As the COVID-19 pandemic ravages communities around the world — including in Toronto, where almost 3,500 people have already died — concern about public health has risen to the forefront of mainstream political discourse. Many Canadian leaders seem more eager than ever to reassure citizens that public policy decision-making is evidence-based, at least where COVID-19 is concerned.
But there is a second, deadly public health crisis now being exacerbated by COVID that needs equal attention and evidence-based intervention today.
In the last four years, more than 20,000 Canadians have died of opioid-related overdoses, and it is heartbreaking to witness. These are our family, friends and fellow community members. Ontario’s chief coroner estimates that 50 to 80 people die each week in Ontario alone. Throughout the pandemic, there have been an unprecedented number of fatal overdose calls to Toronto paramedics. One weekend in May of this year, 13 people died in our city. Tragically, these deaths and hospitalizations are largely preventable.
While a poisoned drug supply is currently driving these statistics, our analysis cannot stop there. The existence of illegal markets is driven by Canada’s history of criminalizing drugs and those who use them. In 2018 alone, there were 6,712 drug arrests in the City of Toronto, and we know racialized and poor communities are more likely to be targeted under these laws. In our time as mayors of Canada’s largest city, we have never known this approach to be helpful.
Therein lies the crux of this public health crisis: the criminalization of drugs fuels stigma and discrimination, forcing people to use drugs — for many, diverse reasons, and sometimes after having been introduced to opioids by the medical system itself — in isolation. This, in turn, impedes a person’s ability to use drugs safely, and deters access to essential health care that aids in the prevention of overdose. It also leads to the spread of infections such as HIV and hepatitis C.
For years, an extensive list of harm reduction experts and others, including people with lived experience, have called on Canadian policy-makers at every level to decriminalize drug possession for personal use, but the political will to do so has been largely absent.
However, even law enforcement now appears to be on board: in 2020, the Canadian Association of Chiefs of Police endorsed decriminalization for simple possession as “an effective way to reduce the public health and public safety harms associated with substance use.” And the federal minister of health has the power to grant an exemption to Canada’s drug laws that would proactively decriminalize throughout the country — today.
Until the Government of Canada decides to pull that life-saving lever, cities are sorting their next steps. Vancouver has already submitted its request for a local exemption to Canada’s laws. Dr. Eileen de Villa, Toronto’s chief medical officer of health, first called for decriminalization in 2018, and has reiterated that recommendation three times since. Earlier this week, the Toronto Board of Health voted to accept de Villa’s most recent recommendation and form a working group to create its own exemption request that could effectively lead to decriminalization in our city. This is a positive step.
Make no mistake: there is widespread support for drug decriminalization in Toronto, with 50 civil society organizations and five former mayors signing a recent call in this regard. Health professionals who find themselves on the front lines are being vocal about the need for change; the Registered Nurses’ Association of Ontario recently said that “decriminalizing personal possession of drugs must be part and parcel of any harm-reduction strategy because it decreases stigma and opens the door to hope, help and health.” Support also comes from people who use drugs, families of loved ones who have overdosed, and 60 per cent of Ontarians who were polled by the Angus Reid Institute in February 2021.
As the death toll mounts, in Toronto and elsewhere in Canada, it is crystal clear that the criminalization of drug use has been a costly public policy mistake that must be remedied. Criminalization is costing human lives at a merciless pace. Racialized minorities and the poor are disproportionately arrested, convicted and incarcerated for possession. And taxpayers pay the costly policing, courts and corrections bills.
For Toronto and Canada, our message is simple: the time to act is now. We need a health- and human rights-based, rather than criminal, approach to drug policy. Our residents deserve better.
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