Toronto Public Health is developing an alternative model to drug criminalization in Toronto as part of a request for an exemption under the Controlled Drugs and Substances Act. See the Alternative Model to Drug Criminalization in Toronto section below for more information.

The Toronto Drug Strategy (TDS) is a comprehensive drug strategy for the City of Toronto based on four integrated parts – prevention, harm reduction, treatment and enforcement. All four parts are needed to effectively reduce the harms of alcohol and other drug use.

The current focus of the Toronto Drug Strategy is the implementation of the Toronto Overdose Action Plan, which provides a comprehensive set of actions to prevent and respond to overdoses. The Plan combines the knowledge and expertise of people who use drugs, their family and friends, and people working in the field with best practices.

Toronto Public Health worked with community partners to develop the Toronto Overdose Action Plan: Prevention & Response, which was endorsed by the Board of Health on March 20, 2017. This includes a comprehensive set of actions for all orders of government to prevent and respond to drug overdoses:

The Toronto Overdose Action Plan was updated in 2019 based on broad community input. This update, which is a supplement to the original Toronto Overdose Action Plan, was endorsed by the Board of Health and City Council in June 2019:

In June 2020, the Toronto Board of Health approved the Toronto Overdose Action Plan: Status Update 2020.

On February 25, 2019, the Board of Health endorsed the Toronto Indigenous Overdose Strategy (TIOS). This strategy was developed by an Indigenous facilitator and is grounded in the input of Indigenous People who use/used drugs, and service providers that work with Indigenous People who use drugs. The recommendations reflect key actions needed in the areas of prevention, harm reduction and treatment. Toronto Public Health (TPH) is supporting implementation of the strategy, and will undertake the actions directed to TPH. Toronto Public Health will also support implementation of the TIOS in collaboration with Indigenous service providers and community members, including Indigenous People who use/have used substances, and other City divisions.

Background: A public health approach to drug use

Although people from all demographic and socioeconomic groups use substances, the harms of criminal justice-based drug policies have disproportionately impacted Black and Indigenous people and other marginalized groups, worsening health and social inequities. By removing the stigma and discrimination associated with drug use, decriminalization can help to create a safe environment for people to access harm reduction programs and other health and social services.

In 2018, Toronto Public Health reviewed the evidence and conducted a community dialogue process to explore how to change the approach to drugs and what a public health approach to drugs could look like in Canada.

In Canada, the federal government, through the Controlled Drugs and Substances Act (CDSA), provides the current legal framework for drugs. The City of Toronto and the Province of Ontario do not have the authority to make or change the legal approach to drugs.

The Toronto Board of Health endorsed the use of a public health approach in developing alternative models to the criminalization of personal drug use in July 2018. At this time, the Board of Health called on the federal government to decriminalize the possession of all drugs for personal use and scale up prevention, harm reduction, and treatment services.

The federal Minister of Health has the authority under the Controlled Drugs and Substances Act to grant an exemption to the Controlled Drugs and Substances Act and allow the possession of drugs for personal use. At its June and November 2020 meetings, the Board of Health called on the Federal Minister of Health to decriminalize the simple possession of all drugs and scale up prevention, harm reduction, and treatment services.

At its June 14, 2021 meeting, the Board of Health asked Toronto Public Health staff to convene a multi-sectoral working group to provide advice on developing a health- and social equity-based alternative approach to drug criminalization, as a step towards requesting an exemption under the Controlled Drugs and Substances Act.

On December 6, 2021, the Toronto Board of Health considered Item HL32.3, Actions to Respond to the Drug Poisoning Crisis in Toronto, and directed the Medical Officer of Health to submit a request to Health Canada by the end of 2021 for an exemption under Section 56(1) of the Controlled Drugs and Substances Act, thereby starting a process to decriminalize the personal possession of illicit substances within the City of Toronto’s boundaries.

The Exemption Model for Toronto

The Toronto model is a public health response to the drug poisoning crisis that recognizes the importance of human rights and the social determinants of health. The model has been informed by multiple stakeholders.

A preliminary request to Health Canada was submitted on January 4, 2022.

Submission to Health Canada: Request for exemption to the Controlled Drugs and Substances Act to allow for the possession of drugs for personal use in Toronto (January 4, 2022).

Next Steps

The process for a request for exemption to be granted is expected to be iterative with ongoing consultations with Health Canada after the initial submission is made.

Toronto Public Health will continue to work with Health Canada and stakeholders to refine the model.

Toronto Public Health encourages anyone with comments about an alternative model to drug criminalization in Toronto to have their say by submitting comments to TPHconsult@toronto.ca. All feedback received is read and thoroughly considered.

Process to develop an alternative model to criminalization

The process to develop an alternative model was designed to centre people with lived and living experiences of drug use, including people who are most impacted by current drug laws, and the agencies and service providers that support them through roundtable discussions, interviews, and a diverse working group.

Working group

Toronto Public Health convened a multi-sectoral working group to provide input into the development of an alternative model to criminalization in Toronto. The working group was led by an external consultant who facilitated the development of the model over five meetings between August and October 2021.

Members of the working group were not asked to endorse the group’s work or the Medical Officer of Health’s request to Health Canada. Participation did not imply support or agreement with either the working group’s advice or the request to Health Canada.

The working group will continue to provide input as Toronto Public Health works with Health Canada to refine the model.

Membership

The working group was chaired by Dr. Eileen de Villa, the Medical Officer of Health for Toronto, and there were about 25 organizations represented:

  • Black CAP
  • Canadian Association of People Who Use Drugs
  • Canadian Institute for Substance Use Research
  • Centre for Addiction and Mental Health
  • Centre for Drug Policy Evaluation
  • Community Action for Families
  • Families for Addiction Recovery
  • Family Service Toronto
  • Gerstein Centre
  • HIV Legal Network
  • John Howard Society – Toronto
  • Ontario Harm Reduction Network
  • Parkdale Queen West Community Health Centre
  • Shelter, Support, and Housing Administration, City of Toronto
  • Social Development, Finance, and Administration, City of Toronto
  • South Riverdale Community Health Centre
  • St. Michael’s Hospital, Li Ka Shing Knowledge Institute
  • St. Michael’s Homes
  • St. Michael’s Hospital
  • The Works, Toronto Public Health
  • Toronto Aboriginal Support Services Council
  • Toronto Drug Users Union
  • Toronto Harm Reduction Alliance
  • Toronto Paramedic Services
  • Toronto Police Service
  • University of Toronto
  • Wellesley Institute

Toronto Public Health received direction from the Board of Health in June 2022 to conduct community consultations throughout the year to inform an updated Toronto Drug Strategy for consideration in 2023.

The Toronto Drug Strategy was initially developed in 2005. Since then, significant progress has been made and a number of changes have taken place, including the legalization of cannabis, access to supervised consumption sites, the initiation of safer supply and drug checking pilots, and the integration of harm reduction and other city-run services. Drug-taking patterns have also changed substantially since 2005. There is an opportunity for Toronto to update its Strategy to both anticipate and navigate future challenges in drug policy.

As part of the refresh process, we are speaking with key stakeholders including people with lived/living experience of drug use, policy makers, community leaders, health care providers, academic partners, civil society organizations, and individuals across the life course.

If you would like to share your perspectives on how drug policy and programming can be improved in the City, please email your thoughts to the drugstrategy@toronto.ca.