Drug overdoses in Quebec are on the rise, and the problem could get worse

CBC

17-06-2025

This is the first of two articles that will focus on the issue of drug overdoses in Quebec, where the situation is heading and what needs to be done to curb this trend.
The 911 caller was in a state of shock.
A little after 4 p.m. on Sunday Sept. 10, 2023, the caller stumbled upon a group of five people and most of them, if not all, looked either unconscious or dead.
According to Urgences- santé 's call records, the first team of paramedics arrived at the corner of Ontario and St-Dominique streets in downtown Montreal in two minutes and four seconds. At least four more ambulances and two advanced-care emergency vehicles followed soon after.
There was also a supervisor on site to help manage the chaos.
The final tally: six overdoses — not five — and two of them were fatal.
A scene like this one is rare.
"What we usually notice is multiple 911 calls from the same sector in a relatively short time frame, like less than 12 hours," said Jean-Pierre Rouleau, the spokesperson for Urgences-santé, the paramedic service that covers the island of Montreal and Laval.
Sindy Wabanonik, a 42-year-old mother of three, is one of the two women who died.
She was among the 536 people reported to have died after a confirmed or suspected overdose in Quebec in 2023.
In 2024, Quebec had its highest single-year total ever: 645 drug overdose deaths. That's about 53 people per month.
There is a growing concern that the province's bout with toxic drugs is only going to get more difficult and that not enough is being done to curb this trend.
"My concern is that we are very much in the early stages of what's going to become a much greater problem that will increase if we don't radically shift the way that we address this issue," said Sarah Larney, a researcher and associate professor at Université de Montréal.
'Not a trajectory that comes down quickly'
Larney says Quebec "has largely been sheltered from the worst of the overdose epidemic in Canada."
In April 2016, the province of B.C. declared a public health emergency after more than 200 people had died in less than four months.
In all of 2017, Quebec recorded 181 cases of people dying after confirmed or suspected drug overdose, according to data from the province's public health institute, the Institut national de santé publique du Québec (INSPQ). In 2018, that total more than doubled, with 424 deaths.
The next significant spike came after the start of the COVID-19 pandemic.
At first glance, the death tolls in Quebec pale in comparison to the ones in provinces like B.C. and Alberta. But fatal drug overdoses are trending downward across much of North America while Quebec is heading in the opposite direction.
"We've seen from those other provinces that this is not a trajectory that comes down quickly," said Larney, who co-authored a 2024 study that looked into whether Quebec had entered a new era of drug-related deaths.
Larney acknowledged the reasons behind the increase in deaths in Quebec can be difficult to pinpoint. She said drugs like fentanyl appear to have travelled from west to east since the start of the pandemic, enabling different drug-trafficking players to get involved.
As the number of drug overdose deaths in the province increased, so has the number of emergency room visits for patients who appeared to have consumed opioids.
According to INSPQ data, the total in 2016 was 1,095. In 2024, it was 1,954.
The portrait has changed
Experts have remarked that the pandemic caused borders to shut down, meaning there were less drugs coming in, including the cocaine necessary to produce crack.
Drug dealers looking to maximize profits despite their depleted cocaine supply started lacing crack with opioids like fentanyl, which are used for pain management but are also highly addictive and potent.
Martin Rivest, a veteran in outreach work, has seen firsthand the change in drug consumption patterns in and around Montreal over the years and the devastation caused by toxic drugs.
"There are moments where there are people you're used to seeing on the street that you just don't see anymore," said Rivest, who works with the Association Québécoise pour la promotion de la santé des personnes utilisatrices de drogues (AQPSUD), a group that advocates for the health and safety of drug users.
"And it's like 'hey, we haven't seen that person. Have you heard any news?' That's how it goes. It's a lot of word of mouth. A lot of times, they're dead unfortunately."
Andréane Desilets has been the executive director of Maison Benoît Labre in Montreal — now the site of a safe drug consumption site — for nearly a decade. She remembers a time when people coming in with signs of overdosing was rare, about a few times per year.
She said once the pandemic hit, overdoses were often "an everyday thing."
In many cases, Desilets said, the people intoxicated weren't aware that the drugs they used had opioids.
"The portrait from 10 years ago, even five years ago, is so different from what it is nowadays," she said.
"The only thing we're seeing is numbers going up and up and up because we don't have what it takes. We don't have the system that it takes."
WATCH | Reaction to bill that aims to keep safe drug consumption sites away from schools:
Some living near safe consumption site in Montreal say new proposed rules don't ease their concerns
1 month ago
Duration 2:22
Bill 103, tabled by the CAQ government, would limit how close safe drug use sites can be to schools and daycares. But parents living near the Maison Benoît Labre in the Sud-Ouest borough say the bill doesn't solve the immediate problems they're facing. Meanwhile, groups that run these sites worry the new rules would make it more difficult to help those in need.
Last month, Montreal Public Health put out a notice warning people of four recent overdose cases involving carfentanil, a synthetic opioid 100 times more powerful than fentanyl.
Rouleau, the spokesperson for Urgences-santé, stresses the importance of not using drugs when you're alone, and preferably having a visible naloxone kit in your possession.
Referring to the six simultaneous overdoses in 2023, Rouleau said: "If these people had consumed the drugs somewhere isolated and no one would've noticed, then maybe the ending would've been way worse."
'1 relapse and that's what happens'
Wabanonik, one of the women who died after that incident, grew up in the Anishinaabe community of Lac Simon in the Abitibi region, about 500 kilometres north of Montreal.
She was the youngest of eight siblings and, like her own children, she lost her mother at a young age — around eight years old.
"She really missed her mom at that age," said Lucien Wabanonik, Sindy's brother, who is also the chief of the Anishinaabe Council of Lac Simon.
"It's crucial that we have that connection with the family and the transmission [of culture], very often, even the majority of the time, it's our mothers that give the culture and the language."
He describes his little sister as an open-minded, outgoing and easy-to-approach person. He knew she had been using drugs going back to her teenage years. He said however that prior to her death, she had gone a few months without using.
"And then one relapse and that's what happens," he recalled. "It's still very hard. It's still fresh in our memory."
The Anishinaabe chief, and others who knew his sister and spoke to Radio-Canada in the last year, believe someone should be held criminally responsible for her death.
Her death was at the centre of three investigations: one by Montreal Public Health and the others by Montreal police and the coroner's office. They've produced very few answers at this point.
In a statement to CBC News last month, a spokesperson for the public health agency said it did not reach "clear conclusions."
"It was not possible for our teams to have access to the substance, allowing us to identify a single source for those intoxications," reads the statement from spokesperson Geneviève Paradis.
Nearly two years after Wabanonik's death, the Quebec coroner's office said its investigation is still not complete.
As for Montreal police, they say their investigation is closed. No arrests were made.
Falling on deaf ears
By speaking out about his sister's passing, Chief Wabanonik is hoping to bring more light to the plight of drug users across Canada.
"We need to understand that those people who live in those situations, they were not always in that situation, and they tried to get out but there's a lack of help."
One of the next steps: getting a sense of how the situation is playing out so far in 2025.
WATCH | How to use naloxone to help someone:
How to administer naloxone if you witness an overdose
2 years ago
Duration 2:28
Sarah Kozusko of Regina's Queen City Wellness Pharmacy gives step-by-step instructions on how to use naloxone to potentially save a life after an overdose.
The INSPQ is expected to publish data on overdose deaths from this year's first trimester some time this month.
As Larney, the associate professor, puts it: "There's a lot of people on the ground who are making a lot of noise, but it's not having much impact with people who can make changes."