Measures of fentanyl consumption in the wastewater of Canadian cities, January 2022 to November 2023
Released: 2024-09-06
Drug use in Canada has become a significant public health concern, with opioid use, addiction, and resulting deaths standing out as particularly pressing issues. In the context of the ongoing opioid crisis in many parts of Canada, wastewater data can provide information to contribute to a better understanding of current drug use and emerging trends.
The Canadian Wastewater Survey (CWS) measures the levels of 10 different drugs—including opioids such as fentanyl—in the wastewater of selected Canadian cities. The latest data from the CWS can now be accessed through a new interactive dashboard entitled "Levels of Drugs in the Wastewater of Canadian Cities"; this includes new data, released today, for the months of July, September and November 2023.
This dashboard allows users to explore the monthly CWS data from the participating municipalities of Halifax, Montréal, Toronto, Saskatoon, Prince Albert, Edmonton and Metro Vancouver.
Norfentanyl is one notable example of a substance that has been measured in wastewater across Canada. Norfentanyl is a byproduct of fentanyl breakdown in the body that can be detected in wastewater to estimate fentanyl consumption (see Note to readers). Fentanyl is an opioid drug of particular concern, as it was implicated in more than 80% of apparent accidental opioid toxicity deaths in 2023, according to the Public Health Agency of Canada.
Norfentanyl levels highest in Metro Vancouver in 2022 and 2023 compared with other participating cities
Wastewater data showed that levels of norfentanyl were four to five times higher in Metro Vancouver compared with all other participating cities throughout 2022 and 2023. However, from January to September 2023, norfentanyl levels declined steadily. Further, although the most recent data indicate a large increase in norfentanyl levels from September to November 2023 (the reason for which is currently unknown), they were at or below those seen in late 2022. Meanwhile, data from the British Columbia Coroner Service show that the proportion of deaths involving fentanyl (or similar drugs known as analogues) in Vancouver was similar in 2022 and 2023.
Infographic 1
Average daily values of load per capita of norfentanyl in the wastewater of Metro Vancouver in 2022 and 2023
Toronto and Edmonton had next-highest levels of norfentanyl in 2022 and 2023
Toronto and Edmonton also had higher levels of norfentanyl in 2022 compared with most other participating cities, though they were well below levels in Metro Vancouver. Although, like Metro Vancouver, the most recent data for Toronto and Edmonton for 2023 show that levels were at or below those seen in 2022. Data for Toronto also indicate that deaths due to opioid toxicity were similar in 2022 and 2023.
Infographic 2
Average daily values of load per capita of norfentanyl in the wastewater of Toronto in 2022 and 2023
Infographic 3
Average daily values of load per capita of norfentanyl in the wastewater of Edmonton in 2022 and 2023
Norfentanyl levels were very low in Halifax, Montréal and Saskatoon in 2023
Norfentanyl levels in the other participating cities—Halifax, Montréal and Saskatoon—were well below the levels seen in Edmonton, Toronto and Metro Vancouver in 2023. For Halifax and Montréal, levels were low in 2022 as well. For Saskatoon, this represents a notable decrease compared with 2022, when levels were more like those seen in Edmonton and Toronto.
Fentanyl is just one of many drugs, including other opioids like oxycodone and stimulant drugs like cocaine and methamphetamine, that have been contributing to the ongoing drug crisis in Canada. Further in-depth analyses of the levels of these and other drugs in wastewater from the CWS, alongside data on hospitalizations, deaths and crime-related statistics, will provide greater insights on drug use in Canada.
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Note to readers
The table published today includes the monthly estimates of average daily load per capita for 10 substances of interest in seven Canadian cities (Metro Vancouver, Edmonton, Toronto, Montréal, Halifax, Prince Albert [Saskatchewan] and Saskatoon) totalling approximately 9 million people. The substances include stimulants (cocaine, measured through its metabolite benzoylecgonine, amphetamine, methamphetamine and ecstasy), opioids (codeine, fentanyl, measured through its metabolite norfentanyl, methadone, morphine and oxycodone) and cannabis, measured through its metabolite THC-COOH. Data from Prince Albert were not included in this release due to a pause in wastewater collection after May 2023. Data from January, March and May 2023, released in November 2023, have been updated according to 2023 population growth estimates.
The wastewater-based approach can provide data that are unbiased, cost-effective and anonymous, with a low response burden to the wastewater treatment plants and, consequently, no response burden to residents within the wastewater treatment plant catchment area. This information can help inform more targeted public health responses and law enforcement activities.
Wastewater samples were collected from the influent of wastewater treatment plants for seven consecutive days during the second week of every month. Results for 2023 were collected in the months of January, March, May, July, September and November. The daily samples were analyzed at the Health Canada Regulatory Operations and Enforcement Branch laboratory in Toronto. Laboratory results and population estimates for each region were then combined to estimate the daily average of drug loads per capita for each month in each municipality.
There are important limitations on the analysis and interpretation of estimates from wastewater samples (many of which have been previously described in the report "Wastewater-based estimates of cannabis and drug use in Canada: Pilot test detailed results"). Given these limitations, results are described as having increased, decreased or stabilized. Stabilized is defined as the lack of substantial increase or decrease. As such, these results should be interpreted with caution. Some of the measured values may include laboratory measurement errors that lead to wrongly quantifying the drug levels. The effects of certain other factors, such as differences in the size and configuration of sewer shed systems or the stability of the drugs in the wastewater and in the stored samples, may affect the comparability of the results, and they are still being investigated. Furthermore, it should also be noted that, while the Canadian Wastewater Survey also measured many drugs in wastewater in 2019 and 2020, the results are not directly comparable with the results for 2022 and 2023 due to a change in analytical methodology in the laboratory. Data for 2021 are not available.
Products
The dashboard "Levels of Drugs in the Wastewater of Canadian Cities" presents provisional monthly estimates of the levels of amphetamine, cannabis, cocaine (benzoylecgonine), codeine, fentanyl (norfentanyl), ecstasy, methadone, methamphetamine, morphine and oxycodone in the wastewater of Halifax, Montréal, Toronto, Saskatoon, Prince Albert, Edmonton and Metro Vancouver.
Contact information
For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; infostats@statcan.gc.ca) or Media Relations (statcan.mediahotline-ligneinfomedias.statcan@statcan.gc.ca).
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