Good morning.

In 2023, Edmonton saw 763 drug-related deaths. A record.

In 2025, Edmonton saw 764 drug-related deaths. A new record.

So what happened? As the rest of the province appears to be getting a better handle on the opioid crisis, the provincial capital is treading water.

The answer is, of course, complicated.

But this week, The Globe and Mail’s Alberta-based health reporter Alanna Smith tried to make sense of that tragic figure.

As Alanna explains, there’s no single explanation for why Edmonton is such an outlier. Experts she spoke with say everything from a highly volatile illicit drug supply and reduced access to services, such as supervised drug-use sites where people can use substances under medical supervision, are a factor.

On top of that, the sheer number of people using drugs, the type of drugs they take and the method they use (inhalation, injection or snorting) also play a role. Some public-health experts even say increased police enforcement is making things worse, driving users out of the public eye, away from help.

Experts have also pointed to the increasing availability of “tranq-dope,” which is a mixture of opioids and tranquillizers, such as veterinary sedatives xylazine and medetomidine. It’s a dangerous blend that comes with increased risk of overdose and death.

Naloxone, the common life-saving medication that reverses the effects of an opioid overdose, isn’t effective against other drugs, including sedatives, benzodiazepines and stimulants.

“It used to be that I could go and give somebody one, maybe two doses, and 15 minutes later, they were up and walking away. I would say now, 80 per cent of the time, they are being transported with no level of consciousness,” said Edmonton outreach volunteer Angie Staines, a licensed practical nurse.

There is always evolution in the world of addiction and recovery, but opioids remain the leading cause of overdose deaths.

While fentanyl remains the most common opioid in Canada, others, which are chemically related but more lethal, have surged in the drug supply. Carfentanil is the prime example, estimated to be 100 times more potent than fentanyl.

Elaine Hyshka, an associate professor at the University of Alberta’s School of Public Health, said carfentanil helps explain the surge in the number of deaths in Edmonton last year.

Provincial data show carfentanil was involved in 69 per cent of fatalities in the region. By comparison, it was linked to just 16 per cent of deaths in Calgary, where a total of 266 people died last year.

While carfentanil is one reason why Edmonton has fared so much worse, another reason is just straight numbers of people using drugs.

Edmonton has the highest dispensation of naloxone, opioid dependency medications and opioid prescriptions for chronic pain management of any Alberta city, The Globe found. The city also has a bigger unhoused population than Calgary, despite having a smaller population.

Of course, another factor could be politics.

The Alberta government has significantly curbed access to harm-reduction services in favour of recovery-focused supports. Supervised drug-use sites are being closed and funding for safer supply programs and outreach is being cut.

While there is some indication that things have gotten worse in a place such as Red Deer, where the the only drug-use site was shut down last March and EMS calls are surging, the government says it’s not clear cut.

The province says attributing the closing to the increase is “misleading.”

No matter what the cause, the opioid crisis remains very much a crisis.

As Haines, the outreach worker, told The Globe: “I think it’s only going to get worse.”

This is the weekly Alberta newsletter written by Alberta Bureau Chief Mark Iype. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.