While the United States has often been the cautionary tale of a fentanyl crisis, Canada’s experience could offer a better model.

The international narrative around the fentanyl crisis has largely been based on the US experience. There is a good reason for this. Consumption of this synthetic opioid has caused hundreds of thousands of drug overdose deaths each year.

Authorities have noted the systematic overprescription of pharmaceutical opioids and the industrial spirit of Mexican drug trafficking networks among the underlying causes that led this illicit market to boom. And these dynamics have served as a benchmark for predicting whether fentanyl consumption could expand to other countries, especially because sophisticated criminal organizations and large pools of opioid users are present around the world.

Canada, however, developed its own crisis on the back of its local criminal dynamics and consumption patterns differing from those of the United States. It could therefore serve as a better example of challenges that may be faced in other regions, such as Europe, Oceania, and Latin America, which are slowly beginning to detect illicit fentanyl in their drug-consuming populations.

“The case of Canada can be seen as a canary in a coal mine,” said Jaime Arredondo, a researcher at the University of Victoria in British Columbia, who has studied substance use extensively.

In fact, Canada recognized it had a problem even earlier than the United States. The provincial government of British Columbia, on Canada’s west coast, declared it had a fentanyl crisis in April 2016, a year and a half before the US government declared the opioid epidemic a national public health emergency.

SEE ALSO: Is the Fentanyl Market Expanding Across Latin America?

Like in the US, fentanyl consumption was on the rise among opioid and injectable drug users, especially in the port city of Vancouver. The city had a long tradition of heroin consumption, established criminal networks, and a wide commercial exchange with China, where fentanyl was produced and shipped to North America. 

But that is where the similarities ended. Canada did not have a history of over-prescription of opioid-based painkillers, which is what had laid the groundwork for the US fentanyl crisis. Yet, over the next seven years, drug overdoses would continue to increase, provoking an unprecedented number of deaths and hospitalizations. 

What’s more, since 2019, drug consumption and drug overdose statistics suggest the fentanyl crisis has spread to eastern provinces and among users with no history of opioid use. This has overwhelmed health services and sparked questions as to why Canada became a hotbed of synthetic opioid use and whether its use patterns will be repeated in other, similar markets around the world.

Below, we offer three patterns that should worry authorities, no matter where they are.

1. Drug Use Bigger Problem Than Over-Prescriptions 

The origins of the fentanyl crisis in the United States have been traced back to the over-prescription of opioids to treat pain and chronic illnesses, which led to high levels of addiction. After authorities cracked down on the doctors and pharmacies prescribing opioids, many people sought alternatives on the black market, such as heroin or counterfeit pharmaceuticals.

Initially, fentanyl traffickers seemed to target these consumers. The most common method used to sell fentanyl then – and still today – was through fake oxycodone pills or counterfeit versions of other prescription opioids. Heroin was also laced with fentanyl.

In contrast, prescription opioid consumption in Canada was nowhere near as high as in the United States. Around 13% of Canadians were using prescription opioids in 2015, compared to almost 36% of the US population, according to government surveys in both countries. In 2013, doctors filed 3 million opioid prescriptions in British Columbia, which accounts for 650.2 prescriptions for every 1,000 people. The rate was 1,176 in West Virginia in 2014, the US state considered one of the epicenters of the US crisis.

The commercialization of fentanyl in Canada thus seemed to spread largely among users already seeking illicit drugs or sedatives. In Canada, for example, fentanyl has been found mainly mixed with heroin, benzodiazepines, and stimulant drugs, according to a 2023 study by Canadian health authorities. In the last four years, there has been a particular increase in fentanyl-laced methamphetamine.

“Drug users in Canada are now facing a contaminated drug supply,” said Arredondo, who has also conducted several drug testing studies.

What’s more, on the streets in Canada, dealers commonly sell fentanyl without trying to disguise it as prescription opioids  – a common practice in the United States. For example, a 2021 academic study found the drug was widely sold in a form known as “pebbles.” Fentanyl is also commonly sold directly in powder form, according to a Canadian government official who analyzes the opioid market and spoke to InSight Crime anonymously.

Fentanyl pebbles seized by the Royal Canadian Mounted Police (Source: RCMP)

“People in Canada are increasingly understanding that what they’re getting is fentanyl. There’s no need to pretend it’s counterfeit pharmaceuticals,” the official told InSight Crime.

2. From Consumption to Production

The fight against fentanyl in the United States has been largely focused on disrupting sophisticated drug trafficking networks in Mexico and China. But Canada’s experience shows how the production of synthetic drugs, unlike plant-based drugs, has a far lower barrier of entry.

The majority of fentanyl consumed in the country continues to come directly from China, according to Canadian authorities. Since 2019, however, there is growing evidence to suggest that local production grew when China imposed stricter controls on fentanyl, just as it did in Mexico.

Drug seizure data tells part of the story. Between 2018 and early 2024, the Canada Border Services Agency registered a slight decline in fentanyl seizures at entry points. At the same time, authorities seized an increasing amount of chemicals at the country’s borders that could potentially be used for synthetic drug production. And in the last two years, Canadian authorities have found clandestine fentanyl laboratories in the provinces of British Columbia, Alberta, and Ontario. Some of these have been characterized as “Super Labs” with the capacity to produce large quantities of the drug.

This shift comes amid the increasingly widespread local production of several synthetic drugs. Since at least 2020, data collected by the Royal Canadian Mounted Police (RCMP) shows that the majority of methamphetamine and ecstasy consumed in Canada is produced locally in clandestine laboratories.

There is also some evidence that Canadian networks have begun to export fentanyl. In 2022, Australian police seized an 11 kilogram shipment of fentanyl powder that departed from an unspecified Canadian port. US law enforcement has also filed several indictments against Canadian citizens for sending small quantities of fentanyl to the United States using the postal service.

3. Constant Innovation

Canada’s experience also highlights the constant evolution of international synthetic drug markets and innovations made by criminal networks seeking to evade international regulations and market stronger substances that could pose a future threat. 

Part of this evolution has been driven by the chemical market in China. An InSight Crime investigation on the dark web and clearnet found that clandestine producers in the country constantly seek to send new and more potent substances to their clients abroad. The chemical composition of these products is often similar to controlled substances, but different enough to evade regulations.

SEE ALSO: The Synthetic Silk Road: Tracing China’s Grey-Market Precursor Chemical Trade

During a search for fentanyl precursor chemicals on the dark web and clearnet, InSight Crime found that several sellers were aggressively promoting ethazene, a synthetic opioid that is currently controlled in the United States but not in Canada or Mexico.

The attractiveness of this substance, according to the sellers, was that it had greater potency than fentanyl and was less regulated around the world.

An advertisement for ethazene by a chemical supplier in China (Credit: 穆小姐 /InSight Crime)

The potential impact of these novel opioids on the streets may not be far off. Since 2019, both Canadian and US authorities have flagged an increase in the presence of nitazene, a specific class of opioids that is less potent than ethazene but more potent than fentanyl. So far, overdose deaths have been limited, but authorities fear they could increase as their commercialization becomes more widespread.

“It’s worrying that stronger substances are coming in, and we don’t know what the effects are going to be,” a RCMP analyst who did not have authorization to speak on-the-record told InSight Crime. .

Canadian civil society organizations also issued an alert in July 2022 about the presence of xylazine, or what is popularly termed “tranq,” a non-opioid sedative used legally in veterinary medicine that is mixed with fentanyl to prolong the effect. The US Drug Enforcement Administration (DEA) issued a similar alert a month later. By March 2024, civil society organizations in Mexico reported detecting the substance in the border cities of Mexicali and Tijuana, Baja California.

“[These new substances] are an innovation from fentanyl. It’s a way for the [illicit] market to respond to increased demand for longer and stronger effects,” the Canadian government official said.

*穆小姐 contributed reporting to this article.