National numbers don’t tell the whole story: Nova Scotia’s overdose deaths are rising

In 2024, the number of opioid-related deaths in Canada dropped by 17% compared with the previous year. Some factors contributing to the decline include changes in the unregulated toxic drug supply, naloxone availability and a decrease in the size of the population at risk of overdose. However, it’s crucial to recognize that although this national figure is encouraging, too many lives are still being lost. The number of opioid-related deaths remains extremely high compared with the period before synthetic opioids became widespread in the drug supply.

These synthetic opioids include fentanyl and nitazenes, which are often mixed with synthetic benzodiazepines. Fentanyl is a synthetic opioid that can be about 50 times more potent than heroin. It has been used in medical clinical procedures since the 1960s, but it has made its way into the unregulated market and has drenched the regular street supply of heroin with an unpredictably strong drug that is killing people at alarming rates.

The national decline (17%) in opioid-related deaths last year doesn’t tell the full story. While some provinces and territories have reported declines in the number of opioid toxicity deaths, the number of deaths has actually increased in other parts of the country, including Quebec, Newfoundland and Labrador, and the Northwest Territories. Quebec reported 645 deaths in 2024, up from 536 in 2023; Newfoundland and Labrador saw 45 deaths, up from 37; and the Northwest Territories reported six deaths, up from three.

I was born and raised in Nova Scotia, and I continue to live and work here. I have worked at almost every harm reduction service and agency in the province. Although there was a slight dip in opioid toxicity deaths from 2023 to 2024 in Nova Scotia, in 2025 we had the highest number of deaths ever recorded. Despite our best efforts, we still had 78 opioid toxicity deaths in 2025, more than in any other previous year.

But opioid use is not the only cause of drug toxicity deaths; we also had a high number of deaths from stimulant and/or polysubstance use. In Nova Scotia, the number of deaths related to use of cocaine and other stimulants such as methamphetamines continues to increase.

As someone who has lived through the challenges of drug use for most of my adult life and has lost countless friends, including my former partner, the love of my life, I understand the severe impact that the toxic drug crisis has had on our communities. The crisis continues to affect too many people in Canada. Too many people have died, and too many families will never be the same. Too many people remain at risk. We must stay vigilant in our efforts to support those struggling with substance use and to prevent further tragedies.

I lost my partner to an overdose last year. She was so young, funny and beautiful. She was full of life but was never given a chance to reach her full potential. She taught me how to accept myself as a drug user, even though she could be hard on me at times. I think about her every day and hope she would be proud that I finally got off all drugs for over six months. I used to blame myself for her death and would switch places with her in a heartbeat. That’s either a poor choice of words or a fitting one, but it’s how I feel.

The toxic drug crisis is a product of a criminalized landscape that allows drug manufacturers to continue to cut and contaminate drugs with deadly synthetic drugs to maximize their profits without any concern for their customers.

In response, Nova Scotia has a drug alert email list that shares reports from the community about toxic drugs in the unregulated supply and reports from the Royal Canadian Mounted Police about potentially harmful drugs seized by the police. Emails sent out through this service include a little bit about each drug, such as what it was sold as, where it was sold and unusual symptoms from the drugs, and sometimes a picture is provided as well. Everyone on the email list also has access to Nova Scotia drug mortality data.

There are two supervised consumption sites in Nova Scotia: one in the North End of Halifax called ReFIX and one in Sydney, Cape Breton, called Peer Six. I helped open ReFIX, Atlantic Canada’s first overdose prevention site in Halifax, which is still operating today in the basement of our local community-based opioid agonist therapy (OAT) clinic. I used to be a regular client of the site, and it saved my life many times. The last time I overdosed there was last year. I had fentanyl I purchased from British Columbia. I remember drawing it up the syringe and noticing that it looked dark and potent. I still almost went ahead and injected it in my leg, but I decided to wait until the site opened.

I will forever be grateful for safe and supervised consumption facilities. They keep people alive.

We need more innovative, creative and effective life-saving harm reduction services as the toxic drug supply continues to worsen, even though the number of overdose deaths is declining nationally. Urgent action is needed to strengthen and protect harm reduction services, including supervised consumption facilities, or else more provinces are going to start seeing a further escalation in deaths driven by the toxic drug supply.

People who use drugs don’t deserve to die because of the substances they use. They deserve access to care and serenity through treatment, harm reduction and safe supply.

Talk is cheap. It’s time for action.

Matthew Bonn is a board member with International Network on Health and Hepatitis in Substance Users, a drug culture advisor with Changemark Research & Evaluation and the social media editor for the International Journal of Drug Policy. He was previously the program manager with the Canadian Association of People Who Use Drugs. Matthew’s freelance writing has appeared in publications including The Conversation, Doctors Nova Scotia, Policy Options and The Coast. He was also on the 64th Canadian delegation to the Commission on Narcotic Drugs. He is a current drug user and a formerly incarcerated person.