Yukon Substance Use Surveillance Report

This report highlights the impact of substance use on the health and well-being of Yukoners. People from all corners of society can experience substance-related harms, ranging from acute alcohol intoxication to a chronic condition like liver cirrhosis or drug toxicity death from unregulated drugs.

Harm and death due to substance use are preventable. The numbers in this report are not just statistics; they represent the lives of Yukoners.

This report offers data on health-related harms from substance use in the Yukon and can be used to guide public health decisions. It helps to:

• understand how substance use affects the health of Yukon’s population and compare it with other regions.
  
• identify groups who would benefit from targeted prevention and intervention efforts
  
• support evidence-based actions by governments and health systems
  
• raise public awareness

The report presents data from:

• Emergency Medical Services (EMS)
  
• Hospital emergency department (ED)
  
• Hospital admissions
  
• Chief Coroner

Some data are reported quarterly and others annually, offering different perspectives on trends. This report includes crude rates, which account for the Yukon’s population size and allow for comparison to other jurisdictions (see data notes for more information on rates). It also provides as well as raw counts, showing the total number of cases or incidents to illustrate the scale of the issue. In some cases, national comparisons were used to measure how the Yukon compares to broader Canadian trends.

Emergency Medical Services (EMS)

The Emergency Medical Services (EMS) data in this report on drug- and alcohol-related responses are collected by paid paramedics using an electronic patient care reporting form. Volunteer paramedics in the Yukon do not currently use this system, so calls they attended are not included in this report.

The locations and hours of paid paramedics are:
- Whitehorse: 7 days a week, 24 hours a day
- Watson Lake: 7 days a week, 8:30am to 6:30pm
- Dawson City: Mon to Fri, 8:00am to 4:30pm

EMS responses in communities other than Whitehorse, Watson Lake, and Dawson City are not captured in this report.

See additional EMS data notes to learn how drug poisoning and alcohol responses are defined.

Figure 1. EMS: Annual rate of paramedic-attended drug poisoning and alcohol events

This graph shows the crude rate per 100,000 for paramedic-attended responses to substance-related incidents. This captures any events coded for drug poisoning or overdose, along with acute alcohol intoxication or withdrawal.

Alcohol-related incidents account for the majority of EMS responses for substance use, though the annual rate has been steadily declining since its peak in 2020. Although the observed rate of drug poisoning responses has decreased since 2021, it remains notably higher than in 2019.

Figure 2. EMS: Quarterly rate of paramedic-attended drug poisoning and alcohol events

Figure 2 provides the same information as Figure 1, but on a quarterly basis.

Paramedic responses to alcohol-related incidents show a seasonal trend, with higher rates during the summer months.

In contrast, paramedic responses to drug poisoning events do not foloow any specific pattern. Although drug poisoning events have declined slightly from 2021 to 2023, the rate in 2023 remained higher than in 2019.

Figure 3. EMS: Monthly counts and rate of paramedic-attended drug poisoning and alcohol events

Figure 3 features a bar chart with monthly counts, with a LOESS trend line (see data notes for more information on LOESS).

Paramedic-attended alcohol-related responses show a seasonal trend of higher volumes during the summer months. The LOESS trend line also shows the observed annual rate steadily declining since a peak in 2020.

Figure 4. EMS: Annual rate of paramedic-attended drug poisoning & alcohol events, by age and sex

Figure 4 provides information on paramedic-attended drug- and alcohol-related incidents. Crude rates are provided for alcohol and drug poisoning by age groups and sex (see drop-down menu to toggle between age and sex graphs).

It shows that individuals aged 20-29, 30-39 and 40-49 have the highest rates of paramedic responses to drug poisoning, with these age groups being the most affected since 2019. Men have consistently shown higher rates than women, though this gap appeared to narrow in 2023.

From 2019 to 2022, alcohol-related responses were most common among those aged 50-59. However, by 2023, the highest rate shifted to the 30-39 age group. Similar to drug poisoning cases, men continued to have higher rates than women.

Table 1. EMS: Five-year counts and percent of locations of paramedic responses to drug-poisoning calls (2019-2023)

Pickup location - drug poisoning	Count (n)	Percent (%)
Residence	630	40.2
405 Alexander	353	22.5
Street/Highway/Road	190	12.1
Hotel	101	6.4
Hospital (Acute & Non-Acute)	43	2.7
Airport/Heliport	33	2.1
Correctional facility	27	1.7
Medical office/Clinic/Nursing outpost	23	1.5
School/College/University	19	1.2
Restaurant/Bar	17	1.1
Single Store/Strip Mall	16	1.0

Note: Percentages less than 1 have not been displayed in this table.

Table 2. EMS: Five-year counts and percent of locations of paramedic responses to alcohol-related calls (2019-2023)

Pickup location - alcohol	Count (n)	Percent (%)
405 Alexander	2,087	32.3
Residence	1,514	23.4
Street/Highway/Road	1,239	19.2
Hotel	452	7.0
Restaurant/Bar	137	2.1
Single Store/Strip Mall	96	1.5
Correctional facility	88	1.4
Mental Wellness & Substance Use Services	91	1.4
Park	86	1.3
Office Building	76	1.2
Medical office/Clinic/Nursing outpost	72	1.1

Note: Percentages less than 1 have not been displayed in this table.

Hospital - Emergency Department Visits

Hospital emergency department (ED) data are drawn from the Canadian Institute for Health Information’s National Ambulatory Care Reporting System (NACRS). NACRS is a national database designed to capture demographic, administrative, clinical and service-specific data from across Canada. Information about each visit is collected at the time of service at the Whitehorse General Hospital, Dawson City Community Hospital, and Watson Lake Community Hospital.

See additional Hospital data notes

Figure 5. Annual rate of substance-related emergency department visits

Figure 5 shows the crude rate per 100,000 for annual substance-related emergency department visits in the Yukon. The visits are categorized into the following four groups:

• “Visits caused by substance use (including alcohol)” are wide ranging and can include acute intoxication, dependence syndrome, harmful use, poisoning, and cirrhosis of liver.
  
• “Visits caused by substance use (excluding alcohol)” is the same as above but does not include any conditions related to alcohol.
  
• “Visits for drug poisoning” are more specific to drug poisoning, and do not include visits related to alcohol use. Drugs captured include: opioids, stimulants, cannabis, hallucinogens, benzodiazepines, and psychotropics.
  
• “Visits caused by alcohol” are similar to “visits caused by substance use” but are exclusively for alcohol.

Annual data help reveal long-term trends by smoothing out short-term fluctuations. This graph shows that alcohol-related visits are much higher than those for drug poisoning or substance use excluding alcohol. While the rates for alcohol-related visits have declined from their peak in 2019, the 2023 rate remains very high overall.

Drug poisoning rates show more year-to-year fluctuation due to the smaller number of visits. After peaking in 2021, the rate in 2023 still remains higher than 2019.

Figure 6. Quarterly rate of substance-related emergency department visits

Figure 6 provides the same information as Figure 5 but on a quarterly basis. Quarterly data help visualize fluctuations throughout the year and can reveal seasonal patterns or other trends in substance-related emergency department visits. Similar to the quarterly data from Emergency Medical Services, substance-related ED visits involving alcohol appear to follow a seasonal trend, with higher observed rates occurring in the summer months.

Figure 7. Annual rate of substance-related emergency department visits, by age, sex, and hospital

Figure 7 shows the crude rate per 100,000 for substance-related emergency departments visits in the Yukon on an annual basis by:

• Age
  
• Sex
  
• Hospital

The age groups with the highest observed rates of emergency department visits — 20-29, 30-39, and 40-49 — are the same as those with the highest rates for paramedic responses to drug poisoning. Between 2019 and 2023, men were seen more frequently than women. Watson Lake Community Hospital reported higher rates of emergency department visits compared to Whitehorse General Hospital and Dawson City Community Hospital, with a notable spike in 2023 (see drop-down menu to toggle between age, sex, and hospital graphs).

Note: For hospital-specific emergency department visit data, patients may be counted more than once. For example, a patient who visited Watson Lake Community Hospital’s emergency department and was then transferred to Whitehorse General Hospital would be counted in both facilities on this graph.

Figure 8. Annual and quarterly percent of the number of substances involved in substance-related emergency department visits

Figure 8 shows an annual and quarterly breakdown of the number of different substances a person may have used before accessing emergency department services. It does not specify which substances were used but indicates the percentage of people using one, two, three, or four or more substances simultaneously. Understanding these patterns can provide valuable insights into substance use behaviours. This graph shows that the majority of visits from 2019-2023 were for a single substance.

Polysubstance use – when two or more substances are consumed together or one after the other – is useful to track because while using multiple substances is common, it can increase the risk of an acute toxicity event. For example, mixing different drugs can make their effects stronger or more dangerous, especially with substances like opioids, alcohol, or benzodiazepines.

Polysubstance use is driven by people’s experience and expectation of substance effects. Substances can be used simultaneously or sequentially to alleviate withdrawal symptoms, enhance a high, reduce overall use, or mimic the effect of another substance.¹

Figure 9. Annual percent of the categories of substances involved in substance-related emergency department visits

Figure 9 shows the frequency of each category of substance as a proportion of the total substances involved in emergency department visits each year.

A single visit may involve one diagnosis (e.g. stimulant poisoning) or multiple diagnoses (e.g. opioid poisoning and alcohol intoxication).

The pattern of substances involved in ED visits has remained fairly consistent from 2019 to 2023, with alcohol consistently being the substance involved in the largest proportion of substance-related ED visits.

Note: Categories of substances accounting for less than one percent are not included.

Figure 10. Five-year percent of common two-substance combinations in substance-related emergency department visits (2019-2023)

Figure 10 shows the most common combinations of two substances among individuals presenting to the emergency department between 2019 and 2023. It provides insights into patterns of substance use, particularly polysubstance use.

Over the five-year period (2019 to 2023), nearly 60% of two-substance ED visits involved a combination of alcohol and a stimulant, making it the most frequent pairing.

Figure 11. Annual rate of frequent emergency department visits for help with mental health and substance use, across jurisdictions

Figure 11 shows the proportion of frequent visitors (with at least 4 visits a year) among those who visit an emergency department (ED) for help with mental health and/or substance use. Frequent visits may strain already busy EDs.

The Canadian Institute for Health Information (CIHI) notes that frequent visits to emergency departments may be an indication that people are not getting access to the services or the support they need for help with mental health and substance use.

For more information on this indicator, see CIHI’s website

Figure 12. Five-year count of drug poisoning emergency department visits that included opioids and/or a CNS depressant (2019-2023)

Figure 12 provides information on individuals who presented to the emergency department having used an opioid and/or a central nervous system (CNS) depressant.

From 2019 to 2023, there were a total of 262 visits that involved an opioid. Within these visits, 21 people (8%) who had opioids in their system also had a CNS depressant present.

There were also a total of 95 visits that involved a CNS depressant. Within these visits, 21 people (22%) who had a CNS depressant in their system, also had an opioid present.

Opioids and CNS depressants (such as benzodiazepines, barbiturates, or alcohol) have compounding effects on respiratory depression, increasing the risk of drug poisoning. ED visits involving both types of drugs may reflect more severe poisonings, as this combination can lead to life-threatening conditions. Understanding the prevalence of these combinations can guide communication and inform medical management strategies.

Figure 13. Five-year count of drug poisoning emergency department visits that included stimulants and/or opioids (2019-2023)

Figure 13 provides information on the individuals who present to the emergency department, having used an opioid and/or a stimulant.

From 2019 to 2023, there were a total of 262 visits that involved an opioid. Within these visits, 47 people (18%) who had opioids in their system also had a stimulant.

There were also a total of 105 visits that involved a stimulant. Within these visits, 47 people (45%) who had a stimulant in their system, also had an opioid present.

While these figures show the drug combinations in individuals who visited the ED for drug poisoning, it remains unknown whether these drugs were intentionally used together or not.

Whether there is a change in the pharmacological makeup of drugs or people are choosing to use multiple substances, understanding the specific drugs involved is crucial for tailoring interventions and determining appropriate responses, such as the use of naloxone.²

Hospital - Admissions

Hospital admission data in this report are sourced from the Canadian Institute for Health Information’s Discharge Abstract Database (DAD), a national database that captures administrative, clinical, and demographic information on hospital discharges across Canada. These graphs present data collected from Whitehorse General Hospital, Dawson City Community Hospital, and Watson Lake Community Hospital.

See additional Hospital data notes

Figure 14. Annual rate of hospital stays for harm caused by substance use

Figure 14 presents the age-standardized rate per 100,000 for hospital stays due to harm caused by substance use, comparing the Yukon to Canada by year. This indicator, collected by the Canadian Institute for Health Information or CIHI, measures the number of hospital stays directly resulting from the use of alcohol, cannabis, and other substances, after adjusting for the age structure of the population. According to CIHI, this indicator provides an indication as to ‘whether residents have access to community-based care to prevent or manage harm caused by substance use’.

The Yukon’s rate has consistently been higher than Canada’s rate from 2018-2019 to 2022-2023. While the Yukon’s rate has declined from its peak in 2020-2021, the most recent rate remains higher than 2018-2019.

Figure 15. Annual percentage of repeat hospital stays for mental health and substance use

Figure 15 shows the percentage of repeated hospital stays by year for mental health and substance use for both the Yukon and Canada.

This indicator from CIHI measures how many patients have at least three repeat hospital stays for a mental health and substance use disorder in a single year. According to CIHI, frequent hospitalizations may reflect challenges in getting appropriate care, medication and support in the community.

Figure 16. Annual rate of substance-related hospital stays

Figure 16 shows the crude rate per 100,000 for annual substance-related hospital stays in the Yukon. The hospital stays in this graph are broken down in the following four categories to allow for greater insight into the patterns of how people use substances:

• “Hospital stays caused by substance use (including alcohol)” are wide ranging and can include acute intoxication, dependence syndrome, harmful use, poisoning, and cirrhosis of liver.
  
• “Hospital stays caused by substance use (excluding alcohol)” is the same as above but does not include any conditions related to alcohol.
  
• “Hospital stays for drug poisoning” are more specific to drug poisoning, and do not include hospital stay related to alcohol use. Drugs captured include: opioids, stimulants, cannabis, hallucinogens, benzodiazepines, and psychotropics.
  
• “Hospital stays caused by alcohol” are similar to “hospital stays caused by substance use”, but are exclusively for alcohol.

This graph shows that most substance-related hospital stays were consistently alcohol-related for the past five years.

Figure 17. Annual rate of substance-related hospital stays, by age, sex, and hospital

Figure 17 shows the annual observed crude rate per 100,000 for substance-related hospital stays, categorized by age, sex, and hospital location (see drop-down menu to toggle between age, sex, and hospital graphs).

The age-specific rates in this graph overlap, and the highest rates have varied over the past five years. The 30–39 age group has consistently remained high, though it was overtaken by a spike in the 40–49 group in 2023. Between 2019 and 2023, men were admitted more frequently than women, although the gap has narrowed in recent years. Whitehorse has had the highest rate of hospital admissions over the last five years, followed by Watson Lake Community Hospital.

Figure 18. Annual and quarterly percent of the number of substances involved in substance-related hospital stays

Figure 18 shows an annual and quarterly breakdown of the number of different substances a person may have used before accessing hospitalization services. It does not specify which substances were used but indicates the percentage of people using one, two, three, or four or more substances simultaneously. Understanding these patterns can provide valuable insights into substance use behaviours. This graph shows that the majority of admissions from 2019-2023 were for a single substance. However, this number is decreasing in recent years and visits with two and three substances appear to be increasing.

Polysubstance use – when two or more substances are consumed together or one after the other – is useful to track because while using multiple substances is common, it can increase the risk of an acute toxicity event. For example, mixing different drugs can make their effects stronger or more dangerous, especially with substances like opioids, alcohol, or benzodiazepines.

Polysubstance use is driven by people’s experience and expectation of substance effects. Substances can be used simultaneously or sequentially to alleviate withdrawal symptoms, enhance a high, reduce overall use, or mimic the effect of another substance.³

Figure 19. Annual percent of the categories of substances involved in substance-related hospital stays

Figure 19 shows the frequency of each category of substance as a proportion of the total substances involved in hospital stays each year.

A single stay may involve one diagnosis (e.g. stimulant poisoning) or multiple diagnoses (e.g. opioid poisoning and alcohol intoxication).

Alcohol consistently makes up a larger proportion compared to other substances. Notably, the proportion of stimulant-related visits has steadily increased from 10% to 19% over the years.

Note: Categories of substances accounting for less than one percent are not included.

Figure 20. Five-year count of hospital stays caused by drug poisoning that included opioids and/or a CNS depressant (2019-2023)

This venn diagram is presented to provide information on the individuals who are hospitalized, having used an opioid and/or a central nervous system (CNS) depressant.

From 2019-2023, there were a total of 76 admissions that involved an opioid. Within these admissions, 18 people (24%) who had opioids in their system also had a CNS depressant present.

There were also a total of 86 admissions that involved a CNS depressant. Within these admissions, 18 people (21%) who had a CNS depressant in their system, also had an opioid present.

Figure 21. Five-year count of hospital stays caused by drug poisoning that included stimulants and/or opioids (2019-2023)

This venn diagram is presented to provide information on the individuals who are hospitalized, having used an opioid and/or a stimulant.

From 2019-2023, there were a total of 76 visits that involved an opioid. Within these visits, 19 people (25%) who had opioids in their system also had a stimulant.

There were also a total of 32 visits that involved a stimulant. Within these visits, 19 people (59%) who had a stimulant in their system, also had an opioid present.

Substance-related Deaths

The data presented here on deaths from drug poisoning are not just statistics; they represent the loss of real individuals – each with their own lives, loved ones, and stories.

The deaths described here refer specifically to acute toxicity deaths from drug poisoning, meaning a person died after being exposed to a harmful amount of a substance in a short period. The data do not currently include deaths related to alcohol use, nor do they encompass all substance-related deaths (for example, cases where someone was intoxicated and died in a motor vehicle collision).

For more information on how a drug toxicity death data is defined, see the Death data notes

Figure 22. Annual rate of opioid toxicity deaths in the Yukon, British Columbia, Alberta, and Canada

Figure 22 shows the crude rate per 100,000 of the opioid toxicity deaths that occurred in the Yukon, British Columbia, Alberta and Canada from 2016 to the first quarter of 2024. The crude rate allows for comparison across jurisdictions with different population sizes. The Yukon’s rate of opioid-toxicity deaths peaked in 2021, surpassing all other provinces and territories. The rate in the Yukon has been declining since then but is still higher than pre-pandemic levels.

Note: British Columbia’s data includes deaths related to all unregulated drugs including, but not limited to, opioids and stimulants.

Data source: Opioid- and Stimulant-related Harms in Canada

Figure 23. Annual counts of acute drug toxicity deaths

Figure 23 provides information on acute drug toxicity deaths that occurred in the Yukon, including:

• Intentional and unintentional deaths
• Deaths from illicit drugs, prescription medication, or over the counter medication
• Acute alcohol toxicity deaths with other illicit substances as contributing causes
  
• Deaths of Yukoners who overdosed in the territory, were medevaced, and later died in another province.

Figure 24. Five-year rates for drug toxicity deaths, by age and sex (2019-2023)

Figure 24 groups data from 2019 to 2023 and shows rates by age and sex, allowing for the observation of trends over five years (see drop-down menu to toggle between age and sex graphs). The age groups most affected by drug poisoning during this period were those aged 20-29, 30-39, and 40-49.

Additionally, when examining the crude rates for men and women from 2019 to 2023, men had a higher five-year rate of drug toxicity deaths than women.

Data notes

Show / hide ‘Data notes’

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Rates: “A rate is a measure of the frequency with which an event occurs in a defined population over a specified period of time. Rates make it easier to compare the frequency of events in different geographic areas…which may have different population sizes”.⁴

LOESS: The LOESS trend line is a weighted regression line that smooths out ‘spikes’ in the data, and may help reveal underlying patterns in the data. This is useful for visualizing trends when counts are low and patterns may be less obvious.

EMS data notes

EMS data are classified according to the following criteria:

Drug poisoning responses:

• Any variation of the words “overdose” or “poison” listed in primary problem or secondary problem or final primary problem, excluding any that also have the code 81.2 (alcohol intoxication)

Alcohol-related responses:

The following combinations in primary problem or secondary problem or final primary problem:

• coded with 81 (drug/alcohol overdose) AND 81.2 alcohol intoxication; OR
  
• coded with 81.2 (alcohol intoxication); OR
  
• coded with TOX03 (alcohol withdrawal); OR
  
• coded with 99.09 (withdrawal detox)

Hospital data notes

Hospital visits and admissions are for all the three hospitals in the Yukon (Whitehorse, Watson, and Dawson). They only include people who are residents of the Yukon.

This report follows the coding standards of the Canadian Institute for Health Research for drug poisoning and substance use. See Appendix 1 for a list of ICD-10 codes used to define substances.

Death data notes

Occasionally, the Yukon reports death-related numbers that differ slightly from those presented by the Public Health Agency of Canada (PHAC) in its national opioid and stimulant surveillance.

This discrepancy arises from different definitions of what is included or excluded in drug toxicity death data. PHAC has more precise definitions, focusing specifically on opioid and stimulant-related deaths, while the Yukon may include acute toxicity deaths from other substances that do not fall into those categories.

Additionally, the Yukon includes deaths of individuals who experienced drug poisoning in the territory, were medevaced to another jurisdiction, and died outside the Yukon (e.g., in British Columbia). These deaths are not reflected in the national numbers reported by PHAC, as they would be included in the data for the jurisdiction where the death occurred.

This report encompasses both intentional and unintentional deaths, as well as deaths related to illicit drugs, prescription medications, and over-the-counter medications. However, it does not currently include deaths solely due to acute alcohol toxicity.

Footnotes

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1. Boileau-Falardeau et al., 2022, https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-42-no-2-2022/patterns-motivations-polysubstance-use-rapid-review-qualitative-evidence.html↩︎

2. Fischer B., 2023, https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(23)00011-X/fulltext#secsectitle0025↩︎

3. Boileau-Falardeau et al., 2022, https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-42-no-2-2022/patterns-motivations-polysubstance-use-rapid-review-qualitative-evidence.html↩︎

4. BCCDC, 2024, http://www.bccdc.ca/health-professionals/data-reports/substance-use-harm-reduction-dashboard↩︎