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

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.

Status: Developing an alternative model

Efforts to determine options for the alternative model to criminalization for Toronto are underway, informed by a multi-sectoral working group and input from key stakeholders and members of the public.

The alternative model will be used as part of a request to Health Canada for an exemption from the Controlled Drugs and Substances Act for the possession of all drugs for personal use in Toronto (also referred to as decriminalization).

A Toronto model will be rooted in a public health approach, with an emphasis on ensuring that people who use drugs who are most at risk of criminalization because of their drug use are involved in the development of the model, that risk mitigation be incorporated throughout, and that best practices and evidence are used to inform the final request to Health Canada.


A preliminary request to Health Canada is anticipated in the fall.

We are listening: Have your say

Although people from all demographic and socioeconomic groups are affected by drug use, the harms of criminal justice based drug policies disproportionately impact Black and Indigenous people, people with mental illness, people recently incarcerated and other marginalized groups, worsening the health and social inequalities among communities. These disproportionate impacts informed the direction from the Toronto Board of Health to form a diverse multi-sectoral working group.

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

Between August 16 and September 27, Toronto Public Health hosted an online questionnaire to gather input from members of the public. Over 5,000 people responded to the questionnaire and staff are in the process of analyzing those responses. In addition, dozens of virtual interviews and roundtables have been held to gather input from people and organizations most impacted by drug use.

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

Working group on an alternative model to criminalization

A multi-sectoral working group is one of the many ways that Toronto Public Health is seeking input on an alternative model to criminalization in Toronto. Led by an external consultant, members of the working group advise on the development of a Toronto model, which will be the basis for the request for an exemption to Health Canada later this year.

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


The working group is chaired by Dr. Eileen de Villa, the Medical Officer of Health for Toronto, and there are 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