As Toronto waits to hear whether the federal government will grant its request to decriminalize illicit drug possession for personal use, harm reduction advocates say approval is urgently needed as governments fail to match the severity of the crisis. of opiates.
This week marks seven months since the city sent its decriminalization request to Ottawa, the same amount of time it took the federal government to greenlight a similar request from British Columbia.
Health Canada says the application is under review, noting that such applications are “carefully and thoroughly reviewed on a case-by-case basis.”
But harm reduction workers say a surge in opioid deaths has underscored the need for action.
“I don’t see urgency. I see complacency,” said Dan Werb, director of the Toronto-based Center for Drug Policy Evaluation, which was hired by the city to help work on the decriminalization application.
“We’re seven years into this high-potency opioid-driven overdose epidemic. We have all the data we need right now. And we’re seeing a government that is slow to respond and also responding in ways that are not really engaging with what they’re doing.” killing people.”
Toronto, which applied to Health Canada for an exemption under the Controlled Drugs and Substances Act for personal drug use in the city, has seen an increase in overdose deaths during the pandemic. More than 1,000 people in the city died from overdoses in 2020 and 2021, almost double the number of deaths reported in the previous two years.
The city and advocates agree that decriminalization alone is not enough to address the opioid crisis.
Toronto submitted a decriminalization model in its application that provides for expanded access to social supports, including housing, as well as safer supply programs to provide pharmaceutical-grade opioid alternatives to street supply.
But Werb said the application board remains “aspirational” without adequate funding from the provincial and federal governments.
Toronto Public Health said it has been in ongoing talks with Health Canada since submitting the application on Jan. 4.
If granted, the waiver would decriminalize drug possession for personal use in Toronto. But which drugs and in what quantity remain open questions, with advocates calling on the federal government to avoid what they call missteps with British Columbia’s exemption.
Ottawa was widely criticized by harm reduction advocates after it set the threshold for personal possession at 2.5 grams under the BC exemption, almost half of what the province requested. The federal government said the decision was made based on comments from police.
Advocates say a low threshold could leave people with the highest opioid dependencies under continued threat of criminalization.
“It just seems like an irrational fear to me, a type of fear that, again, seems to be motivated by law enforcement concerns,” Werb said.
Toronto’s request avoids asking for a specific threshold.
A summary of the city’s consultations with drug users noted that a blanket threshold could overlook different tolerances and purchasing practices, such as people sharing drugs or buying in bulk for discounts.
And while the BC exemption establishes a list of exempt drugs, Toronto calls for the decriminalization of all drugs.
That’s an important distinction, said public health researcher Gillian Kolla, especially given the volatility of the street supply of opioids.
She points out that opioids can be cut with drugs that are not on the BC list, which leaves open the possibility that a person could be arrested if a drug sample tests positive for a non-exempt substance.
“Mainly relying on this law enforcement-based approach that we know hasn’t worked for individuals, that we know hasn’t worked as a society to address the harms of drug use, remains a problem in how we approach decriminalization,” said Kolla, a Toronto-based research associate at the Canadian Institute for Substance Use Research at the University of Victoria.
Toronto police said they were unable to discuss the details of the waiver request. A spokesman said the force supports an “alternative to criminalization done in Toronto.”
Toronto Public Health said that if a waiver is granted, it anticipates “significant lead time for implementation planning similar to what was provided for BC.” BC’s waiver goes into effect at the end of January, eight months after it was granted.
Vancouver filed its own decriminalization application five months before BC filed the province-wide application. Health Canada said that after BC’s waiver was granted, Vancouver wrote to the agency asking it to suspend consideration of the city’s proposal.
One notable difference between the BC and Toronto applications is the “painful silence” of the Ontario government, said Angela Robertson, executive director of the Parkdale Queen West Community Health Center, one of nine federally funded locations offering a safest supply in Ontario.
“It is unfortunate that we do not have a provincial exemption on the table. But right now, given the crisis, we take what we can get and keep pushing for more,” Robertson said.
The Ontario Ministry of Health, in response to questions about its position on Toronto’s decriminalization request, highlighted some of its harm reduction programs and recent investments in addiction treatment.
This report from The Canadian Press was first published on August 5, 2022.