Toronto Public Health is collaborating with the Toronto Overdose Early Warning and Alert Partnership to provide timely information on overdose activity, with a current focus on opioids. Additional data and indicators may be added to this site as they become available.

Last Updated: January 9, 2020

Toronto Paramedic Services is collaborating with Toronto Public Health to share information on calls for suspected opioid overdoses received by paramedics in Toronto. This includes the number and location of cases where the responding paramedic suspects an opioid overdose. This may differ from the patient’s final diagnosis in hospital or cause of death determined by the coroner. These findings are preliminary and subject to change. Please see the Data Notes tab for more information on these indicators.

Since August 7, 2017, Toronto Paramedic Service attended 65 non-fatal and three fatal suspected opioid overdoses per week on average. Fatal cases include those where the patient died on scene and the coroner was notified.

Over this period, an average of 18 non-fatal cases per week had naloxone administered by a community member before paramedic arrival. Paramedics administered naloxone in an average of seven non-fatal cases per week.

Weekly* number of suspected opioid overdose calls received by Toronto Paramedic Services, Toronto, August 7, 2017 to January 5, 2020**Line graph of calls to paramedics for suspected opioid overdoses

Table of calls to paramedics for suspected opioid overdoses by month and week

* Weeks are calculated Monday to Sunday and are labelled with the Monday of each week period. Table shows the most-recent three-month period. ** Due to ongoing review of cases and case definitions, data currently presented are preliminary and subject to change.† August 2017 and January 2020 are not complete months’ worth of data. Data are captured for August 2017 starting on August 3, 2017, and for January 2020 up to and including January 5, 2020. Source: Toronto Paramedic Services. Electronic Patient Care Record. [Weekly: August 7, 2017 to January 5, 2020; Monthly: August 3, 2017 to January 5, 2020]. Extracted January 6, 2020.

 

The map shows the distribution of opioid overdose calls received by Toronto Paramedic Services for December 2019. It includes fatal and non-fatal suspected opioid overdoses combined. The map shows the locations where paramedics made contact with patients. Please see the Data Notes tab for more information on these indicators. For more information on the number of calls by neighbourhood and nearest main intersection, please see Calls to Paramedics for Suspected Opioid Overdoses – Geographic Information (updated September 2019).

Map of suspected opioid overdose calls received by Toronto Paramedic Services, Toronto, December 2019

Map of suspected opioid overdose calls received by Toronto Paramedic ServicesSource: Toronto Paramedic Services, Electronic Patient Care Record, December 1 to 31, 2019.Extracted January 6, 2020.

For additional information, Trends in Paramedic-Attended Opioid Overdoses: A Review of Suspected Opioid Overdoses in Toronto Paramedic Services Data, 2017/18 contains information on demographics of cases, trends by month, day, and time, and Toronto neighbourhood comparisons.


Contact Us

For information about data sources and indicators Surveillance and Epidemiology Unit

seu@toronto.ca

416-392-7450

For information about naloxone and supervised injection services The Works

theworks@toronto.ca

416-392-0520

For information about the Toronto Overdose Early Warning & Alert Partnership Toronto Drug Strategy

drugstrategy@toronto.ca

416-338-3585

Last Updated: January 9, 2020

Substance-related emergency department visits and suspected overdose cases seen at Toronto hospitals fluctuated between April and December 2019 with no discernible trend. Note that neither of these indicators are specific to opioids. Substance-related emergency department visits may be due to intoxication, addiction, overdose, or withdrawal. Suspected overdose cases are a subset of substance-related visits that specifically mention overdose in the chief complaint and meet a set of inclusion criteria. Please see the Data Notes tab for more information on these indicators.

Number of substance-related emergency department visits and suspected overdose cases by week, Toronto hospitals, April 1, 2019 to January 5, 2020* Line graph of hospital visits for suspected overdose cases

Table of hospital visits for substance related visits and suspected overdose cases*The date noted indicates the start of the week. Counts are reported from Mondays to Sundays.Source: Acute Care Enhanced Surveillance System. ED Line Listings. April 1, 2019 to January 5, 2020. Extracted January 6, 2020.

 

There was a large increase seen in the number of emergency department visits due to opioid poisoning in the summer of 2017. Following a decrease in the fall of 2017, the number of emergency department visits have been increasing, with another surge seen in March 2019. Hospitalizations for opioid poisoning have fluctuated during the same period, with no discernible trend. Note that changes to hospital reporting for opioid overdoses at the start of May 2017 may account for some of the peak increase seen in the summer of 2017. Please see the Data Notes tab for more information on this indicator.

Number of emergency department visits and hospitalizations due to opioid poisoning by month, Toronto hospitals, January 2017 to March 2019

Line graph of Emergency Department visits and Hospitalizations due to opioid poisoningSource for ED visit data: National Ambulatory Care Reporting System, January 2017 to March 2019. Ontario Ministry of Health, IntelliHEALTH Ontario.  Extracted November 2019.Source for hospitalizations: Discharge Abstracts Database, January 2017 to March 2019. Ontario Ministry of Health, IntelliHEALTH Ontario. Extracted November 2019.


Contact Us

For information about data sources and indicators Surveillance and Epidemiology Unit

seu@toronto.ca

416-392-7450

For information about naloxone and supervised injection services The Works

theworks@toronto.ca

416-392-0520

For information about the Toronto Overdose Early Warning & Alert Partnership Toronto Drug Strategy

drugstrategy@toronto.ca

416-338-3585

Last Updated: December 20, 2019

There were 300 opioid toxicity deaths in Toronto in 2018. This includes accidental deaths, suicides, and deaths with undetermined intent.The number of opioid toxicity deaths in 2018 is similar to the number in 2017. However, it is 61% higher than the number of people who died compared to 2016 and 119% higher than 2015. In 2018, 1 in 5 of the 1474 opioid overdose deaths in Ontario occurred in Toronto.

Preliminary data indicate that there were 161* deaths in Toronto for the first 6 months of 2019. This number is expected to increase as the cause of death is confirmed for more cases.

Please see the Data Notes tab for more information on this indicator.

Annual number of deaths from opioid toxicity causes, Toronto, 2013 to 2018

Bar graph shows the number of opioid toxicity deaths per year in Toronto from 2013 to 2018

Sources: Public Health Ontario. Interactive Opioid Tool. 2013 to 2018. Accessed on December 20, 2019.Coroner’s Opioid Investigative Aid, May 2017 to June 2019. Office of the Chief Coroner for Ontario, extracted October 28, 2019.

In May 2017, the Office of the Chief Coroner for Ontario (OCC) began using a new tool to collect information on deaths caused by opioid overdoses in the province of Ontario. Coroners now use the ‘Opioid Investigative Aid’ to gather detailed information about people whose deaths were caused by opioids. The number of deaths from May 2017 to June 2019 are presented below.

The numbers reported here are preliminary and subject to change. Only cases that are confirmed by the OCC as opioid toxicity deaths are reported here. As coroners’ investigations proceed, it is expected that new cases for this time period will be identified, so these numbers may rise in the coming months.

The number of opioid toxicity deaths fluctuated by quarter from May 2017 to June 2019, with peaks seen in the third quarter of 2017 and the fourth quarter of 2018. The number of opioid toxicity deaths in the first quarter of 2019 was 50% higher than the same period in 2018. However, such an increase was not seen in the second quarter of the year with a difference of 12% compared to the same period in the previous year.

Number of deaths from opioid toxicity causes by quarter, Toronto, May 2017 to June 2019

Bar graph shows the number of deaths by quarter from May 2017 to December 2018 in Toronto

The data presented below include confirmed opioid toxicity deaths from July 1, 2018 to June 30, 2019.

Preliminary data show that there were 336* confirmed opioid toxicity deaths among residents of Toronto over the one year period from July 1, 2018 to June 30, 2019. The majority of these deaths (94%) were accidental, compared to 92% in the rest of Ontario. Four percent (4%) of deaths in Toronto were classified as suicide, compared to 6% of deaths in the rest of the province.

Seventy-eight percent (78%) of accidental opioid toxicity deaths in Toronto from July 1, 2018 to June 30, 2019 were among males. Fifty-two percent (52%) of all accidental opioid toxicity deaths in Toronto occurred among individuals aged 25 to 44 years.

Accidental opioid toxicity deaths by age group and sex, Toronto, July 1, 2018 to June 30, 2019*

Bar graph shows the number of deaths by age and gender in 2018 and 2019 in Toronto

Among accidental opioid toxicity deaths in Toronto from July 1, 2018 to June 30, 2019, ethno-racial groups include: White (73%), Black (7%), Indigenous (3%), Latin American (2%) and South Asian (2%). Other ethnicities accounted for 6% of accidental deaths. Information on ethnicity was unknown or missing for 7% of individuals in Toronto.*,‡

Fifty-four percent (54%) of individuals were unemployed at the time of death. However, information on employment status was unknown or missing for 30% of individuals.*, ‡

Sixty-five (65%) of people who died by accidental opioid toxicity in Toronto resided in a private dwelling at the time of their death compared to 75% in the rest of the province. In Toronto, 17% of deceased individuals were experiencing homelessness compared to 10% in the rest of the province.  There were no deaths among residents of correctional facilities occurring in Toronto. Information on living arrangements was unknown or missing for 6% of individuals in Toronto.*, ‡

Accidental opioid toxicity deaths by living arrangements of the decedent, Toronto compared to the rest of Ontario, July 1, 2018 to June 30, 2019*

Bar graph of percent of accidental opioid toxicity deaths by by living arrangements of the decedent in Toronto

For the majority (70%) of accidental opioid toxicity deaths in Toronto from July 1, 2018 to June 30, 2019, the overdose occurred in a private residence. This is compared to 76% in the rest of Ontario.

Accidental opioid toxicity deaths by location of overdose incident leading to death, Toronto compared to the rest of Ontario, July 1, 2018 to June 30, 2019*

Bar graph of percent of accidental opioid toxicity deaths by location of overdose incident leading to death, Toronto compared to the rest of Ontario

In 64% of accidental opioid toxicity deaths occurring July 1, 2018 to June 30, 2019 in Toronto, the deceased person was at home at the time of the death.  Fifty percent (50%) of deaths occurred without another individual who could intervene at the time of overdose present; however, information was missing in 30% of cases.*, ‡

There was evidence of an attempt to resuscitate the deceased individual in 48% of the cases. Naloxone use was reported in 30% of accidental opioid toxicity deaths; however, there was missing information in 9% of cases. In 37% of cases where naloxone use was reported, it was administered by bystanders. In 35% of cases, it was used by hospital workers, and in 47% it was by emergency responders. This information was missing in 13% of cases.

Fentanyl was the most commonly reported opioid contributing to death in Toronto from July 1, 2018 to June 30, 2019. Fentanyl and its analogues were more common contributors to accidental death in Toronto (87%) compared to the rest of Ontario (80%).  Carfentanil contributed to 26% percent of accidental opioid toxicity deaths in Toronto, a sizeable increase from 10% for the period of July 1, 2017 to June 30, 2018. A similar trend was seen in the rest of Ontario, where the percent of deaths were carfentanil was involved increased from 13% to 24%.

Accidental opioid toxicity deaths by type of opioid contributing to death, Toronto compared to the rest of Ontario, July 1, 2018 to June 30, 2019*,§

Bar graph shows the number of opioid toxicity deaths per year in Toronto from 2013 to 2018

In 75% of opioid toxicity deaths in Toronto in from July 1, 2018 to June 30, 2019, the opioids contributing to death were exclusively non-pharmaceutical in origin. In 11% of deaths, the opioids were exclusively pharmaceutical in origin, and 9% of deaths the opioids were of mixed origin. In an additional 5% of deaths, the origin of the opioids could not be classified.

Crack-cocaine was the most common non-opioid substance directly contributing to opioid overdose death, contributing to 44% of deaths. Other substances contributing to death included ethanol (alcohol) in 16% of deaths, methamphetamines in 14%, and benzodiazepines in 9%.§

* Numbers are preliminary and subject to change†The second quarter of 2017 is not complete and only contains data for May and June‡Individuals with missing and unknown data are included in the denominator for this analysis.§Drug categories are not mutually exclusive; some deaths are attributed to multi-drug toxicity where a death can include more than one opioid as a cause.||The “All fentanyl combined” category includes fentanyl, carfentanil and fentanyl analogues.

Source: Coroner’s Opioid Investigative Aid, May 2017 to June 2019. Office of the Chief Coroner for Ontario, extracted October 28, 2019.

Contact Us

For information about data sources and indicators Surveillance and Epidemiology Unit

seu@toronto.ca

416-392-7450

For information about naloxone and supervised injection services The Works

theworks@toronto.ca

416-392-0520

For information about the Toronto Overdose Early Warning & Alert Partnership Toronto Drug Strategy

drugstrategy@toronto.ca

416-338-3585

Last Updated: January 9, 2020

On August 21, 2017, Toronto Public Health opened the interim site for supervised injection services at The Works. Services moved to the permanent site on October 30, 2017.

Supervised injection services are health services that provide a hygienic environment for people to inject pre-obtained drugs under the supervision of a trained health care professional. In addition to supervised injection, individuals are provided with sterile injection supplies, education on safer injection, overdose prevention and intervention, medical and counselling services, and referrals to drug treatment, housing, income support and other services. Please see the Data Notes tab for more information on these indicators.

As of January 5, 2020, there were 71,404 visits to the supervised injection service. There were 1,204 visits where an overdose occurred, including 535 visits where the client required naloxone.

Weekly visits to the supervised injection service, The Works, August 21, 2017 to December 31, 2019*,†,Graph of visits to the supervised injection service

 

Tables with monthly and weekly number of visits to the supervised injection service

* As of October 14, 2018, the supervised injection service began opening on Sundays.† Due to an ongoing review, data currently presented are preliminary and subject to change. August 2017 and January 2020 are not complete months’ worth of data. Data are captured for August of 2017 starting on August 21, 2017, and for January 2020 up to and including January 5, 2020.
Sources: NEO database & The Works – Toronto Public Health. Extracted January 9, 2020.

 

Contact Us

For information about data sources and indicators Surveillance and Epidemiology Unit

seu@toronto.ca

416-392-7450

For information about naloxone and supervised injection services The Works

theworks@toronto.ca

416-392-0520

For information about the Toronto Overdose Early Warning & Alert Partnership Toronto Drug Strategy

drugstrategy@toronto.ca

416-338-3585

11/10/2019: interactive Prescription Opioid Tool

As of October 11, 2019, the treatment tab was removed from the Toronto Overdose Information System. Indicators of opioid prescribing in Ontario can be accessed from the interactive Prescription Opioid Tool. This tool uses data from the Narcotics Monitoring System to provide information on opioid prescriptions from retail pharmacies in Ontario.

31/07/2019: Opioid Mortality Surveillance Report

Public Health Ontario recently released a report looking at trends in confirmed opioid toxicity deaths between July 2017 and June 2018. This report details data from the Opioid Investigative Aid implemented in May 2017 which collects information on the demographic characteristics of the deceased and the circumstances surrounding their deaths. Toronto specific statistics can be found under the Deaths tab.

15/01/2018: Survey on Opioid Awareness (2017) Results

Statistics Canada has released results from the Survey on Opioid Awareness. The survey found that 29% of Canadians aged 18 years and older reported using some form of opioids in the past five years. It also found that 78% of Ontarians were ‘very aware’ or ‘somewhat aware’ of the opioid issue.

For more information see the full results and info-graphicPlease note that Toronto-specific statistics are not available

29/05/2017: Interactive tool on opioid-related harms data

Public Health Ontario recently released an interactive tool that explores trends in opioid-related emergency department visits, hospitalizations and deaths from 2003 to 2015 in Ontario. Toronto Public Health has created a summary document that reviews the key findings for Toronto.

Please note that the interactive tool and summary document capture outcomes occurring among Toronto residents only and as such, will include fewer occurrences than those included on this website (which capture all overdose outcomes occurring in Toronto, regardless of where an individual resides).

 


Contact Us

For information about data sources and indicators Surveillance and Epidemiology Unit

seu@toronto.ca

416-392-7450

For information about naloxone and supervised injection services The Works

theworks@toronto.ca

416-392-0520

For information about the Toronto Overdose Early Warning & Alert Partnership Toronto Drug Strategy

drugstrategy@toronto.ca

416-338-3585

Paramedic Response

Monthly and weekly number of suspected opioid overdose calls received by Toronto Paramedic Services, Toronto

Source: Toronto Paramedic Services. Paramedic Electronic Patient Care Record.

Data Notes:

  • This indicator is preliminary and subject to change pending further review of the data source.
  • This indicator includes cases where the responding paramedic suspects an opioid overdose. This may differ from the final diagnosis in hospital or cause of death determined by the coroner.
  • ‘Fatal’ cases include those where the patient died on scene and the coroner was notified. Patients who die after being transported to hospital may be miscategorised here as ‘non-fatal’ cases.
  • This indicator includes only instances where 911 is called and underestimates the true number of overdoses in the community.

Map of suspected opioid overdose calls received by Toronto Paramedic Services, Toronto

Source: Toronto Paramedic Services. Paramedic Electronic Patient Care Record.

Data Notes:

  • This information is preliminary and subject to change pending further review of the data source.
  • The map shows the locations where paramedics made contact with patients, which may or may not be the same location from which 911 was called.
  • The colours of the heat map indicate the relative density, defined as the number of cases per unit area. As a stretch legend is used to visualize the density, this map should not be interpreted in absolute terms when compared to heat maps from other time periods.
  • Suspected opioid overdoses occurring slightly outside the City of Toronto boundaries were excluded from the map.
  • This indicator includes cases where the responding paramedic suspects an opioid overdose. This may differ from the final diagnosis in hospital or cause of death determined by the coroner.
  • This indicator includes only instances where 911 is called and underestimates the true number of overdoses in the community.

Hospital Visits

Number of substance-related emergency department visits by week, Toronto hospitals

Source: Acute Care Enhanced Surveillance System. ED Line Listings.

Data Notes:

  • This data source only captures substance-related visits that result in an individual seeking care in a hospital setting. This is likely an underestimation of the true burden of overdose in the population.
  • ACES is a syndromic surveillance system that classifies visits and admissions into ‘syndromes’ using algorithms to assess and classify open text from the chief compliant recorded at triage or registration. This process allows ACES to provide daily counts of visits.
  • This data source captures visits to acute care facilities in Toronto. However, it does not currently capture visits to specialty hospitals, such as the Women’s College Hospital. Visits to the Centre for Addiction and Mental Health are included in ACES as of November 23, 2017.
  • ‘Substance-related visits’ include instances of intoxication, addiction, overdose, or withdrawal. They include visits caused by opioids or non-opioid related drugs (OPI and TOX syndromes, combined) but excludes those related to alcohol.
  • This indicator includes all visits to Toronto hospitals, regardless of whether or not the individual resides in Toronto.
  • Monday to Sunday week units are used here as the unit of analysis, with the starting date of each week labeled on the x-axis of the graph.

Number of emergency department visits due to suspected overdoses by week, Toronto hospitals

Source: Acute Care Enhanced Surveillance System. ED Line Listings.

Data Notes:

  • This indicator is only available from May 2017 onwards, due to availability of data.
  • This data source only captures suspected overdoses that result in an individual seeking care in a hospital setting. This is likely an underestimation of the true burden of overdose in the population.
  • ACES is a syndromic surveillance system that classifies visits and admissions into ‘syndromes’ using algorithms to assess and classify open text from the chief compliant recorded at triage or registration. This process allows ACES to provide daily counts of visits.
  • ‘Suspected overdoses’ refer to a subset of substance-related visits that specifically reference ‘overdose’ in the chief complaint. It excludes overdoses that specify a substance of non-interest (e.g. alcohol, over-the-counter medication, prescription drugs of non-interest such as blood pressure medication, and toxic products such as cleaning products).
  • ‘Suspected overdoses’ include only visits with a Canadian Triage Acuity Score of 0, 1, 2 or missing.
  • ‘Suspected overdoses’ exclude visits for children less than 10 years of age.
  • For the majority of visits, the substance causing overdoses is not specified. It is important to note that this indicator measures overdoses from all types of substances, not just opioids.
  • ‘Suspected overdoses’ also exclude intentional overdoses or those related to self-harm.
  • This data source captures visits to acute care facilities in Toronto. However, it does not currently capture visits to specialty hospitals, such as the Women’s College Hospital. Visits to the Centre for Addiction and Mental Health are included in ACES as of November 23, 2017.
  • This indicator includes all visits to Toronto hospitals, regardless of whether or not the individual resides in Toronto.
  • Monday to Sunday week units are used here as the unit of analysis, with the starting date of each week labeled on the x-axis of the graph.

Number of emergency department visits due to opioid poisoning by month, Toronto hospitals

Source: National Ambulatory Care Reporting System. Ontario Ministry of Health, IntelliHEALTH Ontario.

Data Notes:

  • This data source only captures overdoses where patients visited the emergency department. It is likely these data underrepresents the true burden of overdose in the population.
  • This indicator includes all visits to Toronto hospitals, including those who are residents of other municipalities accessing care in Toronto.
  • Opioid poisonings were measured using ICD-10 codes: T40.0 – Opium, T40.1 – Heroin, T40.2 – Other opioids (e.g. Codeine, Morphine), T40.3 – Methadone, T40.4 – Other synthetic narcotics (Pethidine) and T40.6 – Poisoning by other and unspecified narcotics.
  • This indicator include visits where opioid poisoning was listed as a main or a contributing cause.
  • Emergency department visits with suspect and query diagnoses were included.
  • Emergency department visits includes only unscheduled visits.

Number of hospitalizations due to opioid poisoning by month, Toronto hospitals

Source: Discharge Abstracts Database. Ontario Ministry of Health, IntelliHEALTH Ontario.

Data Notes:

  • This data source only captures overdoses where patients were hospitalized. It is likely these data underrepresents the true burden of overdose in the population.
  • This indicator includes all hospitalizations to Toronto hospitals, including those who are residents of other municipalities accessing care in Toronto.
  • Opioid poisonings were measured using ICD-10 codes: T40.0 – Opium, T40.1 – Heroin, T40.2 – Other opioids (e.g. Codeine, Morphine), T40.3 – Methadone, T40.4 – Other synthetic narcotics (Pethidine) and T40.6 – Poisoning by other and unspecified narcotics.
  • This indicator includes hospitalizations where opioid poisoning was listed as a main or a contributing cause.
  • Hospitalizations with suspect and query diagnoses were included.
  • In the May 2017 update of this indicator, the data source was changed from the National Ambulatory Care Reporting System to the Discharge Abstracts Database to be consistent with how Public Health Ontario is measuring this indicator. The Discharge Abstracts Database also contains more detailed information about hospitalizations, as records include all information available at the time of discharge which is often more specific than information available at admission.

Deaths

Annual number of deaths from opioid toxicity causes, Toronto

Source: Public Health Ontario. Interactive Opioid Tool.

Data Notes:

  • These data include all manners of death from opioid toxicity (i.e. accidental and intentional) combined.
  • The deaths included here are caused by opioid toxicity, with or without other drugs also contributing to death.
  • Deaths due to chronic substance use, medical assistance in dying, homicides and trauma where an intoxicant contributed to the circumstances of the injury are excluded.

Opioid toxicity death data from the Opioid Investigative Aid

Source: Coroner’s Opioid Investigative Aid. Office of the Chief Coroner for Ontario.

Data Notes:

  • These data only include confirmed opioid-related deaths for which an investigation has identified an opioid as directly contributing to the cause of death. The numbers reported are preliminary and subject to change. As coroners’ investigations proceed, it is expected that new cases for the time period presented will be identified.
  • The deaths included here are caused by opioid toxicity, with or without other drugs also contributing to death.
  • Deaths due to chronic substance use, medical assistance in dying, homicides and trauma where an intoxicant contributed to the circumstances of the injury are excluded.
  • The Office of the Chief Coroner for Ontario implemented the Opioid Investigative Aid in May of 2017. The detailed information resulting from this tool are not available prior to this date.
  • Deaths have been assigned to Toronto based on the six-digit postal code of the residence of the deceased. If the postal code of the residence was not available, the postal code of the incident location was used. If this information was not available, the postal code of the death location was used.
  • Gender is based on gender identity at time of death.
  • Ethnicities include White, Indigenous (First Nations, Métis, Inuit), Black, Latin American, South Asian (East Indian, Pakistani, Sri Lankan), all other ethnic groups combined (Chinese, Filipino, Arab, Southeast Asian (Vietnamese, Cambodian, Malaysian), West Asian (Iranian, Afghan), Korean, Japanese, Other, and Unknown; groupings were based on frequency of occurrence in the data as of the report creation date.
  • Living arrangement categories include:
    • Private dwelling – a separate set of living quarters designed for or converted for human habitation. Must include a source of heat or power and must be an enclosed space that provides shelter/protection from the elements. In Toronto, this includes community housing units
    • Homeless – without stable, permanent, appropriate housing, or the immediate prospect, means and ability of acquiring it; includes no fixed address and those temporarily residing in shelters
    • Collective dwelling – lodging and rooming houses, hotels, motels, tourist establishments, campgrounds and parks, sober living facilities, school residences and training centre residences, work camps, religious establishments, military bases, commercial vessels
  • Incident location categories include:
    • Indoors (private residence) – apartments, condominium, row house/townhouse, rural/agricultural: residential, trailer/mobile home, single-detached house, semi-detached house. In Toronto, this includes community housing.
    • Indoors (public) – includes airports, public bathrooms, commercial/retail buildings, recreational buildings, and other public buildings
    • Indoors (other) – hotel/motel/inn, rooming house, shelter, and supported living facilities
  • An individual is considered to have died at home if the location of death address is the same as the decedent’s home address
  • Emergency Responders refer to EMS, Police and Fire
  • Non-pharmaceutical origin of opioids includes:
    • Heroin, fentanyl analogues (including carfentanil), U-47700
    • Fentanyl without evidence of a patch and no/unknown evidence of prescription and evidence suggesting a non-pharmaceutical origin (e.g., other non-pharmaceutical substances detected on toxicology (e.g., carfentanil, cocaine) or drug paraphernalia on the scene)
    • Morphine without or unknown evidence of a prescription, with or without 6-Monoacetylmorphine (6-MAM) and with evidence suggesting non-pharmaceutical heroin use (e.g., other non-pharmaceutical substances detected on toxicology, such as carfentanil or cocaine or history of consuming or seeking heroin)
  • Pharmaceutical origin of opioids includes: buprenorphine/naloxone, codeine, fentanyl (with evidence of patch or prescription), hydrocodone, hydromorphone, methadone, morphine (with evidence of a morphine or codeine prescription) oxycodone, oxymorphone or tramadol. This category may include opioids that were prescribed to the deceased person or that were prescribed to someone else (i.e., diverted).
  • Origin of opioid could not be classified: The opioid could not be clearly categorized as non-pharmaceutical or pharmaceutical including
    • Fentanyl without evidence of patch and no/unknown evidence of prescription and no evidence suggesting a non-pharmaceutical origin, morphine without or unknown evidence of a prescription for morphine and without 6-MAM and no evidence suggesting non-pharmaceutical heroin use.

TPH Supervised Injection Services

Monthly and weekly indicators for the supervised injection services, The Works

Source: NEO database & The Works – Toronto Public Health

Data Notes:

  • Numbers are preliminary and subject to change.
  • Number of visits refers to the number of clients visiting the supervised injection services (SIS). This includes all visits to the SIS, regardless of whether the client injected. Visits may be from repeat clients.
  • Number of overdoses refers to the number of visits resulting in an overdose event that occurs within the site or that occurs to a client who has injected at the site, as reported by the manager at The Works. This does not refer to unique clients.
  • Number of naloxone administrations refers to the number of visits resulting in a naloxone administration. Note that multiple doses of naloxone may be administered during one overdose event.

Contact Us

For information about data sources and indicators Surveillance and Epidemiology Unit

seu@toronto.ca

416-392-7450

For information about naloxone and supervised injection services The Works

theworks@toronto.ca

416-392-0520

For information about the Toronto Overdose Early Warning & Alert Partnership Toronto Drug Strategy

drugstrategy@toronto.ca

416-338-3585