$4M worth of prescription opioids disappeared from an Ontario pharmacy. No one can say where they went

Opioid painkillers are supposed to be closely guarded on their journey from manufacturer to patient.   

They are highly addictive, can cause deadly drug poisonings and have a high street value. So how could almost a quarter million of them disappear?

The loss of more than 245,000 hydromorphone tablets, all eight milligrams and sold under the brand-name Dilaudid, was reported to Health Canada in May 2023 by a pharmacy somewhere in Ontario. Whether they disappeared from the pharmacy itself, or even whether they made it there at all, is not known.

They would be worth about $4 million if sold on the street.

There was no armed robbery and no break and enter. The loss did not occur all at once, but over an unspecified period of time, said a Health Canada spokesperson.  

The manufacturer of Dilaudid, Purdue Pharma (Canada), told CBC News there were no concerns flagged to them, and the product moved through their supply chain "as appropriate."

CBC News has learned Health Canada referred a pharmacist to the professional regulatory college.

The Ontario College of Pharmacists confirmed it's launched an investigation into the matter, but said it couldn't give further details.

Officially, the reason for the loss cited in Health Canada data is "Loss unexplained." There's no requirement to report such losses to police.

That could be one reason the OPP's top pharmaceutical opioid expert — and several big-city police forces in Ontario polled about the loss by CBC News — either hadn't heard about it or wouldn't answer.

Since the pandemic, unexplained losses from Canadian pharmacies appear to be on the rise, according to a CBC News analysis. It's not clear whether some represent simple accounting mistakes or large-scale diversions to the street, where they fuel addiction and generate huge profits for organized crime.

"It is troublesome that we're seeing such a high rate of unexplained losses," said Patricia Trbovich, patient safety research chair at North York General Hospital and associate professor of health policy at the University of Toronto.

 "There's these controlled substances that are going missing and we don't know why."

CBC analyzed six years (2018-2023) of loss and theft data reported to Health Canada by pharmacies, drug wholesalers, hospitals and other places that handle controlled drugs. CBC obtained the data in an access-to-information request.