As the COVID-19 pandemic recedes, the opioid overdose epidemic continues to kill Torontonians at alarming record levels.

Toronto Public Health on Friday released preliminary figures showing 511 people died just last year from opioid overdoses, but warned that that figure will rise as the provincial coroner’s office finalizes cause-of-death investigations.

The preliminary figure is slightly lower than the total of 539 deaths in 2020, but it represents a 74-per-cent increase from fatal overdoses in 2019 and a 273-per-cent increase from 2015.

The city’s drug-checking service has detected “increasingly toxic and unpredictable contaminants in the unregulated drug supply in Toronto,” including powerful pain-relieving opioids such as fentanyl.

Fentanyl-related deaths that were on the increase before the pandemic increased in the early days of lockdown as support systems, including safe-injection sites, suspended operations or became harder to access.

Toronto, which has a multi-pronged overdose-prevention strategy, took steps, including offering supervised safe-injection sites at homeless shelters, to combat an increase of overdose deaths in shelters.

City council and Dr. Eileen de Villa, Toronto’s public health chief, have called on the federal government to decriminalize all drugs for personal use , as part of a shift to a public-health approach aimed at reducing stigma and solitary deaths.

Health Canada is weighing exemption requests from Vancouver, the British Columbia government and Toronto to decriminalize drug possession in these jurisdictions. Advocates say any delay is unconscionable, given the death toll due to overdoses.

In a statement Friday, de Villa said “In keeping with our response to the COVID-19 pandemic, addressing the drug-poisoning crisis of this size and scale requires resources and action from all levels of government.

“These are preventable losses and members of our community. I extend my sincere condolences to the families, friends and loved ones of these individuals that we’ve lost.”

Zoë Dodd, of the Toronto Overdose Prevention Society, said the city is not trying to prevent overdose deaths with the same energy and resources it deployed against COVID-19.

“We have an emergency management table for COVID, but not for the overdose crisis,” Dodd said. “We could collect all this data, where and how people are dying, and the efficacy of treatment,” instead of watching a “catastrophe” unfold.

Grief at losing friends and family to toxic drugs makes many people more susceptible to overdose themselves, she added.

“When we keep losing people, we generate more intense pain and loss in the future and there are very few supports,” to help people break the cycle, Dodd said.

The city reported that, last year, Toronto paramedics responded to 6,005 non-fatal calls and 357 fatal calls for suspected opioid overdoses, a 65-per-cent jump from 2020. Emergency room visits due to opioid poisoning also jumped, to almost 4,000.

Mayor John Tory, in a statement, said that Toronto remains “ready to work with the Government of Canada and the Government of Ontario — this is principally the responsibility of the provincial healthcare system — to help implement much more robust and expanded healthcare and addiction treatment.

“We know from our health experts that this is what is needed, and it is time that both governments work together with us to get this done to help save the lives of residents in Toronto and across our country.”

David Rider is the Star’s City Hall bureau chief and a reporter covering city hall and municipal politics. Follow him on Twitter: @dmrider