Substance Use

Opioid, tobacco, alcohol, and cannabis use in Canada

Substance use includes legal and illegal drugs. Alcohol, tobacco, and cannabis are the most widely used recreational substances in Canada. They are legal for adults, subject to regulation. A separate and important public health issue is the toxic illegal drug supply. Potent opioids have contributed to high rates of accidental opioid poisoning and death across Canada. This page first compares patterns of alcohol, tobacco, and cannabis use across peer countries and age groups, then examines the opioid-toxicity crisis.

Tobacco, alcohol, and cannabis

Most substance use involves legal substances. Against peer countries, Canada has one of the lowest tobacco-use rates and sits near the middle of the pack on alcohol. Use the Substance menu to switch between them; the two use different units, so the y-axis rescales when you switch.

Within Canada, the picture varies sharply by age. This chart shows the share of Canadians who report using each substance, by age group. Use the Substance menu to switch. Cannabis was added to the national survey only after legalization in 2018, so its line begins in 2019/2020.

The opioid-toxicity crisis

The overdose crisis is a severe public-health emergency, and was one of the drivers of the 2020–2022 decline in life expectancy. Since national surveillance began in 2016, tens of thousands of people have died from the acute toxicity of opioids. These are increasingly from an illegal drug supply contaminated with fentanyl and other drugs. The charts below track that impact: how it has grown, where it falls hardest, who it affects, and how the supply has changed.

The scale of the crisis

Deaths rose from about 2,800 in 2016 to a peak of roughly 8,000 in 2023, and have declined since. The bars show the number of deaths each year; the line shows the rate per 100,000 people, which removes the effect of a growing population.

A geography of risk

The crisis is not evenly spread. British Columbia has a death rate more than double the national figure. Alberta, Saskatchewan, Manitoba, and Yukon also sit above the national rate. Quebec and the Atlantic provinces are lower. National surveillance is reported only at the province and territory level, so this is the most detailed geographical breakdown available. The dashed line marks the Canada-wide rate.

Who is dying

About three in four of the deaths are men, largely in their 20s through their 50s. The chart shows deaths by age group and sex for the latest complete year.

A poisoned, volatile supply

What makes the recent years so deadly is the drug supply itself. Fentanyl, a synthetic opioid roughly 100 times stronger than morphine, was detected in about half of deaths in 2016. This rose to more than four in five by the early 2020s. Deaths also increasingly involve a stimulant such as cocaine or methamphetamine. This uncertainty in the composition of the drug has led to overwhelmingly accidental poisonings. (Toxicology for the most recent year is still being completed, so its shares are preliminary.)

Hospitalizations due to opioids

Opioid poisoning hospitalizations are another form of acute harm. Both are shown here as rates per 100,000 so they sit on the same scale.

About this data

  • Everyday-use figures are self-reported. The tobacco and alcohol peer comparison is from the World Bank / WHO Global Health Observatory. The by-age figures come from Statistics Canada’s Canadian Community Health Survey (table 13-10-0972), pooled into two-year periods and covering ages 18 and over (no 12–17 youth). “Heavy drinking” is the survey threshold (5+ drinks for men / 4+ for women on one occasion, at least monthly); cannabis is any use in the past 12 months.
  • What the opioid figures count. “Apparent opioid-toxicity deaths” are deaths caused by the acute toxicity of one or more opioids, as determined by coroners and medical examiners. Because investigations take time, the figures are dynamic — the most recent quarters are preliminary and are revised upward as cases are confirmed. A partial year (January–September) is shown only where noted.
  • Opioid rates are crude, not age standardized, and use July population estimates as the denominator. Hospitalizations exclude Quebec, which does not report on the same basis; the death figures are nationwide.
  • Stimulants. This page focuses on opioids; the same federal dataset also tracks stimulant-toxicity harms, which have risen sharply in parallel.
  • The opioid data are released quarterly under the Open Government Licence – Canada, and this page refreshes with them. The self-reported survey rates aren’t comparable with the coroner-confirmed opioid-death counts.

Download data