Canada’s opioid crisis has hit Toronto particularly hard, with a surge in overdoses and related deaths. Efforts are being made to combat the crisis, including increasing access to naloxone and holding the pharmaceutical industry accountable. Collaboration among civic leaders, healthcare providers, educators, and law enforcement is necessary to address the crisis at a community level and understand the role of social determinants, such as homelessness. A collective and sustained effort from all sectors is needed to make meaningful progress against this national crisis.