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.