The overdose emergency in Toronto is a serious public health issue. While considerable work has been done, the situation remains urgent. In 2017, there were 303 deaths in the city due to opioid overdose, a 63 percent increase over 2016 and a 121 percent increase over 2015. Too many people are dying and these are preventable deaths.
Experience from around the world has shown that making drugs illegal does not stop people from using them. Despite trillions of dollars spent on the War on Drugs, the global illegal drug market continues to grow and has an estimated value between $426 and $652 billion U.S. per year. Further, the potential harms associated with drugs are worsened when people have to produce, obtain and consume those drugs illegally.
In contrast, countries that have decriminalized personal drug use and possession and invested in public health interventions have seen positive results. For example, since decriminalization, Portugal has seen a reduction in drug use among vulnerable populations and increases in the number of people accessing treatment. There have also been significant decreases in HIV transmission (as high as 85 percent) and drug-related deaths.
As part of its response to the opioid poisoning emergency, Toronto Public Health sought public input about Canada’s current approach to drugs and held discussions on what a public health approach to drug policy could look like. Through this process, we found that Torontonians do not believe the current approach to drug policy is working. They are supportive of drug use being treated as a public health and social issue, not a criminal one. Participants in our public consultation also expressed the need for our health system to scale up prevention, harm reduction, and treatment services to ensure that we can provide the supports people require.
In Canada, it will soon be legal for adults to purchase cannabis for personal use. Some health officials and others are calling for similar changes in our approach to other drugs, especially as we face the current opioid overdose crisis. Too many people in our community are dying from drugs in the illegal market which are contaminated with fentanyl and other potent substances. The resulting trauma is devastating for family, friends, and colleagues, and we must do more. We need a more compassionate approach.
This is why I recently made a recommendation to Toronto’s Board of Health to advocate for the federal government to take a public health approach to drug policy that includes prevention, harm reduction and treatment responses, and the decriminalization of the possession of all drugs for personal use. In addition, I recommended that the Board of Health call on the federal government to strike a task force to explore options for the legal regulation of all drugs.
The current approach to the opioid overdose crisis is not achieving optimal community health, and it is not reducing the health harms associated with drug use. Other jurisdictions’ approaches are getting the outcomes that we seek, and we should explore these opportunities locally. Our residents deserve evidence-based public health interventions that help them to start life healthy and stay that way for as long as possible.
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I said the suicide rate would have a major increase this year. I haven’t read any News report suggesting that this change is motive. I Hate to be RIGHT! I suffer with back problems every day and what once was a Severe Anxiety disorder. My Doctor’s informed me of the changes in the FDA prescription requirements as I had no choice in the Opiod and Zanax matter. Zanax went first. It was the worst Roller Coaster ride ever, never been on a real one. One and half months to stop them and no other safe Benzo given for a smoother ride. The doctor’s are stating that it’s the law. Cover thy own butt. I have so much more to say but I won’t 4 now. I’m just one of the few people out there that made it thru. Thank goodness for family. Bye 4 now.
Dr. De Villa’s message is a breath of fresh air. We need to act on this.
Dear Dr. de Villa,
I agree, and thank you for your well-reasoned and thoughtful argument in favour of the decriminalization of substances in the name of harm reduction and saving lives.
My name is Laura Robertson, and I am on the MOHLTC Emergency Opioid Task Force. We are tasked with addressing the “opioid crisis”, and the street drug and overdose epidemic.
We began to address harm reduction by making Naloxone kits more accessible, and were in the process of examining the best way forward for Safe Injection Sites and Overdose Prevention Sites, among many other critical concerns and issues. We were starting to coalesce as a team and deal with the crisis in more effective ways. A lot of time, effort, and planning went into gathering together a phenomenal cross-section of people with a myriad of personal and professional experience.
Unfortunately, we were interupted by the provincial election. The province went under writ on May 8th, and the Task Force was suspended pending the election. It is now August 2nd, and there has been no word as to when the Task Force will be reinstated, or what will happen next. This provincial silence is appalling in light of the tragic circumstances and the climbing overdose death toll.
I am publicly calling for an immediate reinstatement of the MOHLTC Emergency Opioid Task Force, and am humbly requesting your assistance with this. Please do everything in your power to help us get back to the critical work of dealing with the crisis at hand. More and more lives are preventably and tragically being lost with every passing day.
Help us save lives.
Let’s learn from Portugal and other jurisdictions that have successfully achieved the transition to decriminalization. How did they approach this issue? How did they deal with the social and cultural resistance that most certainly was present? The war on drugs and the perception that drug use is a legal problem and not a public health problem is so ingrained in our cultural psyche that dislodging this concept from the public mind will be challenging, but this is a first step. The public is just getting use to harm reduction as a successful strategy for IV drug use, so we are moving in the right direction. Our upcoming experience in Canada with the legalization of cannabis should also inform positive change. Let’s see the evidence as to what works. On thing we need for a sure is a “compassionate” approach as per the title of this submission in Healthy Debate. And compassionate leadership in healthcare and government. Ultimately our society has to decide as what a life is worth.
I wonder if the “evidence” based paradigm that exists in Canada with regard to healthcare might be interfering with what is the best practical approach to this, as you say decriminalization despite whatever guidelines and evidence might say otherwise? I don’t know, never underestimate the paradigm of EBM and guidelines as overarching arguments over even pure practicality in our society, I will say.
Unfortunately Trudeau doesn’t want to listen to the most reasonable approach to this problem. What will make him listen?G
Good question, but I think Justin is more concerned with his image on the world stage as to everyday ordinary issues here in his own country. Sadly.