Substance use results in substantial healthcare costs in Canada. In 2024, healthcare costs attributable to substance use reached $16.4 billion, with alcohol accounting for $7.8 billion and tobacco accounting for $6.8 billion, together making up approximately 90% of the total costs.

Costs reflect a broad range of health conditions, not just substance use disorders or acute harms (e.g., poisoning events). Substance use contributes to cancers, cardiovascular disease, liver disease, injuries, infectious diseases and other acute and chronic conditions across the healthcare system.

Prescription medications and hospitalizations are major drivers of healthcare cost. Together, these two categories represent approximately 60% of the total healthcare costs related to substance use, followed by physician time and specialized treatments.

Per-person costs vary across regions. Nationally (excluding Quebec), annual per-person costs were $440. Costs were highest in the Northwest Territories ($983), Nunavut ($959) and Yukon ($779), followed by the Atlantic provinces, reflecting differences in substance use prevalence rates and access to healthcare across regions.

Per-person costs of healthcare attributable to substance use remained relatively stable overall, decreasing slightly from $406 in 2017 to $396 in 2024 (-2.5%). However, this decrease masks important shifts across substances, including increases in opioid- and stimulant-related costs alongside declines in tobacco-related costs.

Opioid-related costs are rising the fastest. Although opioids account for the third largest share of the overall costs (4.4%), per-person healthcare costs attributable to opioids increased approximately 30% from 2017 to 2024, likely reflecting the impact of the toxic and unstable unregulated drug market, among other factors.

Hospitalizations are mostly due to alcohol and tobacco use. In 2024, an estimated 694 hospitalizations per 100,000 population were attributable to substance use, with tobacco (48.6%) and alcohol (42.2%) contributing to the majority of those hospitalizations.

Trends highlight the need for policy and monitoring. Legally available substances remain primary drivers of healthcare costs, while opioid-related harms, including medical and non-medical use, along with harms related to stimulants and other substances require sustained attention. Ongoing monitoring is essential to guide interventions and reduce morbidity.