At age 65, Anne had poorly controlled diabetes, coronary artery disease and back pain. One day last summer, her daughter, worried that she could not reach her mother by phone, went to her home and found her lying on the couch, unresponsive. By the time paramedics arrived, Anne was dead. It was classified as a natural death, with chronic hydromorphone use as a contributing factor. Eight days earlier, Anne had filled a prescription for 640 vials of hydromorphone. Given her daily dosage of six vials, 48 should have been used. Now 160 of them were unaccounted for, the equivalent of 20 vials or 40 mg / day. Were they being overused? Sold? Bartered? Her daughter had no answer. In another home, Katie, 21, heads for bed, after telling her boyfriend that she feels tired. When he comes to bed hours later, she is dead. Under the futon, police find a box of burnt fentanyl patches in foil. The cases illustrate the devastation wreaked by the opioid crisis and the increase in overdose deaths alarms Dr. Paul Dungey, Regional Supervising Coroner in Kingston.“ Opioid addiction and opioid deaths aren’ t your stereotypical drug abusers. It could be anybody,” he says. Dr. Dungey says people like Katie light up portions of their patches and inhale the smoke for the hit. And people like Anne – who last visited her doctor a year before her death – are sometimes prescribed injectables that are ripe for abuse. Too often, he feels, there isn’ t even good evidence to show the narcotics are beneficial. Dr. Dungey has a slide of opioid toxicity deaths in Ontario from 2002-2014. Heroin-related deaths have increased fourfold in 12 years. Over that period, deaths from oxycodone have risen 4.5 times, from hydromorphone by 7.5 times, and from fentanyl by 15 times. The deaths reflect a larger health crisis around opioids, which cut across demographics. Dr. Dungey blames a culture that puts too much emphasis on drugs as an automatic solution to pain.“ There should be a multidimensional approach to pain, of which narcotics is just one strategy,” says Dr.