The Addiction Crisis in Quebec City

Quebec City (Capitale-Nationale region) has been identified alongside Montreal as experiencing an unprecedented rate of opioid-related deaths since 2016. The city's public health authority issued specific warnings in early 2024 about protonitazepyne — a synthetic opioid found in green tablets marked "80/OP" that is 25 times more potent than fentanyl — circulating in the Quebec City area. No separate city-level death count for Quebec City is publicly reported; statistics are tracked at the provincial and regional level by the INSPQ (Institut national de santé publique du Québec). Quebec as a province recorded 645 confirmed or suspected drug overdose deaths in 2024, its highest total ever, and was on pace for a second consecutive year above 600 deaths in 2025.

Canada recorded approximately 7,560 apparent opioid toxicity deaths in 2023 (PHAC), and an estimated 7,150 in 2024 — a national decline of about 17% year-over-year. Quebec runs sharply counter to this national trend: it is one of only three jurisdictions (alongside Newfoundland and Labrador and the Northwest Territories) where opioid deaths rose in 2024. Quebec's death rate of 7.3 per 100,000 in 2024 remains below the national peak driven by British Columbia and Alberta, but it is rising while those provinces decline. The federal government appointed a Fentanyl Czar in 2025, whose June 2025 interim report highlighted Quebec's delayed but accelerating fentanyl crisis as a priority concern.

01. What is happening in Quebec City

Note: City-specific data for Quebec City is limited. Figures reflect Quebec-wide trends.

02. A crisis that did not start this month

Quebec is a national outlier: while apparent opioid-related deaths dropped 17% across Canada in 2024, Quebec's toll rose sharply. The province reported 536 deaths in 2023, then 645 in 2024 — a 20% year-over-year increase and the highest annual figure ever recorded. Between January and September 2025, 453 deaths were already confirmed, projecting roughly 604 for the full year. The annual death rate climbed from 5.1 per 100,000 in 2018 to 7.3 per 100,000 in 2024. Fentanyl or its analogues were detected in nearly two-thirds of opioid deaths. New ultra-potent nitazene compounds (protodesnitazene, N-pyrrolidino-metonitazene) were detected in Quebec drug samples in early 2025. Demand for residential treatment rose approximately 16% in both 2024 and 2025, while resources have not kept pace. Fourteen supervised-consumption services operate across Quebec as of mid-2025.

03. Why is it getting worse?

1. Toxic drug supply contamination: Fentanyl or its analogues are present in roughly two-thirds of opioid deaths in Quebec. Unlike Western Canada, Quebec's illicit drug market was historically dominated by heroin and pharmaceutical opioids; the rapid displacement by fentanyl since 2017 caught users and services unprepared. 2. Emergence of ultra-potent novel synthetic opioids: Quebec City was among the first Canadian cities to see nitazene compounds (protonitazepyne, 25x more potent than fentanyl) circulating in the street supply in early 2024. Two additional nitazene variants were detected in Quebec samples in Q1 2025, raising acute overdose risk. 3. Polysubstance use: Stimulant-opioid combinations (cocaine or methamphetamine mixed with fentanyl) are increasingly documented in Quebec overdose deaths, complicating resuscitation and treatment. 4. Treatment capacity gap: Residential treatment applications rose ~16% in both 2024 and 2025, but supply of publicly funded beds has not kept pace, leaving people in the queue during high-risk periods. 5. Harm reduction coverage gaps: Despite federal-provincial funding, supervised-consumption services remain concentrated in Montreal; Quebec City and smaller centres have limited or no on-site overdose prevention sites. 6. Social and economic marginalization: Most overdose deaths affect men aged 40–59, many experiencing housing instability, social isolation, and co-occurring mental health conditions. 7. Quebec as national outlier: Decreases seen in BC, Alberta, and Ontario have not reached Quebec, partly due to later fentanyl market penetration and differing harm-reduction policy infrastructure.

04. Where hope still lives

Communities across Quebec are responding with naloxone distribution, harm reduction programs, and peer support networks. Every person trained in naloxone use is a potential life saved.

05. In the news

The reporting behind this page:

• Quebec on pace to record back-to-back years with 600 drug overdose deathsCBC News · 2025
• Drug overdose deaths in Canada are dropping. So why is Quebec nearing a record high?CBC News · 2024
• Quebec City public health warns of dangerous synthetic opioid 25 times stronger than fentanylCBC News · 2024
• Overdose deaths in Quebec are on the rise, and the problem could get worseCBC News · 2025
• How to fight Quebec's toxic drug problem? A former user says change the conversationCBC News · 2025
• Overdose Epidemic in Quebec: Population-Level Approaches and Clinical ImplicationsMDPI (peer-reviewed journal) · 2025