London, Ontario Reports Third Consecutive Year of Declining Opioid Deaths

Opioid-related deaths and emergency department visits continued to fall in London and surrounding Middlesex County last year, but the region's top public health official warns that progress could quickly unravel.

Newly released Middlesex-London Health Unit data show 62 opioid-related deaths and 335 emergency department visits linked to opioid overdoses in 2025. That compares with approximately 72 deaths and nearly 500 emergency visits in 2024, according to the health unit. The 2024 totals had marked a third consecutive annual decline from the region's 2021 peak.

"So there is progress that's being made, but it is a tenuous process," Dr. Alex Summers, medical officer of health for the Middlesex-London Health Unit, said in an interview. "It is vulnerable to sliding back. And so we have to continue to be diligent."

Factors Behind the Decline

Summers attributed the decline to several factors, including a more stable unregulated drug supply and wider access to naloxone, a fast-acting medicine that temporarily reverses an opioid overdose. Community outreach across London has also been a major factor, he added.

The reduction in overdose mortality aligns with broader trends across Canada and the United States, where harm reduction initiatives have expanded access to naloxone and medication-assisted treatment for opioid use disorder. Public health agencies have increasingly focused on meeting people where they are rather than requiring abstinence before offering support.

But that stability can change almost overnight. A short local surge earlier this year was linked to a more dangerous and unpredictable batch of opioids, Summers said. Medetomidine, a veterinary sedative, and benzodiazepines, often called "benzos," also have been appearing in the unregulated opioid supply, further increasing the risk of overdose.

Supervised Consumption Site Closure Raises Concerns

London also is entering a new period without Carepoint, a supervised drug use site that closed in June. Summers said the effect of its closure on overdoses is not yet known.

Supervised consumption sites have been shown to reduce fatal overdoses by providing sterile equipment, medical oversight, and immediate response when overdoses occur. The loss of such facilities can shift drug use into less visible settings where bystanders may not be present to administer naloxone or call for help.

"We also need to make sure that people are educated in terms of how to use things safely," Summers said. "Things like consumption and treatment facilities have historically played an important role in Middlesex and London."

The Evolving Drug Supply

The health unit measures the crisis partly through deaths in which opioid poisoning contributed to the cause, as determined by Ontario's coroner. The emergency visit count includes cases coded as opioid poisoning or overdose. The 2025 death figure includes probable cases and is subject to change.

The emergence of medetomidine in particular poses new challenges for responders. The veterinary sedative, which has been detected in drug supplies across North America, does not respond to naloxone and can cause prolonged unconsciousness that complicates overdose response.

"There is a real possibility that we can see things worsen relatively quickly if the drug supply gets contaminated or if social services and health services become fragmented or diminished," Summers said.

Despite the decline, Summers said the region remains above levels seen about a decade ago. The latest numbers were released ahead of International Overdose Awareness Day on Aug. 31, marking its 25th year. The annual global campaign remembers people lost to overdoses and promotes prevention.

International Overdose Awareness Day events in London will honor those who have died while emphasizing that overdose deaths are preventable. Advocates continue to push for expanded access to treatment services and harm reduction supplies to sustain the progress seen over the past three years.