Stimulant drugs including cocaine, MDMA and multiple types of amphetamines contributed to roughly half of all accidental overdose deaths in Canada from 2020 to 2021, according to a new report by Statistics Canada that also tracked a sharp rise in overdoses.

The agency highlighted that, in addition to controlled substances like speed and crystal meth, amphetamines can also include medications prescribed to treat conditions like attention deficit/hyperactivity disorder (ADHD).

StatCan reported the trend after the Public Health Agency of Canada discovered it in new data released Wednesday from the Canadian Wastewater Survey (CWS), and found that drug overdoses in Canada also increased by more than 30 per cent during the same period. Since 2019, CWS has regularly collected wastewater samples from municipalities across the country to test for various drugs, including stimulants.

Wastewater data on drug use is typically used to track longer-term multi-year trends. However, StatCan said wastewater data can also provide nearly real-time information, which is useful in the context of an ongoing drug crisis in some parts of Canada.

Right now, that data suggests cocaine use in certain Canadian cities is on the rise, while amphetamine and methamphetamine use have stabilized after spiking prior to 2023.

In most municipalities, cocaine levels in wastewater increased from January to May 2022 compared with the same period in 2020. That trend continued into 2023, according to provisional data for January, March, and May. The data appears consistent with the United Nations 2023 Global Report on Cocaine, which revealed half a million Canadians reported using the drug in 2022 and that cocaine is highly available in Canada. The report also found Canada had a lower retail price for cocaine than many other countries.

AMPHETAMINES AND METH

In its latest report on stimulant use in Canada, StatCan distinguished between methamphetamine — a potent and highly addictive stimulant drug — and amphetamine, which is a metabolite produced in the breakdown of methamphetamine and other amphetamine-related drugs.

Canadian cities including Prince Albert, Sask., Saskatoon, Edmonton, Metro Vancouver, Toronto, Montreal and Halifax were among those with the highest methamphetamine use in the world in 2022, along with cities in the United States, Czechia, Australia and New Zealand.

While high relative to other countries, that use has stabilized in recent years, not increasing considerably since 2020.

On the other hand, amphetamine levels in wastewater were significantly higher in the first half of 2022 compared with the same time in 2020 in cities like Montreal, Toronto and Metro Vancouver. According to StatCan, this suggests an increase in those cities in the use of amphetamine drugs besides methamphetamine.

Based on early data for 2023, this year has not seen significant differences in methamphetamine or amphetamine levels compared with 2022.

DRUG USE VARIES ACROSS CANADA

The StatCan report highlights how rates of stimulant use vary across the country, with some cities emerging as troubling outliers.

According to the report, Prince Albert had the highest concentration of cocaine, methamphetamine and amphetamine per capita out of any Canadian city where wastewater was tested in 2022. That trend has continued so far in 2023.

After Prince Albert, the cities with the highest methamphetamine and amphetamine use so far in 2023 are Edmonton and Saskatoon – also prairie cities – followed by Vancouver, Toronto, Montreal and Halifax.

After Prince Albert, the cities with the highest cocaine use so far in 2023 are Halifax, Montreal, Edmonton, Saskatoon, Metro Vancouver and Toronto.

While wastewater analysis shows rising rates of stimulant drug use in certain Canadian cities in recent years, hospitalizations for stimulant drug overdose appear to have become less frequent since 2020, according to StatCan.

The number of stimulant-related overdose hospitalizations in Canada rose in 2020 to 2,516 hospitalizations per 100,000 people nationally, excluding Quebec, for which hospitalization data was not included. That figure dropped to 2,422 hospitalizations per 100,000 people in 2021, and dropped again to 2,124 per 100,000 people in 2022.

Correction:

This story has been updated to attribute the detection of a rise in stimulant drug overdoses to the Public Health Agency of Canada.