This week marks seven months since the city sent its decriminalization request to Ottawa, the same time it took for the federal government to grant a similar request from British Columbia.
Health Canada says the request is being reviewed, noting that such requests are “considered carefully and thoroughly on a case-by-case basis.”
But harm reduction workers say the rise in opioid deaths has underscored the need for action.
“I don’t see any urgency. I see complacency,” said Dan Werb, director of the Toronto-based Center for Drug Policy Evaluation, which was hired by the city to help work on the decriminalization request.
“We’re seven years into this overdose epidemic caused by high-potency opioids. We have all the data we need at this point. And we’re looking at a government that’s slow to respond and also responding in ways that don’t really address what’s killing people”.
Toronto — which asked Health Canada for an exemption under the Controlled Drugs and Substances Act for personal drug use in the city — has seen a spike in overdose deaths during the pandemic.  More than 1,000 people in the city died of overdoses in 2020 and 2021, nearly double the number of deaths reported in the previous two years.
The city and advocates agree that decriminalization alone is not enough to address the opioid crisis.
Toronto outlined a decriminalization model in its application that envisions expanded access to social supports, including housing, as well as expanded safer supply programs to provide pharmaceutical-grade opioid alternatives to street supply.
But Werb said the implementation plan remains “ambitious” without adequate funding from the provincial and federal governments.
Toronto Public Health said it has been in ongoing discussions with Health Canada since the application was submitted on Jan. 4.
If granted, the exemption would decriminalize possession of drugs for personal use in Toronto.  But which drugs and how much are still open questions, with advocates calling on the federal government to avoid what they call mistakes made with British Columbia’s exemption.
Ottawa was widely criticized by harm reduction advocates after it set the limit for personal possession at 2.5 grams under BC’s exemption, nearly half of what the province requested.  The federal government said the decision was made based on input from the police.
Advocates say a low threshold could leave people with the highest opioid dependence under constant threat of criminalization.
“It just seems like irrational fear to me, a kind of fear that, again, seems to be fueled by law enforcement concerns,” Werb said.
Toronto’s request avoids asking for a specific limit.
A summary of the city’s consultations with drug users noted that a blanket limit could overlook different tolerances and buying practices, such as people who share drugs or who buy larger quantities to get discounts.
And while BC’s exemption sets out a list of exempt drugs, Toronto calls for the decriminalization of all drugs.
That’s an important distinction, said public health researcher Gillian Kolla, especially given the volatility of the supply of street opioids.
He notes that opioids can be cut with drugs not on BC’s list, leaving open the possibility that a person could be arrested if a drug sample comes back positive for a non-excluded substance.
“Relying primarily on this enforcement-based approach that we know hasn’t worked for people, that we know hasn’t worked as a society to address the harms of drug use, is still a problem with how we approach in decriminalization.  ” said Kolla, a Toronto-based researcher at the Canadian Institute for Substance Use Research at the University of Victoria.
Toronto police said they could not discuss specifics of the exemption request.  A spokesman said the force supports a “made-in-Toronto alternative to criminalization.”
Toronto Public Health said that if an exemption is granted, it expects “significant implementation planning time similar to that anticipated for BC” The BC exemption takes effect at the end of January, eight months after it was granted.
Vancouver submitted its own decriminalization request five months before BC submitted the province-wide request.  Health Canada said that after the BC exemption was granted, Vancouver wrote to the agency asking it to suspend consideration of the city’s proposal.
A notable difference between the BC and Toronto applications is the “painful silence” of the Ontario government, said Angela Robertson, executive director of Parkdale Queen West Community Health Centre, one of nine federally funded sites offering a safer program supply in Ontario.
“It’s unfortunate that we don’t have a provincial exemption on the table. But at this point, given the crisis, we’re taking what we can and continuing to push for more,” Robertson said.
The Ontario Ministry of Health, in response to questions about its position on Toronto’s decriminalization application, highlighted some of its harm reduction programs and recent investments in addiction treatment.
This report by The Canadian Press was first published on August 5, 2022.