Xylazine in apparent drug toxicity deaths:

About xylazine

Xylazine is a non-opiate veterinary sedative and analgesic. It is not approved for human use in Canada. Xylazine can decrease bodily functions such as heart rate, breathing, and blood pressure. It can also cause skin infections leading to necrosis. Xylazine may be added to other substances, such as opioids, to increase the bulk or enhance the effects of other substances. There is currently no reversal agent for xylazine in humans.

Xylazine contributes to deaths in Canada

The crude rate of apparent xylazine toxicity deaths in Canada increased from 0.1 per 1,000,000 population (5 deaths) in 2019-2020 to 4.8 per 1,000,000 population (90 deaths) in 2024^{Footnote 1}.

Xylazine contribution to toxicity deaths remains relatively low when compared to apparent opioid toxicity deaths (AOTD). During the same time, AOTDs increased from 99 per 1,000,000 population (3,742 deaths) in 2019 to 173 per 1,000,000 (7,146 deaths) in 2024.

Figure 1. Crude rate (per 1,000,000 population) of apparent xylazine toxicity deaths in Canada, 2019 to 2024^{Footnote 2}

Figure 1: Text description

Increasing presence in drug seizures

In 2024, identifications of xylazine from seized samples in Canada happened almost 14 times more than in 2019.

Figure 2. Number of identifications including xylazine in Canada, 2019 to 2024, from samples analyzed by Health Canada’s Drug Analysis Service

Figure 2: Text description

Rising presence of xylazine in opioids

12.6% of opioid samples also contained xylazine in 2024, compared to 1.1% in 2019.

Limitations

Deaths included in this analysis are limited to records in CCMED where xylazine was mentioned in the cause of death statement, which relies on the medical certificate of death. No additional details on toxicology results are available. Crude rates are based on the sum of populations of the provinces and territories that provided data, which differs depending on the year. Among data on drug seizures, multiple samples may originate from the same seizure, potentially leading to overcounting.

CCMED data were available for 9 to 11 provinces and territories depending on the year.

Data sources

• Mortality data were obtained from the Canadian Coroner and Medical Examiner Database (CCMED). CCMED includes all deaths that are investigated by coroners and medical examiners in Canada. Additional information can be found here: https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=5125
• Drug Analysis Service and Cannabis Laboratory. Ottawa: Health Canada; March 2025. Findings presented here may differ from other data from the Health Canada Drug Analysis Service as these data are presented and analyzed in a different manner. Additional information about the work of the Health Canada Drug Analysis Service can be found here: https://health-infobase.canada.ca/drug-analysis-service/analyzed-drug-report.html

References

• Government of Canada. (2023). Spotlight: The emergence of Xylazine in Canada. Can be found here: https://www.canada.ca/en/health-canada/services/publications/healthy-living/emergence-xylazine-canada.html
• Canadian Centre on Substance Use and Addiction (2022). CCENDU Drug Alert: Xylazine. Can be found here: https://www.ccsa.ca/sites/default/files/2022-07/CCSA-CCENDU-Drug-Alert-Xylazine-2022-en.pdf
• Government of Canada. (2025). Drug Analysis Service and Cannabis Laboratory. Can be found here: https://health-infobase.canada.ca/drug-analysis-service/analyzed-drug-report.html