among young adults under rising mortality rates from accidental poisoning a large proportion of which were due to drug misuse increased overall mortality rates at these ages during making a small negative contribution to changes in life expectancy at birth in england phe c ons d high or rising levels of drug overdose mortality are apparent in several highincome countries eg the uk sweden canada australia although not approaching the levels in the usa ho and hendi in the usa sharply rising death rates from the largescale drug overdose crisis among younger men and women and from unintentional injuries overall are significant contributors to falling life expectancy box sherry et al the usas opioid crisis includes use of both illegal opiates and prescribed opioidbased painkillers canada is also experiencing a serious opioid crisis especially among young and middleaged adults which is slowing improvements in life expectancy government of canada