Illicit Substance-Related Harms in PEI

Illicit substance-related harms are an important health concern nationally and in Prince Edward Island. The unregulated drug supply continues to evolve and may contain opioids, stimulants, and other substances. These substances can increase the risk of overdose and other serious or life-threatening health effects. 

To monitor, assess, and respond to illicit-substance related harms in PEI, public health officials work closely with government, health, law enforcement, and community partners. Based on this collaboration, key risk factors for illicit substance-related overdoses are consuming substances while alone and multi-substance toxicity (i.e., using more than one substance intentionally or unintentionally).

This page summarizes the most recent available data on illicit-substance related harms in PEI, based on multiple data sources.

Information on legal and illicit substance use among Island residents aged 16 and older is also publicly available online. That information is helpful for understanding trends in illicit substance use, as well as knowledge of and behaviours related to various substances. It can also be used to inform public health actions and evaluate their impacts. Please note: The dashboard file is large and may require extra time to open.

On this page:

• Opioid-Related Harms in PEI
• Stimulant-Related Harms in PEI
• Medetomidine: A Substance of Concern
• Illicit Substance-Related Overdose Emergency Department and Death Statistics in PEI 
• Illicit Substance-Related Overdose Island EMS Statistics in PEI
• Drug Checking Service Statistics in PEI (Urgent Public Health Needs Site)

Opioid-Related Harms in PEI 

Opioids are a group of drugs that include prescription pain medications as well as illicit drugs. When used exactly as prescribed, they can help people manage pain safely. But when opioids are misused—by taking too much, taking them differently than directed, or using someone else’s medication, they can be extremely dangerous and even life‑threatening.

National and provincial studies show a downward trend in prescription opioid dispensing from 2018 through 2024, reflecting policy changes, updated clinical guidelines, and increased awareness of opioid‑related risks.

Opioid-related overdoses are being driven by illicitly produced synthetic opioids, such as fentanyl and fentanyl analogues. Fentanyl is an opioid that is prescribed to treat chronic pain; however, synthetic fentanyl or fentanyl analogues produced by the illicit market can be significantly more toxic than pharmaceutical-grade fentanyl. Use of illicit synthetic fentanyl has increased since 2016. Synthetic fentanyl/fentanyl analogue overdoses are often harder to reverse than other opioids and might require higher dosages of naloxone.

National data regarding opioid overdoses and deaths is reported in association with the Public Health Agency of Canada (PHAC).

What are risk factors for opioid-related overdose?

• Taking prescription opioids more often or at higher doses than recommended
• Taking opioids with alcohol or sedatives (benzodiazepines, sleeping pills)
• Consuming opioid after a period of reduced or no drug use
• Consuming illicit, street-sourced drugs
• Consuming drugs while being alone
• Injecting or smoking drugs

More information is available here on overdose prevention and response and the PEI Take Home Naloxone Program. 

Stimulant-Related Harms in PEI 

Stimulants are a group of substances that increase activity in the brain and body. Some stimulants, including amphetamines, pseudoephedrine, and methylphenidate (Ritalin®), are used for medical purposes. Others, such as cocaine and methamphetamine (meth), are not for medical use, are produced in the illicit market and may pose significant risks to health.

Stimulants may increase alertness and energy but can also have adverse effects, including anxiety, agitation, rapid heart rate, high blood pressure, and difficulty sleeping. In some cases, stimulant use can lead to serious health complications such as heart problems, overheating, or overdose. 

Stimulants are not opioids, so naloxone does not reverse its effects. However, stimulants may be mixed with opioids without a person’s knowledge. For this reason, naloxone should still be used if an opioid or stimulant overdose is suspected. 

There is no specific antidote to immediately reverse the effects of stimulants. Medical assistance should be sought immediately in all cases of overdose as treatment relies on managing symptoms and providing supportive care in a controlled, safe environment.

Recent trends indicate that stimulant-related poisonings have become increasingly prominent across Canada, with PEI also observing stimulant-related harms. In response to these emerging trends, the PEI Chief Public Health Office expanded its surveillance activities to include the systematic monitoring of stimulant-related overdose harms in PEI beginning in 2026.

Medetomidine: A Substance of Concern

Medetomidine is a non-opioid veterinary sedative not approved for human use. It has been detected in the illicit drug supply across Canada and is often mixed with opioids such as fentanyl and/or fentanyl analogues.

Because it may be present without a person’s knowledge, medetomidine can increase the risk of serious health effects of illicit drug use, including prolonged sedation, slow or difficult breathing, low heart rate, low blood pressure and loss of consciousness.

Remember: 

• Naloxone does not reverse the effects of non-opioids like medetomidine.
• Naloxone should still be given if an opioid overdose is suspected.
• Medical attention is needed immediately.

What to do in an overdose:

• Call 911 immediately
• Start overdose response
• Give naloxone if opioid overdose is suspected
• Stay with the person and monitor breathing until help arrives

Illicit Substance-Related Overdose Emergency Department and Death Statistics in PEI 

Illicit substance-related non-fatal overdose and death surveillance reports from Emergency Departments and the Chief Coroner’s Office are monitored closely and posted here on a quarterly schedule. If a cluster of events occurs, actions are taken in real time to further assess risk and coordinate a response.

Across Canada, opioid‑related poisoning visits to emergency departments were 22% lower in June 2025 compared with the previous 12‑month period. Prince Edward Island showed a similar trend, with a 40% decrease in opioid‑related poisoning emergency visits in 2025 (26) compared to 2024 (43).

National surveillance data suggest that stimulants are a significant contributor to substance-related harms in Canada. In 2025, stimulant use was associated with a daily average of 14 emergency department visits and nine deaths across Canada.

Data on non-fatal overdose visits to emergency departments¹ in PEI is collected from the PEI Trauma Registry, Prince County Hospital and Queen Elizabeth Hospital. Information on overdose deaths is gathered with support from Health PEI Laboratory Services and the Chief Coroner’s Office. Table 1 provides a summary of this data. 

Note: Systematic monitoring of stimulant-related non-fatal overdoses and deaths began in 2026. Work is underway to develop reporting for stimulant-related overdose visits to emergency departments. This information will be added to Table 1 once it becomes available. 

Data on overdose deaths is also published nationally in association with the Public Health Agency of Canada.  

Table 1. Number of accidental non-fatal overdose visits to emergency departments and fatal illicit substance-related overdoses in PEI

¹ Data is received from the PEI Trauma Registry directly or through regular updates from the National Ambulatory Care Reporting System (NACRS): https://www.cihi.ca/en/national-ambulatory-care-reporting-system-nacrs-metadata

² Surveillance by the Chief Public Health Office of toxicological cases presenting to PEI’s emergency departments began in May 2017.

³ Accidental/unintentional overdoses involving opioids or stimulants do not include overdoses that occurred as a result of intentional self-inflicted harm

⁴Accidental/unintentional deaths involving opioids and stimulants do not include deaths that occurred as a result of intentional self-inflicted harm; only closed (certified) cases are reported.

⁵ Death investigations can take 12 to 18 months to complete. Data for 2026 is incomplete, and numbers may increase as coroner investigations continue.

⁶ Surveillance by the Chief Public Health Office of overdose deaths began in 2016. Data from 2016 to 2025 include opioid-related deaths. Starting in 2026, data include both opioid- and stimulant-related deaths.  

⁷ Reported death was due to toxicity from both opioids and stimulants.

Illicit Substance-Related Overdose Island EMS Statistics in PEI

Illicit substance-related statistics from Island Emergency Medical Services (IEMS) data are monitored closely and posted here on a quarterly schedule. If a cluster of events occurs, actions are taken in real time to further assess risk and coordinate a response.

IEMS data is one of several data sources the Chief Public Health Office (CPHO) uses to conduct surveillance of the complex illicit drug overdose situation in Prince Edward Island. IEMS data captures suspected illicit substance-related overdoses that hospital-based data may not capture. Overdoses where IEMS was not called (e.g., bystander only provided care) are not captured in this data.

The first complete calendar year of reporting from IEMS to the CPHO was 2023, as demonstrated in Figure 1 and Table 2. Stimulant-related IEMS reporting began in 2026, and available data is shown Table 2. This data should be interpreted with caution, as continuous improvements are made to data collection and illicit substance-related case identification. 

Figure 1 shows a decline of 36% in the number of suspected opioid‑related overdoses reported by Island EMS in 2025 (109) compared with the previous year (171 in 2024). This reduction likely reflects changes in the illicit drug supply, and ongoing efforts to raise Islanders’ awareness of the risks associated with the non‑medical use of opioids, including fentanyl and its analogues.

Figure 1. IEMS reported suspected opioid-related overdose patients

Table 2. IEMS statistics of suspected opioid- and stimulant-related overdoses 

¹ IEMS calls disclosed as suspected illicit substance-related overdoses are identified from all 911 patients where paramedics made contact and completed a Patient Care Report (PCR). Cases are further filtered through the following inclusion and exclusion criteria: 

• Inclusion Criteria: (1) All patients identified with primary, secondary, or final problem codes of “drug/alcohol overdose,” “opioid overdose suspected,” “non-opioid overdose,” “substance misuse/intoxication,” “overdose ingestion,” “stimulant overdose,” AND/OR (2) documentation of naloxone administration. 
• Exclusion Criteria: (1) Calls outside of the reporting period, (2) cases where the primary purpose of the call is related to a request for treatment services, withdrawal management services or assistance with social or psychiatric issues, a non-acute situation, strong evidence of or a stated intent that the overdose was intentional or related to self-harm (unless expressed post-intoxication), related to an injury sustained while intoxicated and not the intoxication itself, and calls related to a patient accidentally taking an extra dose of medication when the extra medication is to have little clinical impact on the patient. 

² Surveillance by the Chief Public Health Office of stimulant-related IEMS calls began in 2026.

Drug Checking Service Statistics in PEI (Urgent Public Health Needs Site)

Drug checking services help individuals reduce overdose risk, increase awareness among health and social care providers, and support public health monitoring.

Illicit substance-related statistics from drug checking service data are monitored closely and posted here on a biannual schedule. If a cluster of events occurs, actions are taken in real time to further assess risk and coordinate a response.

Working under a Federal Urgent Public Health Needs Site (UPHNS) Exemption, PEERS Alliance offers a confidential drug checking service that helps people learn what may be in the drugs they are using, including opioids, stimulants, and other substances. Using a very small sample, the service can identify unexpected or potentially harmful substances. 

Data from the Drug checking service was first reported to the CPHO in 2025, as demonstrated in Table 3. This data should be interpreted with caution, as continuous improvements are made to drug testing techniques and data collection processes. 

Table 3. UPHNS statistics of detected illicit substances in drug testing samples 

¹ Fentanyl represented 58% of detected opioids.

² Benzodiazepines (16%) and Tranquilizers (5%)