As Toronto waits to hear whether the federal government will accept its request to decriminalize possession of illicit drugs for personal use, harm reduction advocates say approval is urgent because governments are failing to match the severity of the opioid crisis.
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 request is under review, noting that such requests are reviewed “carefully and thoroughly on a case-by-case basis.”
But harm reduction workers say a rise in opioid deaths has underscored the need for action.
“I don’t see any urgency. I see complacency,” said Dan Werb, director of Toronto’s Center on Drug Policy Evaluation, which was hired by the city to help work on the decriminalization request.
“We’re seven years into this high-potency opioid overdose epidemic. We have all the data we need at this point. And we’re looking at a government that’s delaying the response, and also responding in ways that don’t really engage -se with what is killing people”.
Toronto, which asked 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 of overdoses in 2020 and 2021, nearly double the number of deaths reported in the previous two years.
The city and advocates agree that decriminalization alone is insufficient to address the opioid crisis.
Toronto introduced a decriminalization model in its application that envisions 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 enforcement plan remains “aspirational” without adequate funding from the provincial and federal governments.
Toronto Public Health said it has been in ongoing discussions with Health Canada since submitting the application on Jan. 4.
If granted, the exemption would decriminalize possession of drugs for personal use in Toronto. But which drugs and how many are still open questions, with advocates calling on the federal government to avoid what they call mistakes made with British Columbia’s exemption.
Ottawa was widely criticized by harm reduction advocates after it set the personal possession threshold at 2.5 grams under BC’s exemption, nearly half of what the province asked for. The federal government said the decision was made based on input from the police.
Advocates say a low threshold could leave people with the highest opioid dependencies in continued threat of criminalization.
“It seems to me an irrational fear, a kind of fear that, again, seems to be driven by the concerns of law enforcement,” 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 buying practices, such as people sharing drugs or buying in larger quantities to get discounts.
And while BC’s exemption sets out 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 supply of street opioids.
He notes that opioids can be cut with drugs not on BC’s list, leaving open the possibility that a person could be arrested if a drug sample tests positive for a non-exempt substance.
“Relying primarily on this 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 to decriminalization,” said Kolla, a Toronto-based researcher at the University of Victoria’s Canadian Institute for Research on Substance Use.
Toronto police said they could not discuss the details of the waiver request. A spokesman said the force supports an “alternative to the 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 anticipated for BC.” The BC exemption will take effect at the end of January, eight months after it was granted.
Vancouver submitted its own decriminalization application five months before BC made the province-wide application. Health Canada said that after BC’s exemption was granted, Vancouver wrote to the agency to ask it to suspend consideration of the city’s proposal.
A notable difference between the BC and Toronto applications is the “painful silence” from the Ontario government, said Angela Robertson, executive director of the Parkdale Queen West Community Health Centre, one of nine federally funded locations offering a program of safer supply in Ontario.
“It’s a shame we don’t have a provincial waiver on the table. But at this point, given the crisis, we take what we can get and continue to push for more,” Robertson said.
The Ontario Ministry of Health, in response to questions about its position on Toronto’s decriminalization application, highlighted some of its harm reduction programs and recent investments in addiction treatment.
This report by The Canadian Press was first published on August 5, 2022.