St. Catharines & Niagara Region Addiction Statistics: What the Data Shows

The Niagara Region that spans Ontario, Canada, to Buffalo, New York, in the United States is known for its waterfalls, wine country, and cross-border tourism.

But it’s also home to some of the most severe substance-use statistics in all of Ontario. When the numbers are put side-by-side with the provincial and national averages, a clear pattern emerges: Niagara isn’t just affected by the same addiction crisis as the rest of Canada — in several key measures, it’s affected worse.

Below is a breakdown of the most current, publicly sourced addiction statistics for the Niagara Region, drawn from Niagara Region Public Health, the Ontario Drug Policy Research Network (ODPRN), Public Health Ontario, and the CDC. 

St. Catharines Drug Overdose Data: Niagara’s Opioid Death Rate

The clearest, most alarming data point regarding Niagara Region addiction statistics is opioid mortality.

• In 2024, Niagara recorded 111 opioid toxicity deaths — a rate of 20.4 per 100,000 residents. That’s nearly 50% higher than Ontario’s rate of 13.8 per 100,000 the same year.
• Niagara’s opioid death rate has outpaced Ontario’s every year since 2016. In 2020 and 2021, at the height of the pandemic, Niagara’s rate spiked to 30.8 and 33.4 per 100,000 — both roughly 60 to 75% above the provincial rate in those same years.
• Niagara’s 2024 opioid death rate (20.4 per 100,000) is also well above the current U.S. national rate. CDC data puts the American opioid-involved overdose death rate at 15.9 per 100,000 in 2024. In other words, someone living in Niagara faces a higher statistical risk of dying from an opioid overdose than the average American.
• At the census-subdivision level, Niagara Falls posted an opioid mortality rate of 24.63 per 100,000 in 2025 (26 deaths) — one of the 10 highest rates of any municipality in Ontario — and more than double the provincial rate of 8.96 per 100,000 recorded that year.
• Niagara EMS responded to 1,001 suspected opioid overdoses in 2021 and 657 in 2022. In February 2023, Niagara Region declared a state of emergency over homelessness, mental health, and opioid addiction — one of the first regions in Ontario to do so.

Fentanyl remains the primary driver provincially: it’s attributed to nearly 3 in 4 opioid toxicity deaths in Ontario as of 2025, with stimulants (cocaine, methamphetamine) now co-involved in roughly two-thirds of cases. Niagara’s elevated death rate is consistent with this trend — an unpredictable, fentanyl-contaminated drug supply layered on top of an already high-risk population.

Niagara Region Substance Use: Alcohol

Opioids dominate headlines, but alcohol is the substance used the most by people in Niagara.

• 83.1% of Niagara residents report current alcohol use, according to Public Health Ontario’s Alcohol Use Snapshot, compared to 75.8% provincially — one of the largest gaps between a Niagara substance use indicator and the Ontario average.
• Roughly 3 in 5 Niagara residents aged 19+ are regular drinkers (once a month or more), and about 1 in 3 report drinking at moderate-to-high-risk levels (3+ standard drinks in the past week).
• A total of 44% of Niagara adults exceed Canada’s Low-Risk Alcohol Drinking Guidelines, with residents aged 19 to 44 the most likely to exceed them, according to the Canadian Community Health Survey.
• In 2024, according to the Substance Use and Harms Tool, Niagara residents made 2,513 emergency department visits for conditions entirely caused by alcohol — a rate of 461.0 per 100,000. Interestingly, this is one of the only substance-use indicators where Niagara sits below the Ontario average (525.8 per 100,000); alcohol-related ED visit rates in Niagara have trailed the province since 2018, even as self-reported drinking rates run higher.

The takeaway: more Niagara residents drink, and drink at riskier levels, than the provincial average — but Niagara residents are somewhat less likely to end up in the ER for it, possibly reflecting access-to-care or health-seeking behaviour differences rather than lower actual risk.

Cannabis-Related Harms in the Niagara Region of Ontario

Cannabis tells a more one-sided story.

• In 2023, Niagara recorded 573 cannabis-related ED visits — a rate of 109.1 per 100,000, compared to Ontario’s 82.0 per 100,000.
• Niagara’s cannabis-related ED visit rate has been significantly higher than Ontario’s every year since 2014, the year before the rate began climbing sharply toward legalization.
• Nationally, past-12-month cannabis use in Canada rose from roughly 22% in 2018 to 26% in 2024, a trend Public Health Ontario links to post-legalization normalization and easier access — a trend Niagara’s tourism-driven retail environment likely amplifies.

Youth Substance Use in Niagara

Youth data, gathered through Niagara Region’s oversample of the Ontario Student Drug Use and Health Survey (OSDUHS), shows early and widespread exposure:

• 73% of secondary students and 45% of grade 7-8 students report having had at least a sip of alcohol in the past year.
• 57% of teens report drinking at least once in the past month.
• 35% of high school students report trying cannabis at least once in the past year.
• 14% of secondary students already drink at hazardous or harmful levels.
• One in three secondary students who drink report trying alcohol for the first time while still in elementary school.

Homelessness and Substance Use

Substance use and housing instability are closely linked in Niagara.

The region’s 2021 Point-in-Time count identified 665 people experiencing homelessness — of whom 40.5% self-reported substance use, and 29.2% reported needing substance use treatment services. 

This overlap is a central reason Niagara’s Community Substance Use Strategy (2025-2029) pairs addiction treatment recommendations directly with housing support.

Why Niagara’s Numbers Run Higher

Niagara Region Public Health points to several regional factors that compound addiction risk locally:

• Cross-border accessibility — proximity to U.S. border crossings and international airports affects the availability and movement of substances.
• A large, transient hospitality and tourism workforce — seasonal service-industry work is associated with elevated substance use rates.
• A significant wine, beer, and craft alcohol economy — Niagara is Ontario’s largest grape-growing region, with normalized, high-visibility alcohol culture.
• Socioeconomic and housing pressures — nearly half of all opioid toxicity deaths in Ontario now occur among people living in areas of the highest material deprivation.

What This Means if You or Someone You Love is Struggling

These aren’t just numbers on a public health dashboard — they reflect a regional pattern where addiction, left unaddressed, is measurably more dangerous in Niagara than in most of the province, and in several respects more dangerous than the U.S. national average. That also means effective, local treatment matters more here, not less.

At Twelve Mile Recovery, we see the local side of these statistics every day — including the overlap between opioid and fentanyl addiction and alcohol dependence that shows up in the data above. Our residential program in St. Catharines, along with virtual and aftercare options, is built around the reality that recovery in this region needs to account for exactly these risk factors.

If you or someone you love is dealing with substance use in Niagara, help is available. Contact Twelve Mile Recovery or call/text (289) 301-8852 for a confidential conversation.