To reduce the risks and harms associated with opioid use, it is crucial to understand its health and social impacts. To this end, CCSA collaborates with partners to gain a better understanding of the risks and harms of opioid use and supports evidence-based decisions about opioid policy and practice. CCSA also recognizes that interventions for opioid-related harms must address the broader context of polysubstance use and meet the specific needs of different groups and communities.
What Are Opioids?
Opioids are available in both pharmaceutical and non-pharmaceutical forms. Common opioid pharmaceutical medications, such as codeine, fentanyl, morphine, oxycodone and diacetylmorphine, are primarily used to treat pain. However, people may also use these products for non-medical purposes. Fentanyl and fentanyl analogues of non-pharmaceutical origin are illegally manufactured and are the most widely available opioids in Canada's unregulated drug supply.
Most harms associated with opioids are caused by synthetic opioids, such as fentanyl and to a lesser extent nitazenes, which can be consumed unknowingly through the unregulated drug supply. The presence of these opioids in other substances significantly increases the risk of drug toxicity deaths, as they are extremely potent and can be fatal, even in small amounts.
About the Opioid Toxicity Crisis
The opioid toxicity crisis in Canada has evolved, and the factors that contribute to it are complex and multifaceted. Factors that once played a central role, such as high levels of prescription opioid use and diversion, no longer have as significant an impact. The current crisis is influenced by several factors, including:
- Psychological, social and biological risk factors, such as genetics, adverse childhood experiences, trauma, mental health, poverty, lack of secure housing and other social determinants of health;
- The lack of a comprehensive spectrum of care, including harm reduction and treatment services, that can respond to an individual's physical, mental health and social needs in a timely manner;
- The unpredictable dose and contents of fentanyl from the unregulated drug supply, which can lead to increased risk of drug poisoning and other harms from contaminants like synthetic opioids and non-medical benzodiazepines;
- Disruptions to the drug supply during the COVID-19 pandemic, which led to increased toxicity combined with reduced access to supports and services;
- Unintentional polysubstance exposure from the unregulated drug supply and intentional polysubstance use that includes use of opioids with stimulants;
- Stigma toward those who use substances or are living with substance use disorders;
- Lack of access to prescription opioids, leading individuals to use opioids from the unregulated drug supply;
- Lack of awareness or access to alternative treatments for pain; and
- Use of opioids diverted from friends’ and family members’ prescriptions.
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Guidance, Tools and Resources
CCSA produces research-based publications, tools, and resources to support evidence-based decision-making on substance use health issues. Select your area of interest from the categories below to learn more:
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Substances
CCSA produces a variety of substance use- and addiction-related publications for researchers, policy makers and health service providers. We provide guidance to decision makers through harnessing the power of research, collecting and organizing knowledge, and bringing together diverse perspectives.
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Health and Public Safety
CCSA conducts research, develops tools and resources, and produces targeted materials to support evidence-based decisions and public policy. Review our key resources on health and public safety in relation to substance use health and addiction issues.
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People and Communities
CCSA is dedicated to the health and well-being of individuals and communities, focusing on the impact of substance use across the lifespan, the perspectives of people with lived experience, and the roles of stigma, sex and gender, and educators in substance use health.
