Carfentanil is a synthetic opioid drug with extreme potency and lethal risks, linked to more than a third of Toronto’s accidental opioid toxicity deaths by 2019. Fluctuations of carfentanil in the city pose challenges in addressing its potency and the dose available in the market. Other fentanyl derivatives and potent substances carry unpredictable and concerning risks.

This article calls for a systemic change in Toronto’s approach to drug supply with evidence-informed reforms to address Toronto’s unregulated opioid supply. Reforms include exploration of supply regulation initiatives, expansion of harm reduction programs, and comprehensive support across the substance use care continuum for people who use drugs.

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