The death toll in Canada is spiking. Here’s why.

Here’s the first big health-related news of the summer. According to the Ontario Ministry of Health, there have been more than 1,600 cases of Core-19 — the potent, highly addictive form of fentanyl — reported in the province since last August. That’s the highest total reported in almost seven months, and puts the number of reported cases this year at more than four times higher than the 1,009 reported in 2015.

The increase seems to be happening mostly in rural Ontario, where fentanyl is often sold, shipped or sourced from fentanyl labs in China, and the drug is cheaper to obtain there. (In Hamilton, the west-central Ontario city where many of the deaths are occurring, a small number of users may start injecting heroin or oxycodone recreationally, but all of the fentanyl deaths there are occurring among the people who are heroin or oxycodone addicts, according to the CBC.)

It’s too early to call this an epidemic, but addictions advocate Lisa Corbin says it’s one that could grow if this lack of treatment, policing and provision of even basic harm-reduction services, such as heroin naloxone, continues. (According to The New York Times, a study of a Portland, Ore., naloxone program found that arrests of overdose patients went up and that more heroin users in the program were breathing properly.) Meanwhile, people are injecting with fewer tools to counteract their bad experiences.

The death toll in Oregon this year is already roughly 50 percent higher than the number of overdose deaths it reported in 2015. Corbin says it’s a “ticking time bomb.”

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