A previously reported drop in the number of people suspected of dying from substance use in Manitoba in the first half of 2025 appears to have held up through the rest of the year — a shift one addictions expert says is a positive sign, but represents only “one piece of the puzzle” in addressing preventable drug deaths.

Preliminary provincial data shows a total of 354 suspected substance-related deaths recorded from January to November 2025, the most recent month for which numbers are available. That marks a significant drop from the 530 substance-related deaths recorded from January to November 2024.

Addiction physician Dr. Erin Knight, who is the medical lead for Manitoba’s rapid access to addictions medicine (RAAM) clinics, said she’s happy to see what seems to be the effects of work like getting naloxone and harm reduction education into the community. 

But every day, Knight — who also serves as the medical director of addiction services at Winnipeg’s Health Sciences Centre — still sees people who have recently lost loved ones to what she describes as unnecessary drug poisonings, she said.

“Even though we’ve seen a decline, it is still essentially somebody losing their life in Manitoba every day to a preventable cause,” said Knight, who is also the president of the Canadian Society of Addiction Medicine and has been working in that field for a decade.

“I don’t want to lose the impact that that has on people and communities. And I don’t want to lose the urgency for us to continue to work towards lessening the loss of life that’s unnecessary,” she said.

“I would say this still really is a crisis situation in terms of the impact of preventable deaths.”

While the substance-related death numbers are preliminary and will “almost certainly” change as straggling reports come in, the executive director of Manitoba’s chief medical examiner’s office said any changes will “be very minor in scale.”

The numbers as reported “are considered to be quite accurate,” Stephanie Holfeld said in an email.

Though they include some deaths where drugs were involved and some where only alcohol was a factor, the medical examiner’s office later said “a small fraction” involve just alcohol.

Shift mirrors national trend

Both Holfeld and Knight said Manitoba’s significant drop in drug-related deaths reflects a trend seen across Canada. While it’s unclear exactly what’s behind the shift in Manitoba, Knight said there are a number of factors believed to have played a role in the change nationally. 

Those include a general increase in naloxone availability, changes to the drug supply — like a drop in benzodiazepines seen in opioids — and fewer people at risk of dying a drug-related death, because so many people in that group have already died.

“That piece, where maybe we’re seeing a reduction in overdose deaths or in drug poisoning deaths because people have already died, is quite sad to me,” Knight said.

Other possible factors are changes in how people are using drugs — including the method of consumption and whether they use alone or with other people — and youth potentially using opioids less than some of the older groups of people who use drugs, said Knight.

Last year, Health Canada listed a number of factors that may have played a role in a drop in opioid-related deaths in 2024 compared to 2023. Some — like naloxone availability — were listed as likely contributors.

However, other factors the health agency said provide important benefits, like drug checking services and supervised consumption sites, were listed as unlikely contributors.

That’s in part because deaths declined even in areas with few or no drug checking services, and though most supervised consumption sites opened before 2022, deaths didn’t decline until 2024.

The sites that did open were also limited, which “cannot account for the broad reduction in deaths,” Health Canada said.

‘There is a path forward’

Bernadette Smith, Manitoba’s minister of housing, addictions and homelessness, said the province is “cautiously optimistic” about the drop in deaths and will continue to work to address addictions.

“Those numbers are still high,” said Smith, who is also the MLA for Point Douglas. 

“Nobody wants to be addicted to substances. Families need support. You know, these are someone’s loved ones, and we want to help them realize that there is a path forward.”

She said the province is taking steps that include distributing over 63,000 naloxone kits in the 2025-26 fiscal year, offering programs like mobile withdrawal management services, moving more people from homelessness into housing and working to open a supervised consumption site.

Smith said the province is first working to open a temporary version of that site, with the goal of offering a RAAM clinic and primary health care in the permanent version.

She could not provide a timeline on when it might open, and said the supports front-line workers are providing in the absence of a supervised consumption site are crucial.

“We need to keep people alive long enough to get them to those services,” Smith said.