Toronto Public Health moves forward on comprehensive approach to drug poisoning crisis in Toronto

Given an 81 per cent increase in reported overdose deaths in Toronto over the past year and concern about the increasing role of ultra-potent opioids, Toronto Public Health (TPH) is presenting a report to its Board for new and expanded measures to address the increase suffering caused by this public health crisis.

After extensive multi-sectoral consultation, the report calls for a public health approach to drug use in the city. The recommendations include:

• Increased federal and provincial investments in critical health and social supports including, prevention, harm reduction and treatment services
• A national framework to decriminalize the simple possession of all drugs for personal use
• An approach towards decriminalization within the city’s boundaries, while keeping illegal and maintaining legal penalties associated with drug trafficking, such as production and sale

A report will be considered at the December 6 Board of Health meeting and is now public as part of the meeting’s agenda.

Substance use is a health issue, not a criminal issue, and requires a public health approach to remove structural barriers to accessing health and social services, provide alternatives to the toxic drug supply, and expand services to improve the health and well-being of Toronto’s communities. What began as an opioid poisoning crisis is now most accurately described as a drug poisoning crisis. The criminalization of substance use and the stigma and discrimination experienced by people who use drugs are barriers to accessing health and social services.

“Residents in our city are currently experiencing two public health emergencies– the COVID-19 pandemic and the drug poisoning crisis. The current approach to the drug poisoning crisis is not working and we continue to see tragic outcomes that are preventable. This is why we are aligned with other jurisdictions and recommending decriminalizing the possession of all drugs for personal use and connecting all people who use drugs with health and social supports. Treating substance use as a health challenge, rather than a criminal act, will help create pathways to support and save lives.”– Dr. Eileen de Villa, Toronto’s Medical Officer of Health

Decriminalization alone will not address the drug poisoning crisis. To improve the overall health outcomes of people who use drugs, their families, and communities, decriminalization must be accompanied by new provincial and federal investments and improved access to safer supply programs, harm reduction, and treatment services. As a result, the Board of Health report also includes recommendations for all levels of government to immediately scale-up critical life-saving programs, including evidence-based treatment and supervised consumption services.

An evidence-based and comprehensive public health approach helps people who use drugs to be brought into an environment where they feel acknowledged and safe, and where the burden of having to hide drug use or use drugs alone for fear of judgement is removed. This allows for a space to make a connection with harm reduction peers or workers for those most at risk of drug poisoning or other harms of substance use.

If granted by Health Canada, this exemption would mean that people found in possession of drugs for personal use in Toronto would not be subject to criminal penalties. All activities associated with drug trafficking, such as production and sale, would remain illegal and subject to the penalties under the Controlled Drugs and Substances Act.

There is growing support for decriminalization across Canada, including from the Government of British Columbia , and the cities of Vancouver , Kingston , Montreal , and Ottawa . There is also growing support among law enforcement authorities and civil society for a public health approach to drug policy, including from the Canadian Association of Chiefs of Police , the Ontario Association of Chiefs of Police , Ontario’s Big City Mayors , 47 Toronto-based civil society organizations  and the Centre for Addiction and Mental Health .

The full Board of Health report is available online. For more information, visit the Toronto Overdose Information System page.