Thank you for the question.
In my opening remarks, I referred to the staggering difference we see between 2011 and 2023. In 2011, at the height of the prescription opioid crisis—when as many as one in five Canadians reported using a medical-grade opioid, according to some surveys—we had 91 Albertans die of drug poisoning deaths, and those drugs were primarily opioids. Now, obviously, the numbers are astronomically higher than that.
What we started to see around 2012, when there was a series of very well-intended measures to limit access to prescription opioids at a population level, we saw a very dramatic decline in the population flow of prescription opioids that were either being prescribed to patients or being diverted and sold in the illegal markets.
In Edmonton, where I'm from, when I was doing my Ph.D. research in epidemiological surveys back in 2012, everyone I talked to who was using opioids was using hydromorphone pills that had either been purchased or been prescribed to them. Now that's virtually unheard of. We see so few people using those medications now. Everybody is using fentanyl.
What we believe has happened, according to the evidence we can piece together, is the decline in the prescribing of opioids corresponded with a fundamental shift in the illegal market toward novel synthetic opioids. Basically, we cracked down on prescribing, but we did not address demand. As a result, the illegal market innovated and now we have fentanyl, fentanyl's analogues, carfentanil, nitazene class opioids, fake benzodiazepines and a whole host of other very dangerous drugs that are the primary drugs circulating in the opioid supply, and it's contributing to a staggering amount of death that we have not seen before.
This trend is something we're seeing across Canada, particularly in B.C. and, later but now quite clearly, in Ontario and other parts of the country.