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Toronto's top doctor recommends decriminalizing possession of small amounts of drugs

Toronto's medical officer of health wants to decriminalize possession of small amounts of illegal drugs in the city in an effort to combat the opioid overdose crisis — and she's got support from the local police chief. A report from Dr.
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Toronto's medical officer of health wants to decriminalize possession of small amounts of illegal drugs in the city in an effort to combat the opioid overdose crisis — and she's got support from the local police chief.

A report from Dr. Eileen de Villa to the city's board of health recommends asking the federal government to permit simple possession of all drugs.

It is also asking the province to increase funding to help expand harm reduction services, increase overdose outreach beyond homeless shelters to parks and drop-ins, and deliver mobile drug consumption services outside the downtown area.

"The current approach to the drug poisoning crisis is not working and we continue to see tragic outcomes that are preventable," de Villa said in a statement. 

"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."

Toronto police Chief James Ramer said in a letter to de Villa that the force supports a new approach to drug criminalization.

"We agree that the current approach to managing drug use does not support safe communities or advance the health of people who use drugs," Ramer wrote.

"Decriminalization of the simple possession of all drugs — combined with the scale-up of prevention, harm reduction, and treatment services — is a more effective way to address the public health and public safety harms associated with substance use."

Ramer said a decriminalization model should also include a safe supply of drugs, something health-care workers have demanded for years.

De Villa is asking for an exemption to a section under the Controlled Drugs and Substances Act that would apply only to those living in the city.

She is recommending the city make the request by the end of the year. Toronto's board of health is set to consider her report on Dec. 6.

The report says there were 531 opioid toxicity deaths in 2020, which is an 81-per-cent increase from 2019.

The city, like the rest of the province, is in the midst of a worsening deadly opioid crisis, which has been exacerbated significantly during the pandemic.

Paramedics responded to 5,776 suspected opioid overdose calls over a one-year period between Nov. 1, 2020 to Oct. 31, 2021, a 61 per cent increase in the same time frame the year before. 

There have been 351 deaths, according to paramedic data in that time frame, up 53 per cent from the same period the year prior.

De Villa said the increase is due to multiple factors, including the "toxic nature of the unregulated drug supply, as well as pandemic-related service reductions and physical distancing requirements."

Vancouver has made the same decriminalization request to Health Canada, de Villa noted.

Ontario's Big City Mayors, a group representing the leaders of populous municipalities, has also urged the move in recent months.

Jeff Lehman, the mayor of Barrie, Ont., and the chair of the mayors group, said the province and the federal government have to treat the problem as a public health one, not a criminal matter.

"We've got a federal government that sounds like they're interested," Lehman said in a recent interview.

"It may be a little tougher to convince the Ontario government because I think so far they've had a little bit more of an enforcement and less of a public health approach. And we're going to need to push there to get them to change that."

He said they can't really decriminalize drugs without also offering more treatment capacity.

"We could make the situation worse, so that's where that's where the province really comes in," Lehman said.

He said the time has come to work on the opioid epidemic, especially given how familiar Ontarians have become with the importance of public health.

"We have another epidemic in a way, but it's not spread by a virus," Lehman said. 

"It's spread by drug use, but it's an epidemic that's taking almost as many lives and, just like COVID, we need to take a public health approach and maybe that's why I hear more understanding and support for this approach generally."

Ontario's Ministry of Health said it will review recommendations from municipalities and is committed to combatting the opioid crisis.

It said it has allocated $30 million for up to 21 consumption and treatment sites and has invested $32.7 million for "targeted addictions services and supports, including treatment and care for opioid use disorder."

The federal government did not respond immediately to a request for comment.

This report by The Canadian Press was first published Nov. 29, 2021.

Liam Casey, The Canadian Press