There’s a national overdose hotline that some Canadians call before they’re about to use drugs. But the people dialling in aren’t who you might think.
Since the National Overdose Response Service (NORS) launched nearly five years ago, it’s been reaching drug users who wouldn’t typically use consumption and treatment sites.
Shame and stigma can force people to use drugs alone, putting them at a greater risk of dying from an overdose.
“We do know that a lot of people are hidden substance users,” said Monty Ghosh, an addictions physician in Alberta and a NORS researcher.
“It could be that they’re afraid of losing their job, they’re afraid that the family might leave them, they’re afraid that the children might get taken away from them.”
Ghosh says that’s where the hotline comes in.
He says many people calling in have voluntarily disclosed that they have jobs and stable housing.
“We’re talking [about] people who are lawyers, physicians, engineers, people who are professional athletes,” he said.
“A lot of them are using the service because they don’t identify as the same population as who uses a physical supervised consumption site.”
NORS is like a buddy system — operators stay on the line as people use drugs, ready to alert emergency services if they suspect the person has overdosed. People can also text the line, if they can’t or don’t want to call.
To see who is reaching out and how the hotline works, CBC News met up with an operator in Hamilton, Ont., and listened in on multiple calls.
Canada has a hotline for people who hide their drug use
The operator, Jodi, starts any call by confirming the person’s address, telling them to keep their doors unlocked and pets away. These are all precautions in case EMS has to respond.
One of the calls was from a student who was about to use crack.
“I heard that there was a bad batch going around in my area and I was just wondering if you knew anything about it?” the person asked Jodi.
A quick online search for alerts about tainted substances in the caller’s region turned up empty, so Jodi cautioned, “Start low, go slow.”
Another caller, who was smoking fentanyl, told Jodi she’s trying to use less frequently. When she does, she’s started testing her drugs to stay safe.
“Keep doing that,” Jodi told her. “Just the stuff that’s going around right now, it’s actually really scary.”
Once people use, Jodi stays on the line with them for about 10 to 15 minutes. She makes small talk — asking what they ate for dinner and what their plans are for the evening — all the while paying attention to how they’re responding.
“We’re not therapists, we’re not counsellors, we’re not social workers,” Jodi told CBC News.
“We’re not here to dig deep [into] why they started using drugs. It’s just, ‘Hey, how’s it going today?'”
No one overdosed the night CBC was on the line with Jodi, but it has happened. Of the almost 20,000 calls NORS has received, it’s responded to more than 200 overdoses. According to the organization, nobody has died while using the line.
In comparison, between March 2020 and February 2025, drug consumption and treatment sites across Canada received more than three million visits.
“Our mandate at NORS is to keep people alive while they’re using substances,” said Lisa Morris-Miller, the executive director of the hotline.
Her sister, Rebecca Morris-Miller, founded the line in December 2020, with the help of her friend Kim Ritchie. The pair had complicated pasts with drug use and met during a recovery program.
With a cellphone, $1,000 and some volunteers, Ritchie says they started an early version of the hotline. By the end of 2020, she says partnerships with the University of Alberta and Health Canada led to funding that launched the line across the country.
NORS is the first and only national overdose response hotline in Canada. For two years, Rebecca helped grow the service and became an advocate for people who were struggling.
But throughout, she continued to struggle with her own addiction to fentanyl. In October 2022, Rebecca used drugs alone and didn’t call her own hotline — and ended up dying from an overdose.
“My opinion … is that there is still so much stigma associated with substance use, so much that … one of the key founders of this organization wouldn’t call her own line,” said Lisa Morris-Miller.
Most NORS callers are from Ontario, Alberta, B.C. and Saskatchewan, according to researcher Ghosh.
The most recent data from the hotline shows that of more than 3,200 calls, about 50 per cent were women and 16 per cent identified as gender diverse.
In interviews, Ghosh said these callers told them that they prefer the hotline because of stigma and safety.
While the organization hasn’t released research on this, Ghosh says about 10 per cent of their calls have asked about referrals for mental health, opioid treatments or treatment centres.
Ian Tait, communications director for the Ambulance Paramedics of British Columbia CUPE 873, says he isn’t surprised to hear who is using the service.
“In British Columbia … we go to million-dollar mansions for, you know, issues with substance use,” said Tait, who is also an advanced care paramedic supervisor.
He said that most of the overdose calls they respond to are for people who are unhoused, with mental health and substance use issues.
Tait cited an app called Lifeguard, which he says people in B.C. will often use. Those with the app will activate it before taking their drug of choice and they then have to deactivate it within a certain period of time. If they don’t, EMS will be alerted.
“In this type of crisis, we have to look at ideas that are outside of the box,” he said.
Faith O’Toole, a 22-year-old Ottawa resident, has been revived multiple times because of the hotline.
Having used crack and fentanyl since she was a teenager, O’Toole has lost count of how often she’s overdosed.
Her mom, Tamara, allowed Faith to keep living at home and using drugs, but insisted she call the hotline.
“Of course I don’t want my child to use drugs — nobody does. But if they’re going to and I can’t make her stop, what can I do to help keep her as safe as possible?” said Tamara.
She estimates Faith has overdosed at least three times while using NORS.
“Overdosing sucks, but the hotline is really useful,” said Faith. “It’s convenient. I mean, if you have a phone … you can call and you’re safe.”
But Faith no longer lives at home and says she doesn’t call the hotline as often.
Despite how helpful virtual resources like hotlines and apps can be in this crisis, experts say they can’t replace controversial drug consumption and treatment sites.
The hotline fills some gaps — like being available around the clock and allowing people to smoke their drugs (which many drug sites don’t allow) — but it’s not accessible to everyone.
For example, some people might not have a cellphone, says Caleb Clay, administrative manager for a mobile overdose prevention site at Sunshine House in Winnipeg.
“I think that physical and virtual options can work hand in hand,” he said. “I don’t think physical sites will ever go away.”
Ghosh says these sites are essential, specifically because they’re often used by people who are experiencing homelessness, and can provide them with a range of support. For example, they connect people to the local mental health care system, help bandage wounds or offer drug test strips and clean needles.
But drug consumption sites have historically faced a lot of backlash.
Most recently in Ontario, the provincial government shut down several facilities under new legislation and said it doesn’t plan on approving any more sites.
Right now, NORS has 20 employees across the country and is fully funded by Health Canada until 2028.
NORS operator Jodi says people who call in just want to protect themselves, without judgment. She gets it, because she was once addicted to drugs, too.
“It’s kind of embarrassing,” one caller told Jodi the evening CBC listened in.
“What’s embarrassing?” Jodi asked.
“You know — you don’t want to tell your family, but you don’t want to be alone,” they said.
“Well, we’re always frickin’ here for you,” Jodi said. “Nothing to be embarrassed [about] here.”
