The Addiction Crisis in Sault Ste. Marie

Sault Ste. Marie has one of the most severe opioid crises of any mid-sized city in Ontario. In 2023, the city recorded 37 opioid toxicity deaths and held the highest opioid death rate in the province. In 2024, 38 deaths were recorded, placing Sault Ste. Marie second in Ontario for opioid mortality rate at approximately 48.36 deaths per 100,000 population — more than three times the provincial average of 14.3 per 100,000. Between 2018 and 2024, a total of 243 people in Sault Ste. Marie died from opioid toxicity. Drug supply is driven largely by fentanyl trafficked from southern Ontario. A partial improvement was reported in late 2025 following the October 2025 opening of the city's new HART Hub (Homelessness and Addiction Recovery Treatment Hub), operated by Maamwesying North Shore Community Health Services and providing Indigenous-led services, addiction medicine, primary care, and housing outreach. Algoma Public Health continues to report opioid-related ED visit rates and death rates that consistently exceed the Ontario average.

Canada recorded approximately 7,560 apparent opioid toxicity deaths in 2023, according to the Public Health Agency of Canada (PHAC). Preliminary 2025 figures from PHAC indicate 5,630 apparent opioid toxicity deaths reported to date for 2025, with British Columbia, Alberta, and Ontario together accounting for 78% of national deaths. The crisis remains concentrated in Western Canada but Northern Ontario communities — particularly Sault Ste. Marie, Thunder Bay, and Sudbury — record per-capita death rates that rival or exceed those of the hardest-hit British Columbia cities. Fentanyl and its analogues remain the dominant driver nationally, present in the vast majority of toxicity deaths.

01. What is happening in Sault Ste. Marie

02. A crisis that did not start this month

Ontario recorded 2,639 opioid toxicity deaths in 2023 and 2,231 in 2024 — a 15% year-over-year decrease, though still well above pre-pandemic levels. The 2024 provincial mortality rate was 14.3 deaths per 100,000 people, down from a peak of 19.4 per 100,000 in 2021. Fentanyl and related substances were present in more than 83% of Ontario opioid toxicity deaths in 2024, while stimulants appeared in 69% and prescription benzodiazepines in 45% of deaths — a sharp rise from 33% the prior year. Ontario's opioid crisis is highly uneven geographically, with Northern Ontario communities like Sault Ste. Marie, Thunder Bay, and Sudbury recording rates far above the provincial average. The province has committed nearly $550 million to establish 28 HART Hubs across Ontario, with $3.8 billion over 10 years under the Roadmap to Wellness mental health strategy.

03. Why is it getting worse?

The opioid crisis in Sault Ste. Marie is driven by several compounding factors: (1) Fentanyl supply from organized trafficking networks based in southern Ontario, which has contaminated the local drug supply with highly potent and unpredictable substances. (2) Relative geographic isolation as a Northern Ontario city, limiting access to specialized treatment, harm reduction services, and rapid emergency response compared to larger urban centres. (3) Socioeconomic vulnerability including higher rates of poverty, unemployment, and housing instability, which correlate with higher substance use disorder rates. (4) Polysubstance toxicity — deaths increasingly involve combinations of fentanyl, stimulants, and prescription benzodiazepines (benzodiazepines present in 45% of Ontario opioid deaths in 2024), creating unpredictable overdose risk. (5) A significant Indigenous population in the region facing compounding trauma, systemic healthcare gaps, and culturally unsafe services — addressed only recently by the Indigenous-led HART Hub. (6) Historically inadequate treatment infrastructure relative to the scale of need, though the opening of the HART Hub in late 2025 represents a meaningful step forward.

04. Where hope still lives

Communities across Ontario 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:

• 'People are becoming desperate': Sault Ste. Marie has Ontario's highest opioid death rateCBC News · 2024
• Sault opioid death rate for 2024 is 'very worrisome': ShoemakerSooToday · 2025
• Ontario launches Indigenous-led HART Hub in Sault Ste. Marie to expand mental health and addictions careWire Service Canada · January 16, 2026
• 'A step in the right direction': Opioid death stats improve since HART Hub openedSooToday · 2026
• How fentanyl traffickers from down south fuel Sault Ste. Marie's opioid crisisVillage Report · 2024
• More than 2,200 died of opioids in Ontario last year as numbers trend downwardCBC News · 2025