Health, Care & a Long Life

Published 2026-07-30 · part of the research library.

Two very different groups of people are affected by systems that mostly aren’t run by the city: people struggling with opioid use, and seniors who need long-term care. Opioid deaths across Canada fell in 2025, but Ontario remains one of just three provinces that account for most of the country’s opioid deaths. Toronto runs 10 long-term care homes itself, with a waitlist of more than 7,500 applications.

Where things stand

1. Across Canada, opioid deaths fell in 2025 to 5,630 — real progress. But British Columbia, Alberta, and Ontario together still account for 78% of all opioid deaths in the country.
2. In Toronto, five deaths tied to opioids happened in one week in April 2026, after a new, more dangerous substance turned up in the local drug supply.
3. Toronto Public Health recorded 464 confirmed and probable opioid toxicity deaths among Toronto residents in 2024 (a preliminary count) — down 16% from the 2020-2022 average, but still 50% above pre-pandemic levels.
4. Ontario’s own supervised consumption sites medically reversed almost 22,000 overdoses between March 2020 and May 2024, with no recorded deaths on site. The province has been shifting resources toward treatment-focused hubs instead of that model.
5. Toronto runs 10 long-term care homes itself. As of May 2025, more than 7,500 applications sat on the waitlist for a spot in one of them.
6. On two measures the city tracks closely in its own long-term care homes — antipsychotic drugs given without a diagnosis, and residents who fall — Toronto beats the provincial average by a wide, steady margin: 14.2% versus 19.4% on antipsychotic use, and 9.9% versus 15.4% on falls. Families and residents report 93% overall satisfaction.
7. A government-appointed commission that studied Ontario’s long-term care system found seniors in long-term care made up half a percent of Ontario’s population but 61% of its COVID-19 deaths in 2020, following what the commission itself called “chronic underfunding, severe staffing shortages, outdated infrastructure and poor oversight.”
8. The province promised to raise care time in every long-term care home to four hours per resident per day by March 2025. No source fully confirms that target was met — the province’s own Auditor General follow-up shows direct-care hours had reached about three hours 49 minutes by the end of 2024/25, on the way to the target but not yet there by the most recent reported year.

What the city controls vs. what needs the province

The city can act on directly: running its own 10 long-term care homes, where it already outperforms the provincial average on key quality indicators; funding outreach workers who follow up after an overdose is reversed; publishing local data, like a monthly dashboard tracking overdoses and new dangerous substances in the local drug supply; deciding whether to publish a public wait-time target for its own long-term care waitlist, the way it already publishes quality-of-care indicators.

Needs the province: licensing and funding long-term care homes, setting staffing rules, and running the inspection system; the law restricting supervised consumption sites, and the funding for the treatment-focused hubs replacing them; setting the province’s own staffing-hours targets. The federal government is involved in drug policy too, alongside the province.

One honest gap: this page doesn’t have solid, sourced figures on Toronto’s mental-health crisis-response system beyond what it shares with the opioid and long-term-care material above. One related, well-sourced fact does live elsewhere in this library: Toronto’s Community Crisis Service — a mental-health response team, not police — has resolved 78% of transferred 911 mental-health calls without police involvement since it launched in 2022; see the Safety & Emergency Readiness page for that figure and its sourcing.

Go deeper

• Opioid crisis & public health response — overdose deaths, supervised consumption sites, drug supply.
• Long-term care & seniors services — Toronto’s own homes, waitlists, quality indicators, the provincial commission’s findings.
• Aging well: home care — aging-in-place and home-care services beyond institutional long-term care.
• Mental health crisis response

How this connects to the election

Several of the levers described above sit with Toronto’s city council and mayor, particularly the city’s own long-term care homes; the province controls the larger opioid-response and long-term-care-licensing levers directly, as noted above. A resident who wants to ask a candidate for city council or mayor what they would do about any of these levers can use the neutral, non-partisan candidate question bank for this category — every question there works identically for any candidate, any party. This page does not endorse, score, or rank any candidate or party, and does not direct a reader to any organization or campaign.

Sources & receipts

1. National and provincial opioid-death figures — Health Canada substance-related-harms data; see the opioid crisis backgrounder above (fact 1).
2. April 2026 Toronto opioid-death cluster — see the opioid crisis backgrounder above (fact 2).
3. Annual Summary of Opioid Toxicity Deaths in Toronto (fact 3).
4. Supervised-consumption-site overdose-reversal figures — see the opioid crisis backgrounder above (fact 4).
5. Long-term-care home count and waitlist size — City of Toronto long-term-care reporting; see the long-term care backgrounder above (fact 5).
6. Long-Term Care Annual Performance Report (fact 6).
7. Ontario’s Long-Term Care COVID-19 Commission Final Report — see the long-term care backgrounder above (fact 7).
8. Ontario Auditor General 2025 follow-up on long-term-care staffing hours — see the long-term care backgrounder above (fact 8).