The morning I met Sarah McKenzie in her modest East Vancouver apartment, she had just spent 36 hours calling every pharmacy within bus distance. The 68-year-old retired teacher, who lives with chronic pain from a spinal injury, was down to her last three days of medication.
“I’ve been on the same pain management plan for eleven years,” she told me, her hands trembling slightly as she poured tea. “Now I’m being treated like I’m doing something wrong by asking for my prescription.”
Sarah isn’t alone. Since August 2025, patients across Canada have faced unprecedented shortages of prescription painkillers, creating a cascading crisis that healthcare providers warn shows no signs of abating before spring 2026.
The current shortage began when Canadarm Pharmaceuticals, which manufactures approximately 40% of Canada’s prescription opioids, experienced production delays following a facility compliance issue at their Manitoba plant. According to Health Canada data, the shortage initially affected only certain formulations of hydromorphone, but has since expanded to impact multiple medications including controlled-release morphine and oxycodone products.
Dr. Anita Grewal, pain specialist at Vancouver General Hospital, describes the situation as “the perfect storm.”
“We’re seeing manufacturing issues coincide with regulatory changes and increased global demand,” she explains as we sit in her office, surrounded by patient files flagged for medication concerns. “The patients suffering most are those with legitimate pain needs who’ve been stable on their regimens for years.”
Data from the Canadian Institute for Health Information shows emergency room visits for pain management increased 27% nationwide between September and October. In British Columbia alone, the provincial poison control center has recorded 118 cases of adverse events related to untreated pain or substitution of medications since the shortage began.
When I visited the Downtown Eastside Neighborhood House in late October, harm reduction worker Miguel Rodriguez pointed to another concerning trend: “People who can’t access their prescribed medications are turning to street alternatives. We’re seeing first-time buyers who never thought they’d be in this position.”
Health Canada spokesperson Christine Wong confirmed via email that the agency is “working closely with manufacturers and distributors to expedite approvals for alternative suppliers,” though she acknowledged that “due to the complex nature of controlled substance regulations, temporary solutions may take several months to implement.”
For physicians on the front lines, the shortage has forced impossible choices. Dr. James Chen, a family physician in Toronto’s Danforth neighborhood, described rationing remaining supplies among his most vulnerable patients.
“I’m having to decide who gets their full prescription and who doesn’t,” he said during our phone interview. “Then I’m spending hours trying to find pharmacies with stock, or cobbling together alternatives that aren’t quite right for the patient. It’s exhausting and ethically draining.”
The Canadian Pain Society has called for the federal government to implement emergency measures similar to those used during critical medication shortages in the COVID-19 pandemic. Their October report, “Pain Unmanaged: The Human Cost of Medication Shortages,” documents cases where patients have lost employment, experienced severe depression, or been hospitalized after losing access to their medications.
Indigenous communities face particular challenges during the shortage. When I traveled to northern British Columbia last week, community health director Leanne Cardinal from the Carrier Sekani Family Services described how geography compounds the problem.
“Many of our elders live with chronic pain from decades of physical labor,” she explained as we drove between communities served by their mobile health unit. “Now they’re told to try a different pharmacy, but the nearest alternative might be a three-hour drive away. That’s assuming they even have transportation.”
The shortage has revived debate about Canada’s pharmaceutical supply chain vulnerabilities. Dr. Joel Lexchin, professor emeritus at York University and pharmaceutical policy researcher, points to deeper systemic issues.
“We’ve created a system where a single manufacturing disruption can cascade into a national crisis,” he told me. “Countries with national pharmaceutical manufacturing strategies and better stockpiling protocols aren’t experiencing shortages at this level.”
Some patients have found community in their shared struggle. In Winnipeg, chronic pain advocate Teresa Ng has organized a mutual aid network where members help each other locate pharmacies with stock and provide transportation.
“The system is failing us, so we’re supporting each other,” she explained during our video call, pausing occasionally as pain flared in her joints. “But we shouldn’t have to do this. This is a policy failure with real human consequences.”
For healthcare providers, the shortage has reignited concerns about pain management training. Dr. Grewal notes that many physicians have limited options when primary medications are unavailable.
“Our medical education system still doesn’t adequately prepare doctors to manage pain, particularly in complex cases,” she says. “Now we’re asking them to improvise during a shortage with patients who are suffering and desperate.”
As winter approaches, experts warn that transportation disruptions could further complicate distribution of the limited supplies that are available. Health Canada’s most recent projection suggests normal supply chains won’t be restored until at least March 2026.
Back in East Vancouver, Sarah McKenzie finally found a pharmacy with a partial supply of her medication – enough for two weeks at a reduced dose. When I called to check on her a few days later, her voice was strained.
“I’m rationing pills, taking half my usual dose,” she said. “The pain is worse, but I’m more afraid of running out completely. I never thought access to healthcare would feel so precarious at this stage of my life.”
As Canada confronts this ongoing crisis, patients like Sarah remain caught between systems meant to prevent medication misuse and the very real human need for pain relief – a balance that, for now, remains painfully out of reach.
