The number of drug-related deaths in Manitoba has been rising again over the last several months, according to the province’s chief medical examiner.
Dr. John Younes says the drug-related deaths peaked in late 2023 and early 2024, before coming down later in 2024 and plateauing in 2025. He says based on his observations so far this year, the number of those tragic deaths is climbing once again.
“It’s a national tragedy. And that’s not just Canada, it’s really the whole developed world,” Younes told Global News, adding drug-related deaths have essentially tripled in Manitoba in just a few years.
“And what I see is just the tip of the iceberg. For every death that we see, there’s probably eight or nine or 10 or more people out there who are struggling with addictions and at risk of overdosing.”
A report from the Public Health Agency of Canada lists three likely reasons as to why drug-related deaths started to decline in 2024, including better availability of naloxone, drug dealers changing how they mix the drugs and the fact that there may be fewer drug users because so many have already lost their lives to addiction.
Younes notes the impacts of the drug crisis go beyond overdoses.
“The scope of the problem is enormous, the burden on the province is enormous,” he said.
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“It’s not even just the actual drug toxicity deaths that we see here. The behaviour that drug use is linked to also leads to increased deaths of other sorts, whether it be homicides, suicides, accidents while operating motor vehicles or other means, as well as increased burdens of deaths in young people due to natural disease that is propagated by chronic drug use.”
Dr. John Younes says based on the cases his office sees, it appears drug-related deaths are rising in Manitoba once again.
Marney Blunt / Global News
Since the drug crisis began spiralling out of control in the wake of the pandemic, Younes explains that about half of drug-related deaths in the province are due to stimulant drug toxicity, such as cocaine and methamphetamine, either from the drugs themselves or due to the drugs exacerbating underlying medical conditions.
The other half of drug-related deaths in Manitoba is from ‘down,’ a potent combination of dangerous drugs. It first started as a combination of meth and fentanyl, but has since evolved drastically.
“Now down preparation you might get on the street might have two or three fentanyl analogues or drugs that are like fentanyl, methamphetamine, maybe cocaine, and then the big change in the last two or three years is the addition of Benzodiazepine — what we call synthetic, made strictly for illicit drug use and not for clinical or therapeutic use,” Younes said.
“And then on top of that, in the last couple of years the addition of one or more of the veterinary tranquillizer drugs like xylazine or medetomidine, which are called ‘tranq’ and other things, which are generally responsible for what you see with people in the streets (when) sometimes they’re kind of frozen in place or in some weird contorted position.”
“We’ll get six to eight different things appearing on a toxicology screen of someone who’s overdosed on down.”
The components of down change from month-to-month and year-to-year, he says. Even fentanyl evolves. Younes says para-fluorofentanyl, a fentanyl analogue, is even more common on the streets than fentanyl now.
What makes down so deadly is an impact that toxicologists call ‘synergy,’ he says.
“If you take the sedating effect of one class of drugs and the sedating effect of another class of drugs and you mix them together, the combined sedating effect is greater than some of the individual parts. So they sort of propagate each other,” Younes said.
“So in these combinations that we see on the street now, in down, where there might be three or four or five drugs in there that have a respiratory depressing effect or central nervous system depressing effect with a huge synergistic effect, and that’s what kills most people … They have a sedating effect of all these different classes of drugs that they are using.”
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