The Decibel - Why are drug deaths rising in Edmonton, but falling elsewhere?

Episode Date: May 11, 2026

Canada has seen a decline in deaths related to drug overdose the past two years. But the reality at the local level is a little more complicated. In some cities, like Edmonton, this rate is increasing. The city saw its deadliest year for drug deaths in 2025. One of the Globe’s health reporters, Alanna Smith was in Alberta to figure out what’s going on. She’s here to share what she learned about why the situation in Edmonton is so bad, and the pushback against harm reduction policies, like safe consumption sites. Questions? Comments? Ideas? Email us at [e-mail] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Deaths related to drug overdoses have been falling in Canada for the last two years. This may sound like good news, but the picture is more complicated at the local level. There are some pockets of the country where the rates are going in the opposite direction, like in Edmonton. That city surpassed its deadliest year for drug deaths in 2025. So the Globe's health reporter, Alanna Smith, went to Edmonton to figure out what's going on there. Today, she's here to tell us what she learned. I'm Cheryl Sutherland, and this is the decibel from the Globe and Mail. Alana, thanks so much for joining me today.

Great to be back. So it sounds like drug-related deaths are moving in the right direction, which means they are declining. So let's start with that. What do we know about why overdose deaths are declining in Canada and the U.S.? You're right. It is looking a bit optimistic when you look at drug death numbers right now, especially when you look at national data. For example, in 2023, there were over 8,000 deaths across Canada. Now we have the data for 2025.

It's not complete yet. We're still waiting for the last quarter. But the death total right now is 4,162. So essentially cut in half. That's much lower. Now, why is this happening? It's a bit of a complicated question. But experts have pointed to a range of reasons.

So that can include the clamp down on Chinese companies exporting fentanyl and precursor chemicals used to make the drug. There's obviously the changing drug supply. There's also a widespread exception. accessibility of naloxone, which is a life-saving medication that can reverse the effects of an opioid overdose. There's changes in drug consumption from injecting to snorting. And then there's also this grim reality that opioids have already killed many at-risk users. That's really sad to think that so many people have died and so there's less people to die. Is that the sense

there? That is the sense there. I mean, experts caution that we're still waiting for data to come in. It's kind of preliminary to say, you know, this trend will continue. We'll continue to see these downward numbers for the years to come. But right now, there is some cautious optimism that this will continue. Okay, so let's talk about what's going on in Edmonton, because things are different there. Can you walk me through some of the numbers? So while the national data obviously shows a decline, when you look at places like Edmonton or also places in the United States, kind of pockets over both countries, you're actually going to see disparities in those parts of the country. And so in Edmonton, for example, they surpass their record annual death toll in 2025. So provincial data

shows there were 764 deaths. This is a 12% increase from 2024, but that death tally is actually expected to continue to go up as suspected cases are certified. Just by way of comparison, Calgary has a bigger population than Edmonton, but it only recorded 266 drug deaths in 2025. Okay, so the big question is why, and we will get into that. But before we do, you went to Edmonton to see what's going on there. What did you see? Yes, so I went to Edmonton in mid-April. And what I did is I went on two outreach sessions, I guess you could call them, with a volunteer group called 4B harm reduction. And that's run by Angie Staines. And basically 4B harm reduction, she started it, I don't know, roughly six years ago.

And it's in honor of her son Brandon. I also want to point out that 4B, and you say it's for her son Brandon and for Brandon. That's where the name comes from. Exactly. Now Brandon spent many years living rough and using substances on the streets of Edmonton. He's now actually three years into recovery and actually volunteers with Angie by his side. And so I was fortunate to go on an outreach session with Angie and another outreach session with Brandon. And essentially what we did is we walked around locations in Edmonton that have a larger unhoused population.

And it's typical of many big cities. This population is kind of concentrated around social services. So shelters, supervised consumption sites, that sort of thing. And what we saw is that people were in need of the supplies. that they were handing out. And so that was everything from sterile pipes, needles and cookers, so safer drug use supplies. But also snacks, bandages, cigarettes. Angie herself is a licensed practical nurse so she can help in some ways with wound care. So that was a big thing people were asking about as well. What was it like for you going out with Angie? Like what was your sense

of being out with her and seeing the population? It's sad. I think you talk to folks on the streets and you hear the same thing over and over again, which is that there just aren't enough supports available for them, whether that's a place to sleep at night, whether that's access to, of course, housing or just general social services, where they're going to get their next meal. There's a huge encampment effort in Edmonton,

so people aren't able to really erect tents and stay there, especially not for long periods of time. So there's this constant moving from here, there, and people are often getting ushered outside of, you know, sidewalks and pushed into alleyways. And so people are just moving around constantly and they don't have the supports that they need. And so Angie is doing this. She's a former nurse.

And so she probably comes across people that are overdosing, right? What happens when she does? Like, what does she do when someone is overdosing? So Angie, I mean, she has spent years just trekking Alberta's streets. She's always armed with naloxone, which I had mentioned is a medication that can reverse the effects of an opioid overdose. And she basically just wanders around different streets, allude, you know, zigzagging through Edmonton. And if she sees somebody that's in need of help,

which thankfully we didn't see anybody when I was there for the outreach efforts, but it does happen to her often. She's able to administer naloxone or their life-saving interventions and sure that there's, you know, an ambulance called that sort of thing. She told me that she's estimated she's reversed more than 150 drug poisoning since 2020.

And every single year, she says she has the same thought. It can't get any worse, but it does. Yeah, I'm very taken by that. that she's saying that it's getting worse every year. So let's talk about what's going on in Edmonton. What do we know about why this is happening in Edmonton? I wish I had a simple answer for you. I feel like there's never a simple answer to these questions.

But this one, again, is like multifaceted. There's a complex interplay of factors. And so there's this highly volatile drug supply. But there's also reduced access to support services, such as supervised consumption sites. There's differences in the city's drug-using population. People have also pointed to police enforcement as one of the triggers to the crisis as well. So let's go through these one by one.

Starting with the drug supply, what are we seeing there? So the evolution of the illicit drug market, it is constantly changing. And because we don't have a lot of testing services in Alberta or really anywhere in cross Canada, it's hard to know exactly what's circulating, you know, day by day, minute by minute. But what I can say is that there is increasing circulation of very dangerous mixtures of drugs. So one of those is trankdope. And what trank dope is is a mixture of opioids and tranquilizers. So this could include the veterinary sedative xylazine.

Of increasing concern right now is metatomodine. And this dangerous blend leads to severe respiratory depression. What that means is like shallow or ineffective breathing. And that increases the risk of poisoning. And the issue here is that naloxone, while it can reverse the effects of an opioid overdose, it is not effective against any other drugs. So sedatives, benzos, stimulants, it just won't have the same reaction. So that would mean naloxone is less effective because it's targeting the opioids, not the tranquilizer part.

Yeah, it's interesting too because Angie said, you know, when she was doing outreach, you know, years ago, she could give somebody one shot on naloxone, maybe two shots of naloxone. 15 minutes later, they'd be up and walking. Now she said she is almost always using multiple doses of naloxone. She tries not to go anywhere past three, but most people are being transported with no level of conscience. Wow. So that's Trank Dope. That's one example. Is there anything else changing in the drug supply? Well, opioids remain the leading cause of overdose deaths. Fentanyl is still the most dominant opioid in Canada, but we are seeing analogs of that powerful synthetic, which means they're chemically related

to fentanyl, but they're often more lethal. So one example of that is car fentanyl, and that's estimated to be about 100 times more potent than fentanyl. So provincial data shows that the percentage of drug deaths that involved car fentanyl in 2025 was 53% for the province. But when you break that down by zone, we have five zones in Alberta. The percentage of deaths involving car fentanyl in Edmonton, for example, 69%. If you're going to compare it to Calgary, that's only 16% of deaths there. And the only closest percentage-wise is the North Zone with 37%, which is anything above the Edmonton zone. So there's just a huge amount of car fentanyl and circulation in Edmonton. Do we have any sense of why?

Not particularly. I mean, it just depends on where the drugs are coming from and who's making them. I spoke to one expert. Her name is Elaine Hishka. She works at the University of Alberta. She's an associate professor there in the School of Public Health. And what she was saying is that when she was looking early last year into why there was this rise of car fentanyl, she actually noticed there was also a simultaneous rash of carfentinal deaths in Saskatoon.

And so those two cities, Edmonton, and Saskatoon, they're connected by Highway Street. What's interesting about that is highway corridors. I mean, they're essentially the bloodstream of the illicit drug market. That's where traffickers obviously move large quantities over great distances. But what's particularly interesting about these is it's also a place where there's a lot of police seizures. And so I was also talking to somebody in Denver, and that's another city that's on track to have its deadliest year for 2025. And she highlighted Denver's placement on Interstate's 25, which is a major north-south corridor. But she said, there's been so many seizures by law enforcement agencies, it might point to why their drug death numbers are so high up. And the reason there is that essentially once drugs are confiscated by police, then traffickers need to pivot, right? And so they go to more potent, more synthetic alternatives as a replacement because they don't need as much drug. They just need smaller quantities of the drug. And so this makes it cheaper, faster to produce, easier to conceal. But on the other side, it also increases the toxicity of unregulated drugs.

Wow, that is so interesting and awful. But let's talk about population. What are the population factors that might be contributing to an increase in overdose deaths? I was speaking to another expert, too. She's a forensic pharmacologist with Alberta law enforcement response teams. She says the regional differences in drug supply. She doesn't think that's a major factor of what's going on in Edmonton. She actually pointed more to how big the drug using population is and what types

substances they're using. Provincial data hints that Edmonton has a larger drug using population. For example, it has the highest dispension of naloxone, highest dispension of opioid dependency medications, and highest dispension of opioid prescriptions for chronic pain management of any Alberta city. The capital also has a bigger unhoused population than Calgary, despite having a smaller population. Do we know why Edmonton has a higher drug using population? I don't think we have a very clear answer on that. I mean, one factor that people point to is that Edmonton has a large catchment area. So, for example, like, basically everybody north of Edmonton, which is a huge swath of the province, many times they trickle down to Edmonton,

for whatever reason, whether it's work or to access services, like health care services, for example. There's also some data that points to the effects of the prison population on a city's overdose numbers. Ebenton is surrounded by quite a few prisons. It has the highest concentration of prisons than any other city in Alberta. And people who are released from prison have much higher risk of overdose. And so that's also a factor that experts have pointed to that could be leading not only the number of drug users in Edmonton, but also the increase in the number of deaths. After the break, the tension and pushback around state consumption sites. I'm Robin Doolittle, and I'm a reporter and the deputy head of investigations

at the Globe and Mail. And we need your help. Every year, seniors in Canada are defrauded out of millions of dollars. And we want to look into this. We're starting an investigative project that's going to examine the scams that target the elderly. If you or a loved one has been impacted by a grandparent scam or a fraud like this, the Globe and Mail would like to speak with you. You can reach us at Elderfraud at Globenmail.com. That's Elderfraud at Globeandmail.com. Okay, Lana, so we've talked about the drug supply and population factors that seem to be affecting Edmonton's rates here. What about police enforcement? How is that playing into what's going on?

So it came up often when I was on those outreach efforts with Angie is that people who are living rough, they were constantly pointing to police enforcement and just the presence of police as a factor to why the crisis is so aggravated in Edmonton. And so in Edmonton, the city's police service expanded its enforcement efforts against encampments really significantly in late, 2003. And so what that means is they're removing tents and belongings from people so that they can't essentially set up a permanent spot on, say, sidewalks or alleyways. And so please say these efforts will improve public safety, they'll protect the vulnerable. But there are people that say it's actually having the opposite effect, and it's pushing folks who are using drugs or experiencing

homelessness into isolation. And so what that means is that, you know, they're using drugs in places that the public can't see in places that even their friends don't know where they are. The North Saskatchewan River runs through Edmonton. And so there's a lot of green space or a lot of trees. I guess it depends if it's winter or summer. But there's a lot, a lot of area that surrounds this river valley. And if you go high enough up into the river valley, I mean, you're practically invisible to the naked eye. Nobody can see you.

And that's a real concern because if you're using drugs down there or up there, I should say. It's just, it's very unlikely somebody will find you in time if you have an overdose. Okay, so what you're saying here is that police enforcement is pushing people out into these areas. What did you hear from people in Emmington about this increased police enforcement? So a woman I met in Edmonton was Tristan Yatman, and so she spent eight years on and off Edmonton streets. She's 28 years old. And what she told me is that, well, one, the police presence has significantly increased over the last couple of years. But she just said she doesn't even know where her friends are.

She can't even count on her fingers how many people she's lost to drug overdose. She said there are just fewer and fewer places for people to get the help they need and to feel safe. So while I was actually speaking with Tristan and Ebbenton, she was ushered away from the entrance of a grocery store in Chinatown by what seemed to be an employee in April. And this is something that happens a lot to folks who are living unhoused. There's just no place for them to go. I'd asked her, you know, what do you need? What do you want to see? And she said, we just need more support.

The problem is most people, she said, have just totally lost hope. Something else that's been happening with this ongoing drug crisis is this tension, right, Alana? And it's actually very apparent, especially recently. There's been pushback from the public. People are complaining about open drug use in their neighborhood, parks. You know, there's businesses expressing concerns about safe injection sites nearby. I mean, personally, I'm having these conversations with people who were in support of harm reduction, but aren't any more. more for various reasons. Like there's this real tension happening I'm seeing and I'm hearing. What is it like in Edmonton? Like, what's the picture there? I think it's similar in most major cities. It is a very visible crisis happening. I don't think many people can walk down the

downtown streets of Calgary, which is where I live or Edmonton or Toronto, pretty much any major city, but even smaller cities, I think it's just homelessness and drug use is something that's happening visibly on our streets. And it's very difficult for people to see that. And I mean, I don't blame them, right? It's hard to see people who are using substances, who are living rough. I know when I was on the outreach efforts, we saw a lot of people with wounds on their hands. I mean, it's sad, right? And it's difficult to see. And for many people, it's unusual. They feel threatened by it. Maybe they think that they're not safe around these folks. And whether or not that's real. The problem is that that all bleeds into how people think about harm reduction

services, for example. Yeah. And on the harm reduction sites part of this, there does seem to be a lot of opposition to them. We're talking about safe injection sites, for example. Are they effective? Like, what do we know about that? They are effective, yeah. Supervised drug use sites, I mean, their primary goal is to ensure that people don't die when they're using substances. It's to keep people alive. And if you look at them from that perspective, absolutely they've been successful. In Eminton, for example, in the last quarter of 2025, there were nearly 11,000 visits to the community sites. And during those visits, 57 resulted in overdoses. And so those were attended to with supportive care, oxygen, naloxone, or EMS services. There have been no deaths in these sites.

Yeah. So that's a really important distinction here, that the goal of harm reduction is to reduce deaths and it seems to be doing what it set out to do. But there is criticism of safe consumption sites that they encourage people to use drugs. What do we know about whether that's actually happening? I think there's a lot of misunderstandings about supervised consumption sites. So one thing I just want to be really clear about is that nobody can get drugs at a supervised consumption site. To access this service, you bring your own drugs to use in the site under medical supervision. But that's not the only support that's provided with these services. When you go into a supervised consumption site, you can access wound care. You know, they can connect you to any sort of

service you need, whether that be detox, recovery, et cetera. I know there's a lawsuit pending here in Calgary about the closure of their site. And the person who brought forward that lawsuit, he said he would not have been able to enter into recovery if it wasn't for the support of folks at supervised drug use sites, which were there for him when he needed to just simply stay alive and continue to be there for him when he was ready to make that next step into recovery. Another part of this is, of course, the government. And the government has been paying attention to the public outcry about harm reduction policies like safe injection sites.

What is the Alberta government's philosophy around the opioid crisis? So politics play a huge role in this crisis. And that's particularly true in Alberta. So the governing United Conservative Party, which has been in power since 2019, they've drastically limited access to harm reduction services. So this includes the closing of supervised drug use sites, ending funding for safer supplies programs. So similar to what Angie does, for example, and also ending funding for street outreach groups. And that's been done by multiple levels of government. And so last March, maybe one example is that the UCP closed the only drug use site in Red Deer.

Now, the government has kind of pointed to Red Deer as an example of, well, if we close the site, there's no harm that follows based on a study that was provided by one of their Crown corporations. But new provincial data kind of puts that into question. It shows that opioid-related calls for emergency services reached levels never seen before in Red Deer after the closure of this site. And in March, actually, the city recorded its highest monthly total of EMS calls at 32. Now, I know 32 doesn't sound like a lot, but for a place like Red Deer, it is a lot. And so Alberta says you can't really attribute the closing of the site to the increase. They say that's misleading. And something important to note is that in Edmonton, there are now two drug use sites.

There used to be four. And so they do plan to close those sites as well, but the timing is unknown. And Alberta is not an outlier here, right? Like there are other parts of Canada that are also going the same direction. Yeah. Other provincial governments, particularly those that are conservative leaning, they're taking that similar path to Alberta, which is a focus on recovery. oriented supports rather than harm reduction supports. So you can take Ontario, for example, which has cut funding or banned nearly every drug use in the site in the province from operating.

But, I mean, it's not just conservative governments. In BC, for example, they ended their decriminalization program earlier this year. Politicians do have this very difficult job of balancing the needs of the drug using population and ensuring they have access to health services, while in addition to that balancing the desires of the general population, which is to feel safe when they're walking the downtown streets. And this kind of division between harm reduction and public safety, I mean, they are constantly going at each other. And so it makes the job of politicians difficult in some ways because they are beholden to both groups, right? And arguably, the drug-using population is much smaller than the general population. And so I think that

what we're seeing, particularly among conservative governments, is that they want the general population to agree and believe in the policy practices they're taking because that's the larger voting group. You know, something that you talked about earlier was that Angie said how every year it's getting worse and that's, you know, surprising to her. And I think it's, I think many people who live in cities will say the same thing and it's surprising to them as well. And, you know, I just think about how this crisis started 10 years ago, the opioid crisis.

And why aren't these government policies working? Like, why aren't things getting better? That's such a hard question to answer. And I wish I had a simple response for you, like many of these questions. But I think the broader issue is, I mean, harm reduction alone is not going to solve this crisis. Recovery services alone are not going to solve this crisis. Ask any addictions expert. there has to be this, you know, ecosystem of care available from housing, health care services,

obviously harm reduction, supervised consumption sites, access to opioid agonist therapies, detox, treatment, recovery, post recovery. And I'm not sure any province, any city, any country really, has figured out the perfect balance in order to be able to address the problem, but also address this ever-evolving drug supply. And I think something that's really important to point out is that think of the drug crisis as any other health issue. Let's take diabetes, for example. There is not one single solution in order to help people with diabetes. And it's the same for people who are using drugs.

They need access to multiple different supports. For some people, they're not ready. They're not willing to enter into recovery yet. So they just need to stay alive. For others, they are willing to make that next step. And that's when those recovery services come into play. So I think Alberta focusing its efforts pretty much solely on recovery focus supports, a lot of experts would tell you that's not the right direction to take. What does this all mean for programs like Angie's in Edmonton?

Well, Angie, she says she's thankful that she doesn't rely on provincial funding. That's a big issue for certain outreach organizations because with that funding is stripped, obviously they can't provide the services that they intend to provide. Now, Angie, she relies solely on donations, but also what she calls the bank of Angie, her own bank account. And that's hard. I mean, she has said she has thought many times about just stopping what she's doing. It takes a very incredible emotional toll on her, but it's also a financial toll as well. But she keeps coming back to this idea, well, if I don't come out and I can't help these people, who will, as the numbers keep dwindling for outreach and safer supply programs? Another event I attended in Edmonton in mid-April is that 4B hosted a training session on how to recognize and respond to an overdose.

This is really uplifting in a way because it shows that people are still trying to learn how to use this life-saving medication to really save their neighbors. People they see on the street, the public. And so some of the signs to recognize if you think somebody might be overdosing are blue lips, slow breathing, contorted sleeping positions. and then if you're willing and comfortable to use naloxone, she explained that the best place to put it is in kind of the fatty areas of somebody, so their stomach or their thigh. And while Angie says it doesn't seem like the crisis is going away anytime soon,

and if anything, it may continue to get worse, she really stressed that just having this knowledge of how to save somebody's life is more critical than it could ever be. And, you know, this is not a race, she said, it is a marathon. Alana, thank you so much for joining me today. Thanks for having me. That was Alana Smith, the Globe's Health Reporter. That's it for today.

I'm Cheryl Sutherland. Our associate producer and intern is Cynthia Jimenez. Our producers are Madeline White, Rachel Levy McLaughlin and Mahal Stein. Our editor is David Crosby. Adrian Chung is our senior producer, and Angela Pichenza is our executive editor. Thanks for listening. Thank you.