Prescription opioid use may be decreasing in Canada but the use of bootleg fentanyl is on the rise.

According to Health Canada, opioids are prescribed as pain relievers for both acute and chronic pain. Opioids like codeine can also be used to treat severe coughs while others can even help ease addiction to other opioids. The most used types of opioids are hydromorphone, morphine and oxycodone.

Opioids are extremely prone to being abused because they are highly addictive, and due to the “high” the user may feel.

A found that 14.9 per cent of the general population, those 15 and older, reported using prescription opioids while 2.3 per cent of the general population reported abusing prescription opioids.

According to the , high-income countries such as Canada, Australia and the United States reported a high prevalence of misuse of prescription opioids. Canada topped the list of countries with the highest consumption of opioids at 812.19 mg per capita, with the U.S. in second with 749.19 mg per capita.

Bootleg fentanyl

Synthetic fentanyl, not prescription, may have a higher potency than normal fentanyl. It is sometimes pressed into fake pills such as OxyContin or Xanax but can also be found mixed into other street drugs like heroin. Most people are unaware that they are consuming fentanyl when it is laced with other drugs.

According to a , bootleg fentanyl is about 40 times more potent than heroin and 100 times more potent than morphine.

In Ontario alone, deaths attributed to fentanyl doubled from 45 in 2008 to 116 in 2012, according to a . The same report also shows that toxic drug related deaths surpassed vehicle related deaths in Ontario in 2013, with 776 compared to 662.

However, Alberta has been one of the hardest hit provinces when it comes to bootleg fentanyl. The drug related deaths have risen from six in 2011 to 270 in 2015, a 4,500-per-cent increase.Drug vs. Vehicle deaths graph

fentanyl Ontario deaths