulant Use and Related Harms: Focus on Methamphetamine and Cocaine


In response to reports of increasing harms related to methamphetamine use in Canada, this bulletin summarizes recent changes in stimulant-related harms in Canadian communities. It includes reports from municipalities, provinces and territories describing notable trends in stimulant use, levels of concern and local responses.

Drug Trends and Related Harms at Canadian Music Festivals (August 2017)

Drug Trends and Related Harms at Canadian Music Festivals


This bulletin provides a snapshot of drug use trends, drug risks and lessons learned emerging from Canadian music festivals between May 1, 2017, and July 31, 2017. This information can be used to inform efforts to safeguard attendees at subsequent festivals.

Calling 911 in Drug Poisoning Situations (March 2017)

Calling 911 in Drug Poisoning Situations


This bulletin provides the first Canadian estimates on rates of calling 911 in drug poisoning situations. People trained to administer naloxone and who had used a naloxone kit to treat an overdose did not call 911 in 30% to 65% of cases. The bulletin recommends that anyone distributing naloxone to laypeople emphasize that calling 911 in drug poisoning incidents is critical.

Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs (June 2016)

Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs


This bulletin aims to outline the implications of newer synthetic opioids for frontline workers and those working in related fields. This bulletin includes information on W-18, although emerging evidence calls into question whether W-18 is an opioid. 

The Availability of Take-Home Naloxone in Canada (March 2016)

The Availability of Take-Home Naloxone in Canada


This bulletin describes the availability of take-home naloxone programs in Canada and the steps required to make naloxone available without a prescription. It notes that access to naloxone, a drug used to temporarily reverse the effects of opioid overdose, is only one part of an overdose prevention strategy, which should also include overdose prevention education, training and services.

Deaths Involving Fentanyl in Canada, 2009–2014 (August 2015)

Deaths Involving Fentanyl in Canada, 2009–2014


This bulletin reports on the marked increase in the number of deaths involving fentanyl in Canada between 2009 and 2014, with data collected from 12 participating provinces and territories. During this period, deaths involving fentanyl increased significantly in Canada’s four largest provinces, ranging from almost doubling to an increase of over 20 times.

Fentanyl-related Overdoses (February 2015)

Fentanyl-related Overdoses


This alert is to advise that, as of February 6, 2015, there continues to be reports of fatal and non-fatal overdoses that are suspected or confirmed to involve non-pharmaceutical (illicit) fentanyl. Most overdoses appear to be in individuals who thought they were using heroin, oxycodone, cocaine or another substance, but have mistakenly taken fentanyl.

Drug-related Harms at Canadian Music Festivals (September 2014)

Drug-related Harms at Canadian Music Festivals


This bulletin addresses drug-related deaths and illnesses that occurred at Canadian music festivals during the summer of 2014. The bulletin issues a call for additional information and announces the assembly of a group of experts to develop recommendations for preventing, preparing for and responding to drug-related overdoses at large festivals.

Synthetic Cannabinoids (March 2014)

Synthetic Cannabinoids


This bulletin contains an overview of synthetic cannabinoids and their presence in Canada.

Increasing Availability of Counterfeit Oxycodone Tablets Containing Fentanyl (February 2014)

Increasing Availability of Counterfeit Oxycodone Tablets Containing Fentanyl


This alert is to advise that counterfeit oxycodone (popular brand name OxyContin®) pills containing fentanyl have become increasingly available in several Canadian communities. The presence of fentanyl in these counterfeit pills increases the risk of overdose among people using them. 

No Confirmed Reports of Desomorphine (“Krocodil”/“Crocodile”) in Canada (November 2013)

No Confirmed Reports of Desomorphine (“Krocodil”/“Crocodile”) in Canada


This bulletin finds that, as of November 21, 2013, there have been no confirmed reports of desomorphine in Canada or the United States. Unconfirmed reports might have resulted from the observation of severe wounds at injection sites among drug users.

Illicit Fentanyl (July 2013)

Illicit Fentanyl


This alert notes that reports from Canada and the United States indicate that illicit fentanyl produced in clandestine laboratories, rather than diverted prescription-grade fentanyl, has been appearing for sale on the streets.

Misuse of Opioids in Canadian Communities (May 2013)

Misuse of Opioids in Canadian Communities


This bulletin provides a series of short snapshots describing opioid misuse and local responses in Vancouver, Saskatoon, Winnipeg, Toronto, Ottawa and St. John’s.

Bath Salts (June 2012)

Bath Salts


This alert provides information on a new and emerging synthetic amphetamine-type drug referred to as “bath salts.”  

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